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Shift from group to individual coverage evident in AIS annual health plan survey

Brian Anderson

WASHINGTON, D.C. – The number of health insurance policies sold directly to consumers for 2016 increased by 9.3 million people, or 10% over last year, according to data in the forthcoming AIS’s Directory of Health Plans: 2016.

The number of people covered under group policies was comparatively stable, with a slight decrease in risk-based groups and a slight increase in administrative-services-only/self-funded group membership.

Enrollment increased in both commercial and public sector markets for non-group policies, editors found. AIS data show that the biggest hikes were in the number of Medicaid enrollees, number enrolled via public exchanges, and number in Medicare-Medicaid dual-eligible programs.

Individual (non-group) commercial risk-based enrollment increased 3.5% overall, but the number of those people who enrolled via public exchanges increased 48%, to a total of 9.7 million people, according to health plans in the annual AIS survey.

AIS’s Directory of Health Plans: 2016 counts almost 300 million people covered by health insurance, about 92% of the U.S. population. These data document a significant shift away from employer-sponsored health insurance, which can be attributed to a combination of trends:

• While total commercial risk lives remain fairly flat, about 3.5% of this market has shifted from group coverage to purchasing individual/family coverage on or off exchanges.

• The continued growth of the public sector now has more than half of all risk-based membership in government-sponsored entitlement programs, with 6 million new Medicaid HMO enrollees, plus another 2 million in new plans targeting dual eligibles.

• Growth in provider-sponsored health insurance has created new coverage opportunities at the local community level, reaching out to some of the most vulnerable high-risk populations.

As a result of these trends, some 99 million consumers are now covered under non-group policies.

Available in various formats, AIS’s Directory of Health Plans: 2016 will ship in early June for book/CD/USB purchasers. Subscribers to the online version can get immediate access to the data via an interactive website. For more information, or to order AIS’s Directory of Health Plans: 2016, visit https://aishealth.com/marketplace/aiss-directory-health-plans. For more information on the online version and to access a free demo, visithttps://aishealthdata.com/dhp.

About AIS’s Directory of Health Plans: AIS’s Directory of Health Plans is the most comprehensive resource available on the U.S. health plan market, with enrollment data and contact information for all health plans operating in the United States. By maintaining impeccable research standards and strict methodology through 13 annual editions, the Directory offers true year-over-year comparisons and extremely accurate and sensitive insight into developing trends. AIS’s Directory of Health Plans: 2016 will be available in June for book/CD/USB purchasers and is available now for subscribers to a new interactive website. Learn more at http://aishealth.com/marketplace/aiss-directory-health-plans and https://aishealthdata.com/dhp.

About AIS: Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for nearly 30 years. It develops highly targeted news, data and strategic information for managers in hospitals and health systems, health insurance companies, medical group practices, purchasers of health insurance, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, databases, websites, looseleafs, strategic reports, directories, webinars and virtual conferences. Learn more at http://AISHealth.com.



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