Health

Self-funded plans: Which states have the most (and the least)?

THE STATES WITH THE SMALLEST PERCENTAGES OF SELF-FUNDED PLANS

5.MICHIGAN

PERCENTAGE OF SELF-FUNDED PLANS (2022): 51%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 62%

INCREASE/DECREASE? -eleven%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,243

POPULATION COVERED BY EMPLOYER INSURANCE: 5,146,500

(Photo: Sean Pavone/Shutterstock.com)

4. SNOW

PERCENTAGE OF SELF-FUNDED PLANS (2022): 46%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 56%

INCREASE/DECREASE? -10%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $4,835

POPULATION COVERED BY EMPLOYER INSURANCE: 1,506,500

(Photo: Shutterstock.com)

3. ARIZONA

PERCENTAGE OF SELF-FUNDED PLANS (2022): Four. Five%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 68%

INCREASE/DECREASE? -23%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,058

POPULATION COVERED BY EMPLOYER INSURANCE: 3,356,000

(Photo: Gregory E. Clifford/Shutterstock.com)

2. CALIFORNIA

PERCENTAGE OF SELF-FUNDED PLANS (2022): 42%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 43%

INCREASE/DECREASE? -one%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,931

POPULATION COVERED BY EMPLOYER INSURANCE: 18,985,300

(Photo: IM_photo/Shutterstock.com)

1. HAWAII

PERCENTAGE OF SELF-FUNDED PLANS (2022): 35%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 29%

INCREASE/DECREASE? +6%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $6,188

POPULATION COVERED BY EMPLOYER INSURANCE: 700,300

(Photo: emperorcosar/Shutterstock.com)

THE STATES WITH THE LARGEST PERCENTAGES OF SELF-FUNDED PLANS

5. DELAWARE (tie)

PERCENTAGE OF SELF-FUNDED PLANS (2022): 70%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 55%

INCREASE/DECREASE? +15%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,477

POPULATION COVERED BY EMPLOYER INSURANCE: 491,600

(Photo: Paul Brady Photography/Shutterstock.com)

5. OHIO (tie)

PERCENTAGE OF SELF-FUNDED PLANS (2022): 70%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 63%

INCREASE/DECREASE? +7%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,406

POPULATION COVERED BY EMPLOYER INSURANCE: 5,717,700

(Photo: Kenneth Sponsler/Shutterstock.com)

3. INDIANA

PERCENTAGE OF SELF-FUNDED PLANS (2022): 71%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 70%

INCREASE/DECREASE? +1%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,692

POPULATION COVERED BY EMPLOYER INSURANCE: 3,769,800

(Photo: Sean Pavone/Shutterstock.com)

1. NEBRASKA (tie)

PERCENTAGE OF SELF-FUNDED PLANS (2022): 73%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 70%

INCREASE/DECREASE? +3%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,873

POPULATION COVERED BY EMPLOYER INSURANCE: 1,082,000

(Photo: Kristopher Kettner/Shutterstock)

1. NORTH CAROLINA (tie)

PERCENTAGE OF SELF-FUNDED PLANS (2022): 73%

PERCENTAGE OF SELF-FUNDED PLANS (2021): 61%

INCREASE/DECREASE? +12%

AVERAGE EMPLOYER CONTRIBUTION FOR SINGLE COVERAGE: $5,383

POPULATION COVERED BY EMPLOYER INSURANCE: 4,993,500

(Photo: Sharkshock/Shutterstock.com)

More and more employers are implementing self-funded health plans. A recent Kaiser Family Foundation Survey of Employer Health Benefits noted a “meaningful increase in the share of workers in self-funded plans” in 2020, with sixty-seven percent of covered workers enrolled in such plans. That number is up six percent from the previous year.

“Employers who choose to implement a self-funded health plan are attracted to the unique cost management opportunities when compared to premiums, taxes, profit margins and other requirements that apply to fully insured plans,” wrote Christine Cooper, CEO of aequum LLC, in an op-ed for BenefitsPro. “All industry professionals expect the trend towards self-insurance will continue.”

Related: How new trends help brokers build self-funded plans

AHIP.org has just released an extensive report documenting employer-provided health coverage by state. The report includes statistics on factors including the number of employees covered by employer-sponsored plans in the state, the average employer contribution for single coverage, and percentages of self-funded employer plans vs. fully insured plans.

Most states’ percentages range from the low 50s to the high 60s, although there are some clear outliers on either side of that scale.

“Health insurance providers are proud to partner with America’s employers to provide comprehensive health coverage to working families,” said Jeanette Thornton, senior vice president of product, employer, and commercial policy at AHIP. “We’ll continue to offer new and innovative solutions so employers can choose plans that meet the diverse needs of their employees.”

Click here for the full report, and see our slideshow above for the states with the largest and smallest percentages of self-funded plans⁠—as well as which states saw that percentage increase or decrease since last year.


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