25 statistics on non-group healthcare insurance enrollees

Practice Management

Kaiser Family Foundation surveyed individuals who purchased their own health insurance in the non-group market. The survey sought their experiences and opinions about coverage.

In the non-group market, 64 percent are in a marketplace plan and 19 percent are in an Affordable Care Act-compliant, non-marketplace plan purchased from a broker or insurance company. Twelve percent have pre-ACA, non-compliant plans.

 

Here are 25 statistics:

 

1. State of health. In 2016, 80 percent of those with ACA-compliant plans reported excellent, very good or good health. Seventy-eight percent of those with marketplace plans only reported excellent, very good or good health.

 

2. Employer coverage. Most of those with non-group coverage can't access coverage from an employer. This is because they are self-employed (31 percent), unemployed (28 percent) or their employers do not offer health plans (21 percent).

 

Of the 18 percent who work for employers offering coverage, 5 percent are not eligible and 1 percent are in a waiting period to enroll. Six percent report it's more cost-effective to buy their own coverage than to pay the employer plan premium.

 

3. Deductibles. Nearly 50 percent of individuals with ACA-compliant non-group coverage reported their plans include annual individual deductibles of at least $1,500 or family deductibles of at least $3,000.

 

Forty-six percent of marketplace plan enrollees reported having high deductibles, compared to 61 percent of ACA-compliant non-marketplace plan enrollees. This difference is likely due to marketplace enrollees qualifying for cost-sharing subsidies.

 

4. Health plan ratings. Most ACA-compliant non-group plan enrollees rated their overall coverage favorably, with 14 percent rating their plans as "excellent." About half rated their plans as "good."

 

Thirty-one percent of these enrollees rated their coverage as "not so good" or "poor," however.

 

ACA-compliant non-marketplace plan enrollees were more likely to rate their plans unfavorable than marketplace plan enrollees (38 percent compared to 29 percent).

 

5. Coverage value. About half of those with ACA-compliant non-group plans rated the value of their coverage as "only fair" or "poor." More employer-sponsored plan enrollees rated their coverage value as "good."

 

6. Plan satisfaction. Of those individuals with ACA-compliant non-group plans, 75 percent reported they are "very" or "somewhat" satisfied with their plans' hospitals and primary care providers. About 60 percent noted they are satisfied with their plans' specialists.

 

Fifty-four percent of ACA-compliant plan enrollees and 59 percent of marketplace plan enrollees reported satisfaction with their premiums.

 

Read more from the Kaiser Family Foundation survey here.



More articles on practice management:
Great Plains Orthopaedics, OSF HealthCare to merge: 4 points
JAAOS offers open access publishing option: 5 things to know
5 ways to strengthen the physician-administrator relationship

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers