Group insurance: A better deal for most people than individual plans

Health Affairs

Volumn 29, Issue 1, 2010, Pages 156-164

  McDevitt, Roland ^a   Gabel, Jon ^b   Lore, Ryan ^a   Pickreign, Jeremy ^c   Whitmore, Heidi ^d   Brust, Tina ^a  

^a Health Care Research   (United States)

^b National Opinion Research Center   (United States)

^c NORC   (United States)

^d NORC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; COST; EMPLOYER; ENERGY EXPENDITURE; FINANCIAL MANAGEMENT; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HEALTH SURVEY; HUMAN; MAJOR CLINICAL STUDY; MATERNAL CARE; PREFERRED PROVIDER ORGANIZATION; SIMULATION;

COST-BENEFIT ANALYSIS; HEALTH BENEFIT PLANS, EMPLOYEE; HUMANS; INSURANCE COVERAGE; INSURANCE POOLS; UNITED STATES;

EID: 77957371853     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2009.0060     Document Type: Article

References (20)

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7. Data for 2006 from Mark Farrah Associates, Enrollment figures from the Health Coverage Portal (proprietary database).
8. Estimates are calculated by the Employee Benefit Research Institute from the 2005-2007 Current Population Survey, March Supplement. Fronstin P. Sources of health insurance and characteristics of the uninsured: analysis of the March 2007 Current Population Survey. EBRI Issue Brief no. 310. Washington (DC) : Employee Benefit Research Institute; 2007 Oct.
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11. Our definition of income excludes the forgone pay that workers receive as health insurance benefits.
12. CDHPs are defined here to include plans with a deductible of at least $1, 000 and either a health savings account (HSA) or a health reimbursement arrangement (HRA). High-deductible plans without an account are also common in the individual and small-group markets.
13. Plans with no out-of-pocket maximum typically limit member cost sharing to fixed copayments. This arrangement tends to keep out-ofpocket spending low.
14. Gabel JR, McDevitt R, Lore R, Pickreign J, Whitmore H, Ding T. Trends in underinsurance and the affordability of employer coverage, 2004-2007. Health Aff (Millwood). 2009;28(4):w595-606.
15. About 19 percent of individual insurance applications are withdrawn before the process is complete, to avoid a denial of coverage that must be reported on subsequent applications. Of the other applications, 89 percent are offered coverage. Of those offered coverage, 40 percent are offered standard rates, 49 percent are offered lower preferred rates, and 11 percent are offered higher than standard rates. Eight percent are offered policies with exemptions for particular conditions. America's Health Insurance Plans, Center for Policy and Research. Individual health insurance 2006-2007: a comprehensive survey of premiums, availability, and benefits. Washington (DC) : AHIP; 2007 Dec.
16. The consensus among economists is that employees pay for employers' contributions to their health insurance through lower earnings. Still, employer subsidies for health insurance change the pricing that consumers face when purchasing insurance.
17. We adjusted premiums to the group median actuarial value of 0.8011 percent using the following formula: Adjusted premium = premium × (0.8011 ÷ actuarial value of plan).
18. U. S. Census Bureau. Poverty thresholds for 2007 by size of family and number of related children under 18 years [Internet]. Washington (DC) : Census Bureau; 2007 [cited 2009 Nov. 19]. Available from: http://www.census.gov/hhes/ www/poverty/threshld/thresh07.html
19. Ziller EC, Coburn AF, McBride TD, Andrews C. Patterns of individual health insurance coverage, 1996-2000. Health Aff (Millwood). 2004;23(6):210-21.
20. Estimates based on Watson-Wyatt Worldwide analysis of the Thomson Reuters MarketScan Commercial Claims database for active employees (2006) and the actuarial values calculated in this study.