U.S. Group Health Insurance Market Size, Share & Trends Analysis Report By Plan Type (HMO, PPO, POS, HDHP/SO, Conventional (Indemnity plans)), By Firm Size (Small Firm, Large Firm), By Region, And Segment Forecasts, 2023 - 2030

Report Overview

The U.S. group health insurance market size was estimated at USD 1.345 billion in 2022 and is expected to expand at a compound annual growth rate (CAGR) of 2.3% from 2023 to 2030. The increasing demand for group health insurance, known as employer-sponsored insurance, and its rising average premium price has led to a spectacular development of the U.S. group health insurance market. Furthermore, rising internet usage and digitalization positively influence the overall U.S. market. In 2020, the COVID-19 pandemic decreased employment and negatively impacted employer-sponsored insurance. For instance, according to September 2022 article from the American Medical Association (JAWA Network), employer-sponsored insurance (ESI) enrollment decreased by 7,23,796 members during the COVID-19 pandemic and did not return to pre-COVID levels by mid-2021.

Furthermore, according to KFF's Employer Health Benefits Survey 2022 report, as the situation of uncertainties post-COVID-19 pandemic continues to arise - inflation has increased to 8% in 2022 while worker wages have increased by 6.7%. However, these changes have no direct effect on the premium in 2022, where the average annual premiums for employer-sponsored health insurance are USD 7,911 for single coverage and USD 22,463 for family coverage, respectively. These amounts are relatively similar to the premium in 2021. 

While many of the 2022 premium were decided upon in the fall of 2021, before the degree of price rises was apparent, this shows that the growing inflation and worker earnings did not directly influence the group health insurance premiums in 2022. In addition, it is anticipated that average premiums would rise in 2023 as long as inflation maintains above-normal levels, which will have a limited impact on market expansion. 

The rising premium cost of group health insurance has been a crucial metric for insurance companies. According to KFF's Employer Health Benefits Survey report for 2021 and 2022, these premium costs are rising yearly.  The table below shows the average annual premium for single and family coverage.

Plan Type Insights

Based on plan type, the market is segmented into five types - health maintenance organization (HMO), preferred provider organization (PPO), point of service (POS) plans, high-deductible plan with a savings option (HDHP/SO), and conventional (also known as indemnity plan).

In 2022, the PPO plan's revenue share was over 45%, which was the highest. These plans are the types that do not require a primary healthcare barrier to screen for specialists and hospital visits and offer lower cost sharing for in-network services. Furthermore, according to the KFF employer health benefits survey 2022 report, PPO plans accounted for 49% of the enrolment of covered workers in 2022. Furthermore, the average costs for single coverage (USD 8,272) and family coverage (USD 23,426) in PPOs are greater than the overall average prices for both single and family coverage. 

Basic annual premium differences among the notable different plan types, 2022

By Firm Size Insights

Based on firm size, the market is segmented into two types - small (employee size less than 199 or equal to 199) and large (employee size more than 200) firms. The large firm segment dominated the market in 2022 and is expected to maintain its dominance throughout the forecast period. This dominance is further supported by the employee cost-sharing parameter, which reveals that workers at large companies have relatively lower average deductible amounts, influencing the acceptability of group health insurance programs. For instance, according to the KFF's 2022 survey report, the average deductible for covered employees at small businesses is significantly higher than that for large companies, coming in at USD 2,543 vs. USD 1,493.

Furthermore, the small firm category is further divided into Self-funded or level-funded plans and fully insured plans. Over the forecast period, the level-funded plan segment would expand rapidly, with a CAGR of around 4.9%. This is reinforced by the fact that according to the Employer Health Benefits 2021 Annual Survey Report from KFF - 42% of small businesses that offer health benefits offered level-funded plans; this is significantly higher than the number for 2020, when this percent was 13%.

Regional And State Insights

The South region held the largest share of the U.S. market in 2022 due to the presence of noteworthy insurance plans and the substantial population covered by overall group health insurance.

In terms of revenue share for the South in 2022, Florida State dominated. The fact that a sizable portion of the population in Florida has employer-sponsored coverage serves as the key supporting evidence. For instance, in Florida, 40% (21.3048 million people) of the population had employer-sponsored health insurance in 2021, according to the KFF's insurance coverage data.

Furthermore, the Midwest region continued to hold the second-largest share of the U.S. group health insurance market, with the state of Illinois providing the greatest amount of revenue share in 2022. Over the forecast period, the market will continue to rise due to factors such as group health insurance adoption and cost/benefit analysis. 

Key Companies & Market Share Insights

One of the major health insurers in the country is United Healthcare, a division of UnitedHealth Corporation (UHC). For all kinds of enterprises, it provides a menu of group health insurance solutions, including specialty, extra dental, vision, pharmacy, and medical insurance plans. KAISER FOUNDATION GRP, BCBS, and ANTHEM INC GRP are a few of the other providers holding a notable presence in the overall U.S. group health insurance market. 

Companies in the overall health insurance sector, which includes the market for group health insurance, have been implementing various techniques to retain its clients and expand their market presence - while print advertising isn't completely gone, one of these tactics is digital marketing. These days, however, digital advertising takes precedence over all other forms of marketing. In order to increase market share, having a strong social media presence is invaluable, especially when combined with ads on relevant networks, such as Twitter, LinkedIn, etc. Some prominent players in the U.S. group health insurance market include:

• Health Care Service Corporation

• Unitedhealth Group

• Kaiser Foundation Health Plan, Inc.

• Blue Cross Blue Shield Association

• Anthem, Inc. (Now Elevance Health)

• The IHC Group

• Health Partners Group Ltd

• Mississippi Insurance Group, LLC

• Providence Health Plan

• Harvard Pilgrim Health Care, Inc. 

U.S. Group Health Insurance Market Report Scope    

U.S. Group Health Insurance Market Segmentation

This report forecasts revenue growth at global, regional, & country levels, and provides an analysis of the industry trends in each of the sub-segments from 2018 to 2030. For this study, Grand View Research has segmented the U.S. group health insurance market report based on plan type, firm size, and region:

• Plan Type Outlook (Revenue, Billion, 2018 - 2030)

  • Health Maintenance Organization (HMO)

  • Preferred Provider Organization (PPO)

  • Point of Service (POS)

  • High-Deductible Health Plans with a Savings Option (HDHP/SO)

  • Conventional (Indemnity plans)

• Firm Size Outlook (Revenue, Billion, 2018 - 2030)

  • Small Firm

    • Self-funded or Level-funded Plan

    • Fully Insured

  • Large Firm

• Region Outlook (Revenue, Billion, 2018 - 2030)

  • Northeast

    • Connecticut

    • Massachusetts

    • Pennsylvania

    • New Jersey

    • New York

    • Others

      • New Hampshire

      • Rhode Island

      • Vermont

      • Maine

  • Midwest

    • Illinois

    • Indiana

    • Michigan

    • Ohio

    • Wisconsin

    • Iowa

    • Kansas

    • Minnesota

    • Missouri

    • Nebraska

    • Others

      • North Dakota

      • South Dakota

  • West Group

    • Arizona

    • Colorado

    • Nevada

    • Utah

    • California

    • Oregon

    • Washington

    • Others

      • Idaho

      • Montana

      • New Mexico

      • Wyoming

      • Alaska

      • Hawaii

  • South

    • Florida

    • Georgia

    • Maryland

    • North Carolina

    • South Carolina

    • Virginia

    • Alabama

    • Kentucky

    • Tennessee

    • Louisiana

    • Oklahoma

    • Texas

    • Others

      • Delaware

      • West Virginia

      • Mississippi

      • Arkansas