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Small Business Health Insurance in California 2011 - A Snapshot

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Market Size

In terms of insured lives, the small business health Insurance market (companies with fewer than 50 employees) is but a small subset of the overall employer-sponsored or group health insurance market of approximately 15 million Californians. Some 3 million Californians, have health coverage through small business health insurance plans representing 9% of the total population.of 38 million. click_image.png

Market Share Among Insurers

Currently, four of the largest commercial insurers cover over three-fourths of the small group enrollees. Small group enrollment is distributed nearly equally between HMO and PPO products: 46% in HMOs and 54% in PPOs. Similarly, enrollment is close to evenly split between the two regulators: the Department of Managed Health Care (DMHC) having 54% of enrollees and the California Department of Insurance (CDI) having 46%.

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Trending to High Deductible Plans

Small business health insurance enrollees are now more likely to be enrolled in high-deductible plans (35%). Enrollees often trade higher out-of-pocket costs at the time of service for lower premium contribution amounts.

Actuarial Values Substantially Higher than Individual Plans

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Actuarial values confirm that the coverage obtained through small business health insurance is substantially more comprehensive than individual health insurance coverage. Even high-deductible small business health insurance plans have significantly higher actuarial value than individual plans.

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