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 - Industry Analysis, Share, Growth, Regional Outlook and Forecasts, 2023-2032

The U.S. group health insurance market size was exhibited at USD 1,346.00 billion in 2022 and is projected to hit around USD 1,706.26 billion by 2032, growing at a CAGR of 2.4% during the forecast period 2023 to 2032.

Key Takeaways:

  • 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 preferred provider organization (PPO) held the highest revenue share, with over 45.11% of the market. Furthermore, due to its widespread adoption and acceptability compared to other plans like HMO, HDHP/SO contributed to the second-largest revenue share of over 26% of the market in 2022. According to the Kaiser Family Foundation's (KFF) Employer Health Benefits 2022 Annual Survey Report, a higher proportion of covered employees are covered in HDHP/SOs than in HMOs in small and large firms.
  • Based on firm size, the market is segmented into small (employee size less than 199 or equal to 199) and large (employee size more than 200) firms. Due to relatively lower employee cost-sharing, large firms hold a major portion of the market and are anticipated to maintain dominance over the forecast period.
  • South region dominated the market and accounted for the largest revenue share of over 35.9% in 2022 due to increased acceptance of employer-sponsored health insurance. The market for overall U.S. group health insurance market s anticipated to expand as a result of factors including rising group health insurance awareness and the cost of that insurance across different U.S. regions.
  • Large companies plan to offer group health insurance to employers in all states in the U.S., which supports the market expansion. For instance, the November 2022 Health Insurance Market Concentration report from Government Accountability Office (GAO) stated that PREMERA BLUE CROSS GROUP had a 93.8% market share in Alaska in 2020, indicating company focused on the Small Group Health Insurance Market.

U.S. Group Health Insurance Market Report Scope

Report Coverage Details
Market Size in 2023 USD 1,378.30 Billion
Market Size by 2032 USD 1,706.26  Billion
Growth Rate From 2023 to 2032 CAGR of 2.4%
Base Year 2022
Forecast Period 2023 to 2032
Segments Covered Plan Type, Firm size
Market Analysis (Terms Used) Value (US$ Million/Billion) or (Volume/Units)
Report Coverage Revenue forecast, company ranking, competitive landscape, growth factors, and trends
Key Companies Profiled 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.

 

The availability of group health insurance enables the advantage for companies with an advantage in the hiring phases that aids in retaining qualified personnel, and increases engagement and productivity at work as a whole. According to statistics from the Kaiser Family Foundation's Health Insurance Coverage of the Total Population data for 2021, 49.5% of Americans rely on a group health plan chosen by their employer for insurance coverage, showcasing the high demand for group health insurance. 

In 2022, the South area owned the biggest proportion of the U.S. market, followed by the Midwest region. This is due to the presence of prominent insurance plans and a sizable population with standard group health insurance. Florida State has the largest revenue share for the South in 2022, while Illinois has a sizable revenue share supporting the Midwest region. Additionally, the market is aided by the growing popularity of Preferred Provider Organization (PPO), High-Deductible Health Plans with a Savings Option (HDHP/SO) plans. According to the Employer Health Benefits 2022 Annual Survey Report from the Kaiser Family Foundation (KFF), the PPO and HDHP/SO plans accounted for 49% and 29% of covered workers' enrolment in 2022, reflecting the rising demand for these plans. 

The U.S. market for group health insurance is affected to some extent by the overall consolidation of the healthcare sector. For instance, at the start of 2020, Cigna and Oscar collaborated to sell health insurance policies to small businesses. The plans use member-focused technologies from Oscar and the regional and national provider networks of Cigna. As a result, Cigna and Oscar are able to provide small group health insurance across the nation in more than a dozen of the most important areas, including Kansas City, Georgia, Connecticut, Tennessee, and Arizona. 

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. 

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.

Segments Covered in the Report

This report forecasts revenue growth at country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2018 to 2032. For this study, Nova one advisor, Inc. has segmented the U.S. Group Health Insurance market.

By Plan Type 

  • 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)

By Firm Size 

  • Small Firm
  • Self-funded or Level-funded Plan
  • Fully Insured
  • Large Firm

By Region 

  • 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

Frequently Asked Questions

The U.S. group health insurance market size was exhibited at USD 1,346.00 billion in 2022 and is projected to hit around USD 1,706.26 billion by 2032

The U.S. group health insurance market is expected to grow at a compound annual growth rate of 2.4% from 2023 to 2032

Some key players operating 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

Key factors that are driving the market growth include increasing adoption of group health insurance, increasing government initiatives, and growing awareness of overall health insurance.

Chapter 1. Methodology and Scope
                   1.1. Market Segmentation and Scope
                   1.2. Market Definitions
                       1.2.1. Plan Type
                       1.2.2. Firm Size
                           1.2.2.1. Small Firm - Plan Funding Type
                   1.3. Research Methodology
                   1.4. Information Procurement
                       1.4.1. Purchased Database
                       1.4.2. Nova one advisor’s Internal Database
                       1.4.3. Secondary Sources & Third-Party Perspectives
                       1.4.4. Primary Research
                       1.4.5. Details of Primary Research
                   1.5. Information Analysis
                       1.5.1. Data Analysis Models
                   1.6. Market Formulation & Data Visualization
                       1.6.1. Premium Price - Employer-Sponsored Volume Analysis
                       1.6.2. Bottom-Up Market Estimation
                   1.7. Data Validation & Publishing
                   1.8. U.S. Group Health Insurance Market: CAGR Calculation
                   1.9. List of Abbreviations
                   1.10. Objectives
                       1.10.1. Objective - 1
                       1.10.2. Objective - 2
                       1.10.3. Objective - 3
                       1.10.4. Objective - 4
                   1.11. List of Secondary Sources
Chapter 2. Executive Summary
                   2.1. Market Snapshot
                   2.2. Segmental Snapshot
                   2.3. Competitive Insights Snapshot
Chapter 3. Market Variables, Trends, and Scope
                   3.1. U.S. Group Health Insurance Market - Market Dynamics
                       3.1.1. Market Driver Analysis
                           3.1.1.1. Increasing adoption of group health insurance
                           3.1.1.2. Increasing government initiatives
                           3.1.1.3. Growing awareness of the overall health insurance
                       3.1.2. Market Restraint Analysis
                           3.1.2.1. Limited reach of certain group health insurance plans in the U.S region
                   3.2. Business Environmental Tools Analysis: U.S. Group Health Insurance Market
                       3.2.1. Porter’s Five Forces Analysis
                       3.2.2. PESTLE Analysis
                   3.3. Regulatory Framework
                   3.4. Employer-sponsored Insured Population, by state, from 2008 - 2022
                   3.5. Covid-19 Impact Analysis
Chapter 4. U.S. Group Health Insurance Market: Plan Type Estimates & Trend Analysis
                   4.1. U.S. Group Health Insurance Market, By Plan Type: Key Takeaways
                   4.2. U.S. Group Health Insurance Market: Plan Type Movement & Market Share Analysis, 2023 & 2032
                   4.3. Preferred provider organization (PPO)
                       4.3.1. Preferred provider organization (PPO)Market Estimates And Forecasts, 2020 - 2032
                   4.4. Health maintenance organization (HMO)
                       4.4.1. Health maintenance organization (HMO) Market Estimates And Forecasts, 2020 - 2032
                   4.5. Point of service (POS)
                       4.5.1. Point of service (POS) Market Estimates And Forecasts, 2020 - 2032
                   4.6. High-Deductible Health Plans with a Savings Option (HDHP/SO)
                       4.6.1. High-Deductible Health Plans with a Savings Option (HDHP/SO) Market Estimates And Forecasts, 2020 - 2032
                   4.7. Conventional (Indemnity plans)
                       4.7.1. Conventional (Indemnity plans)
                       4.7.2. High-Deductible Health Plans with a Savings Option (HDHP/SO) Market Estimates And Forecasts, 2020 - 2032  
Chapter 5. U.S. Group Health Insurance Market: Firm Size Estimates & Trend Analysis
                   5.1. U.S. Group Health Insurance Market, By Firm Size: Key Takeaways
                   5.2. U.S. Group Health Insurance Market: Firm Size Movement & Market Share Analysis, 2023 & 2032
                   5.3. Large Firm
                       5.3.1. Large firm Market Estimates And Forecasts, 2020 - 2032
                       5.3.2. Self-Funded Or Level-Funded Plan Market Estimates And Forecasts, 2020 - 2032
                       5.3.3. Fully Insured Market Estimates And Forecasts, 2020 - 2032
                   5.4. Small Firm
                       5.4.1. Small firm Market Estimates And Forecasts, 2020 - 2032
Chapter 6. U.S. Group Health Insurance Market: Regional Estimates & Trend Analysis
                   6.1. U.S. Group Health Insurance Market: Regional Movement Analysis, 2023 & 2032
                   6.2. Key Country Dynamics
                   6.3. Competitive Scenario
                   6.4. Regulatory Framework
                   6.5. South
                       6.5.1. South U.S. Group Health Insurance Market Estimates And Forecasts, 2020 - 2032
                       6.5.2. Florida
                           6.5.2.1. Florida Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.3. Georgia
                           6.5.3.1. Georgia Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.4. Maryland
                           6.5.4.1. Maryland Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.5. North Carolina
                           6.5.5.1. North Carolina Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.6. Virginia
                           6.5.6.1. Virginia Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.7. Alabama
                           6.5.7.1. Alabama Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.8. Kentucky
                           6.5.8.1. Kentucky Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.9. Tennessee
                           6.5.9.1. Tennessee Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.10. Louisiana
                           6.5.10.1. Louisiana Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.11. Oklahoma
                           6.5.11.1. Oklahoma Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.12. Texas
                           6.5.12.1. Texas Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.5.13. Others (Delaware, West Virginia, Mississippi, Arkansas)
                           6.5.13.1. Others Group Health Insurance Market estimates and forecasts, 2020 - 2032
                   6.6. Northeast
                       6.6.1. Northeast U.S. Group Health Insurance Market Estimates And Forecasts, 2020 - 2032
                       6.6.2. Connecticut
                           6.6.2.1. Connecticut Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.6.3. Massachusetts
                           6.6.3.1. Massachusetts Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.6.4. Pennsylvania
                           6.6.4.1. Pennsylvania Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.6.5. New Jersey
                           6.6.5.1. New Jersey Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.6.6. New York
                           6.6.6.1. New York Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.6.7. Others (New Hampshire, Rhode Island, Vermont, Maine)
                           6.6.7.1. Others Group Health Insurance Market estimates and forecasts, 2020 - 2032
                   6.7. Midwest
                       6.7.1. Midwest U.S. Group Health Insurance Market Estimates And Forecasts, 2020 - 2032
                       6.7.2. Illinois
                           6.7.2.1. Illinois Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.3. Indiana
                           6.7.3.1. Indiana Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.4. Michigan
                           6.7.4.1. Michigan Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.5. Ohio
                           6.7.5.1. Ohio Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.6. Wisconsin
                           6.7.6.1. Wisconsin Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.7. Iowa
                           6.7.7.1. Iowa Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.8. Kansas
                           6.7.8.1. Kansas Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.9. Minnesota
                           6.7.9.1. Minnesota Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.10. Missouri
                           6.7.10.1. Missouri Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.11. Nebraska
                           6.7.11.1. Nebraska Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.7.12. Others (North Dakota, South Dakota)
                           6.7.12.1. Others Group Health Insurance Market estimates and forecasts, 2020 - 2032
                   6.8. West
                       6.8.1. West U.S. Group Health Insurance Market Estimates And Forecasts, 2020 - 2032
                       6.8.2. Arizona
                           6.8.2.1. Arizona Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.8.3. Colorado
                           6.8.3.1. Colorado Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.8.4. Nevada
                           6.8.4.1. Nevada Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.8.5. Utah
                           6.8.5.1. Utah Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.8.6. California
                           6.8.6.1. California Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.8.7. Oregon
                           6.8.7.1. Oregon Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.8.8. Washington
                           6.8.8.1. Washington Group Health Insurance Market estimates and forecasts, 2020 - 2032
                       6.8.9. Others (Idaho, Montana, New Mexico, Wyoming, Alaska, Hawaii)
                           6.8.9.1. Others Group Health Insurance Market estimates and forecasts, 2020 - 2032
Chapter 7. Competitive Landscape
                   7.1. Company Categorization
                   7.2. Company Market Share Analysis, 2023
                   7.3. Strategy Mapping
                   7.4. Company Profiles/Listing
                       7.4.1. HEALTH CARE SERVICE CORPORATION
                           7.4.1.1. Overview
                           7.4.1.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.1.3. Product Benchmarking
                           7.4.1.4. Strategic Initiatives
                       7.4.2. UNITEDHEALTH GROUP
                           7.4.2.1. Overview
                           7.4.2.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.2.3. Product Benchmarking
                           7.4.2.4. Strategic Initiatives
                       7.4.3. KAISER FOUNDATION HEALTH PLAN, INC.
                           7.4.3.1. Overview
                           7.4.3.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.3.3. Product Benchmarking
                           7.4.3.4. Strategic Initiatives
                       7.4.4. BLUE CROSS BLUE SHIELD ASSOCIATION
                           7.4.4.1. Overview
                           7.4.4.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.4.3. Product Benchmarking
                           7.4.4.4. Strategic Initiatives
                       7.4.5. ANTHEM, INC. (NOW ELEVANCE HEALTH)
                           7.4.5.1. Overview
                           7.4.5.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.5.3. Product Benchmarking
                           7.4.5.4. Strategic Initiatives
                       7.4.6. THE IHC GROUP
                           7.4.6.1. Overview
                           7.4.6.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.6.3. Product Benchmarking
                           7.4.6.4. Strategic Initiatives
                       7.4.7. HEALTH PARTNERS GROUP LTD
                           7.4.7.1. Overview
                           7.4.7.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.7.3. Product Benchmarking
                           7.4.7.4. Strategic Initiatives
                       7.4.8. MISSISSIPPI INSURANCE GROUP, LLC
                           7.4.8.1. Overview
                           7.4.8.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.8.3. Product Benchmarking
                           7.4.8.4. Strategic Initiatives
                       7.4.9. PROVIDENCE HEALTH PLAN
                           7.4.9.1. Overview
                           7.4.9.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.9.3. Product Benchmarking
                           7.4.9.4. Strategic Initiatives
                       7.4.10. HARVARD PILGRIM HEALTH CARE, INC.
                           7.4.10.1. Overview
                           7.4.10.2. Financial Performance (Net Revenue/Sales/EBITDA/Gross Profit)
                           7.4.10.3. Product Benchmarking
                           7.4.10.4. Strategic Initiatives

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