Employers Increasingly Opt for Self-Funded Health Plans

The share of employer-sponsored health insurance (ESI) enrollees who are in self-funded plans — meaning the employer, rather than an insurer, collects premiums and bears responsibility for paying claims — increased to 60% in 2021 from 55% in 2015, according to a recent Health Affairs study.

Based on 2015 and 2021 Clarivate Interstudy enrollment data, researchers found that in 80.5% of U.S. counties in 2021, the majority of ESI enrollees were in self-funded health plans. Over the years, 78.2% of counties saw growth in the share of ESI enrollees in a self-funded plan. Generally, that growth was concentrated in states with a lower percentage of self-funded plan enrollees in 2015.