Report

Employer-Sponsored Healthcare

Employer-Sponsored Healthcare

Pages 21 Pages

Employer-Sponsored Healthcare Q1 2023 TPAS AND BENEFITS SOLUTION PROVIDERS SECTOR SPOTLIGHTLarge and Growing Addressable Market 2 U.S. Health Insurance Market by Coverage Type Employer-Sponsored Individual Traditional Medicare Medicare Advantage Medicaid ~105M Lives Employer Self-Funded ~55M Lives Employer Fully Funded Health Plan by Coverage Type Fully Insured Health Plan ~55M Lives Covered (35%) ? Employer purchases health insurance from a carrier; carrier assumes financial risk of providing healthcare for employer’s beneficiaries × Carrier keeps any surplus × Lack of customization × Limited insight into cost drivers × No rate, access, or repricing control × Lack of dedicated support × Misaligned incentives Self-Funded Health Plan ~105M Lives Covered (65%) ? Employer pays for claims

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