“Self-Insured Health Plans: State Variation and Recent Trends by Firm Size,” and “All or Nothing? An Expanded Perspective on Retirement Readiness”

November 2012, Vol. 33, No. 11
Paperback, 24 pp.
PDF, 1,519 kb
Employee Benefit Research Institute, 2012

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Executive Summary

Self-Insured Health Plans: State Variation and Recent Trends by Firm Size



  • The percentage of workers in private-sector self-insured health plans has been increasing. In 2011, 58.5 percent of workers with health coverage were in self-insured plans, up from 40.9 percent in 1998. Large employers (with 1,000 or more workers) have driven the upward trend in overall self-insurance. The percentage of workers in self-insured plans in firms with fewer than 50 employees has been close to 12 percent in most years examined.
  • The prevalence in self-insured plans varies by state, with Massachusetts having the third-highest prevalence of self-insurance in the small-group market (behind Hawaii and Alaska).
  • Overall, 58.5 percent of workers were in self-insured plans in 2011, but the percentage ranged by state, from a low of 30.5 percent to a high of 73.8 percent.
  • Massachusetts, the only state to have enacted health reform similar to PPACA, has seen an increase in the percentage of workers in self-insured plans among all firm-size cohorts, except among workers in firms with fewer than 50 employees.

All or Nothing? An Expanded Perspective on Retirement Readiness



  • Approximately 44 percent of the Baby Boomer and Gen-Xer households are simulated to be at-risk of running short of money in retirement assuming they retire at age 65 and retain any net housing equity in retirement until other financial resources are depleted. However, that includes a wide range of personal circumstances, from individuals projected to run short by as little as a dollar to those projected to fall short by tens of thousands of dollars.
  • Nearly one-half (49.1 percent) of Gen Xers have at least 20 percent more than is simulated to be needed; approximately one-third (31.4 percent) have between 80–120 percent of the financial resources necessary to cover the retirement expenses and uninsured health care costs; and about 1 in 5 (19.4 percent) are projected to have less than 80 percent of what is needed.
  • Among Gen Xer single females simulated to have no future years of defined-contribution-plan eligibility, nearly two-fifths (39 percent) are in the most vulnerable (less than 80 percent) category, although this shrinks to only 8 percent for those with 20 or more years of future eligibility in a defined contribution plan.