America's Benefit Specialist October 2023

an increasingly attractive option mainly for small and midsize employers, as fewer of them were self-insured in 2010, whereas many large employers were al ready offering self-insured health plans at that time. What has happened to the availability of and enrollment in self-insured health plans since passage of the ACA? Using data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC), the Employee Benefits Research Institute examined trends in offerings and utilization, with a particu lar focus on the time period from 2010 to 2022. Key findings: • The percentage of private-sector establishments offering a self-insured health plan increased through 2016 but has since ebbed and flowed with no discernible long-term trend. • Recent trends have been more clearly defined when examined by firm size. • Since 2018, the percentages of small and midsize establishments offering at least one self-insured plan both increased. In contrast, the percent age of large establishments offering a self-insured plan has declined. The decline among large establishments occurred in most years since 2013. • Overall, the percentage of workers in self-insured plans has been bounc ing around between 58% and 60% since 2010 but fell to 55% in 2022. This occurred despite the increase in self-insurance among small and mid size companies because of the drop in self-insurance among large firms. • Self-insurance varied substantially by state. Overall, the percentage of pri vate-sector enrollees in self-insured plans varied from 33% in Hawaii to 70% in Ohio. MORE EMPLOYERS ADDRESSING BURNOUT AND NEEDS OF A DIVERSE WORKFORCE In 2023, nine in 10 employers increased their support for one or more core em ployee wellbeing dimensions, including

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