title: Changes in benefit payments and health insurance premiums among firms switching health insurance carriers.
abstract: Employer-purchased group health insurance is a major source of funding in the US healthcare system, accounting for approximately one third of each healthcare dollar spent. Surprisingly, little is known about employers' behavior in purchasing health insurance or the circumstances leading employers to switch health insurance carriers. We descriptively analyzed data for a cohort of 95 insured groups between 1985 and 1991 to determine the frequency with which employers switch health insurance carriers and the growth pattern in premiums and benefit payments before the switch was made. Thirty-seven percent of groups switched carriers during the study period, with at least five groups switching each year from 1987 through 1991. The groups that switched insurance carriers experienced higher average annual rates of growth in benefit payments than those that did not switch (18% versus 11%). Groups that switched did not have significantly higher observed premium growth rates than those that did not switch, suggesting that employers decided to switch insurers before absorbing an increase in premiums. However, some firms that switched experienced below average increases in both benefit payments and premiums, indicating that premiums and anticipated premium increases are not solely responsible for the decision to switch health insurance carriers.
authors.affiliation: University of Washington, Seattle 98195, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Wickizer
authors.forename: K M
authors.initials: KM
authors.lastname: Travis
authors.forename: P J
authors.initials: PJ
authors.lastname: Feldstein
mesh_terms: D015331:Cohort Studies; D003256:Community Participation / Q000706:statistics & numerical data*; D003657:Decision Making; D005249:Fees and Charges; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000706:statistics & numerical data*; D006302:Health Services Research; D007342:Insurance Benefits; D007343:Insurance Carriers / Q000706:statistics & numerical data*; D014481:United States