Self-Insured Health Plans in 2023: Why Large Employers Are Leading the Shift

In 2023, the self-insured health plan market experienced a shift toward larger employers, with smaller companies opting out due to rising costs and regulatory challenges. According to the Employee Benefit Research Institute (EBRI), self-insured plans for companies with under 100 employees dropped from 18% to 16%, while larger employers saw an increase from 72% to 74%.

A self-insured health plan allows employers to cover healthcare costs directly instead of paying insurance premiums, offering greater flexibility but higher risk—especially for smaller businesses. Larger employers tend to benefit more from this model.

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