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Health & Medical Insurance in the US: Market Research Report

Market Research • Market Size • Industry Statistics • Industry Analysis • Industry Trends

Health & Medical Insurance Market Research Report | NAICS 52411b | May 2016

Picture of health: Sweeping federal reform and an aging population will drive industry demand

IBISWorld’s Health & Medical Insurance market research report offers insightful industry analysis and research into the market at the national level. IBISWorld’s in-depth industry market research is presented in a logical and consistent format. The industry report contains key industry statistics, market size, industry trends, and growth and profit forecasts for a 5-year outlook period.

Report Snapshot
Industry Statistics & Market Size
Revenue
$777bn
Annual Growth 11-16
4.0%
Annual Growth 16-21
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Profit
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Employment
527,380
Businesses
851
Industry Analysis & Industry Trends

The Health and Medical Insurance industry, which is made up of carriers of private, group and public health, medical, dental insurance, was characterized by slow growth five years ago as a result of reduced employer coverage and continued consumer deleveraging. However, consistent increases in healthcare expenditure and medical cost inflation, as well as a sharp decline in the uninsured rate, have driven industry growth in recent years. In the coming years, as the baby boomer generation ages, more people will need medical coverage and the retirement of baby boomers will particularly increase Medicare expenditure... purchase to read more

Industry Report - Industry Products Chapter

The majority of industry revenue is generated from premiums that are related to fully funded insurance policies. Under this traditional coverage, the health insurer is financially responsible for paying all the incurred coverage benefits and administration costs of healthcare benefits. In return, the company receives a premium. Health insurers also generate income by providing network-based health and well-being services to beneficiaries in government-sponsored healthcare programs such as Medicare and Medicaid.

In addition to healthcare premiums, insurers also generate revenue from fees and product sales. For example, industry participants generate a significant amount of fee revenue for managing care for self-funded insurance plans... purchase to read more

 


Industry ProductsRelated ReportsTable of Contents

What is the Health & Medical Insurance Industry?

This industry underwrites (i.e. assumes the risks of and assigns premiums for) health and medical insurance policies. Insurance is the transfer of the risk of a loss in exchange for payment. Operators also provide administrative services for self-funded insurance plans (whereby an employer provides health benefits to workers with its own funds). Under this structure, the industry operator is a third-party administrator and is not responsible for health benefit payments.

Industry Products
Pharmacy benefit management (PBM)Preferred provider organization (PPO) plansHigh-deductible health plans (HDHPs)Health maintenance organization (HMO) plansPoint-of-service (POS) plansFee-for-service (FFS) plansMedicaid (via private firms)Medicare (via private firms)
 
Industry Activities
Underwriting health and medical insurance policiesUnderwriting dental policies Providing pharmacy benefit management servicesManaging care between the health provider and individual recipient Administering of self-funded insurance plansInvesting health insurance premiums


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