Originally published in February 2025, this updated report provides new material on physician practice management (PPM) arrangements, reference-based pricing arrangements, minimum essential coverage (MEC) and MEC+ plans, and PPM-based “mirror plans.”
Small employers’ efforts to provide robust major medical coverage to workers and their families have long proven futile, primarily due to underwriting challenges. Groups of under 50 employees are often relegated to state small group market coverage, which tends to be expensive. Slightly larger groups, while being underwritten based on their own experience, still suffer from a near-total lack of transparency. Increasingly, these employers are looking for alternatives, which include pooling under association-style plans, group medical stop-loss arrangements, level-funded products, and individual coverage Health Reimbursement Arrangements.
This Special Report examines the options available to small employers – and the obstacles they routinely encounter – as they seek to make affordable health insurance coverage available to their employees and their families.
