Employer Health Goes Individual
Doug Imbruce@dougimbruce
−0.9%
since Oct 9
The idea
I believe employer health spending is shifting from one-size group plans to individual budgets as ICHRA, now the CHOICE Arrangement, gains ground. To express this, the basket owns the storefronts where workers shop for coverage, insurers built for individual plans, cash-pay health sellers that gain a new path to employees through those storefronts, and the company holding the accounts the money lands in. I left out group-plan incumbents and payroll companies on purpose, kept some cash to add on volatility, and would rethink this if CHOICE stalls or employers stick with group plans.
What it owns
- Direct-to-consumer health companies can reach workers through employer-sponsored marketplaces without signing up employers individually. · Hims & Hers HealthIt sells direct-to-consumer primary care and prescriptions, and reaching workers through employer-sponsored marketplaces expands its customer base beyond self-directed buyers., GoodRxIt provides transparent cash pricing for prescriptions, which becomes more valuable when workers manage individual health budgets and price-shop for medications., Teladoc HealthIt offers virtual care and mental health services that workers with individual budgets can purchase directly, bypassing traditional employer group plans., Hinge HealthIt provides digital physical therapy services that workers with individual health budgets can access directly rather than through employer group plans., LifeMDIt operates a telehealth platform that could reach workers through employer-sponsored marketplaces as workers gain the ability to choose their own care.37%
- Oscar owns Lucie and ICHRAx, the marketplace platforms where employers direct workers to shop for individual health plans using employer-funded budgets. · Oscar HealthIt owns the marketplace platforms where workers shop for individual plans using employer budgets, positioning it as the central infrastructure in this transition.24%
- Insurers selling individual and supplemental plans gain customers as employers shift workers from group coverage to employer-funded individual shopping. · CenteneIts Ambetter brand sells individual health plans on marketplaces, capturing workers who receive employer budgets to purchase their own coverage., AflacIt sells supplemental coverage like accident and hospital insurance available on employer-sponsored marketplaces, reaching workers who shop with employer-funded budgets., Molina HealthcareIt sells individual health plans through marketplaces where workers with employer-funded budgets shop for their own coverage.18%
- HealthEquity administers the individual health accounts where employer funds flow, growing in assets as more workers move to individual plans. · HealthEquityIt administers health savings and individual health accounts that receive employer contributions, growing its asset base as individual plan adoption increases.12%
- Cash10%