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The three largest plans by revenue in every year from 2011 through 2016 were UnitedHealth Group, Kaiser Foundation Health Plan and Anthem. (Photo: Shutterstock)

Among the carriers that offer fully insured health plans, overall the top line has prospered while the bottom line has deteriorated since the enactment of the Affordable Care Act – but the largest plans have fared much better than others, according to the study, “Health Plan Financial Trends 2011-2016,” by the Deloitte Center for Health Solutions.

Industry-wide, revenue for fully insured health insurance products rose 55 percent, from $548 billion in 2011 to $849 billion in 2016. Enrollment increased by 29 percent during this period, from 143 million to 184 million members. However, underwriting gains and margins declined during this period. In 2011, U.S. fully-insured health plans posted aggregate underwriting gains of $19.2 billion. In 2016, underwriting gains were $13.6 billion, a decline of 29 percent from 2011 levels. The sector’s overall 2016 underwriting margin of 1.6 percent was 52 percent below the industry’s aggregate 3.5 percent margin in 2011.

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Katie Kuehner-Hebert

Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.

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