Caveat: Always remember that every number & statistic involving employee benefits, insurance, health etc. has a 1,000% built-in distortion factor. That's not because of lying. It is because basic terms have very different meanings to different people. For example, in answer to the simple question how many "lives" does your plan have? A family of mom & dad + 10 children is variously counted as 1,2,3,4, or 12 "lives" by different TPAs or plans. Thus, take numbers & statistics as a guide rather than gospel...and be extremely careful any time you compile or compare statistics.
A learning example:
Several years ago, a consulting firm published a
survey of employee benefit health plans, showing:
65% = Self-Funded (presumably including both self-funded with and without
stop-loss, since some researchers divide the two).
15% = "Experience-rated" plans through an insurance company.
14% = "Minimum-premium" plans through an insurance company
6% = traditional Fully-insured.
When that was published, I was called by the press for comment, and I noted that legally & technically, a large number of the Experience-rated and Minimum-premium plans would be considered by the Department of Labor to actually be considered self-funded, depending on the fine print, and especially where the insurance company had protections to keep itself from being stuck with unexpected losses. Thus, some significant percent of those Experience-rated and Minimum-premium plans should be considered added to the self-funding column, and the rest to the insured column.
Shifting vocabulary: At that time, the association reprsenting health insurance companies considered Minimum-premium and Experience-rated as "insured" plans. In the following year, the insurance association, totally reversed itself, and started counting all Minimum-premium and Experienced-rated as self-funded. (Since the status is case-by-case, the wholesale switch is innaccurate both ways.) That means that the association of health insurance companies was suddenly declaring that 62% of the total business of their member insurance companies is self-funding!
The moral of this story and hint to researchers is that whether a plan is legally a self-funded entity or fully-insured depends on its funding format...not some fancy marketing name or if an insurance company or other entity is sponsoring or administering it. So, the truth is that there is no firm percentage. Many prestigious resarch entities come up with studies & numbers occasionally, but then you are left with vastly different statistics from equally-prestigious sources.
I see hundreds of studies and am asked to brainstorm on many. My technique is to look at, what was asked in what context, and who was polled, and then cross-reference the parts that seem to fit. From that process, I think that the most accurate statementd is that between 75-80% of employee benefit health plans are technically/legally self-funding, even if they happen to use some fancy other name and/or don't realize that they fall into the legal category of self-funding.