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Health Insurance and Wellness Programs - US - February 2010

This report explores the ownership of health insurance in America today, the types of wellness programs that are provided by employers to encourage healthier behavior among employees, and the ramifications of the Health Care Reform legislation that is now moving through Congress.

Part of the discussion centers on health care providers, especially the efforts the industry is taking to maximize their profitability in today’s economic climate, as well as strategies taken to support or negate critical elements of upcoming health care legislation. Advertising efforts will be explored, starting with how each company utilizes the myriad media vehicles to communicate the benefits of their health care and wellness plans to employers as well as prospective individual policyholders. Examples of targeted messaging through direct mail, email, print and TV advertising has also been gathered and will be shown and discussed.

The report will culminate with an overview of the healthcare consumer, particularly the types and brands of health insurance owned, the source of their insurance, the types of wellness programs provided and participated in, and their views about the different aspects of the new health care legislation.

As the year 2010 starts, the Health Care Reform bill is perhaps making its way to the desk of President Obama for signature. This would be a moment in history, as, according to President Obama, this is the most important reform of the health care system since Medicare.

There are certain tensions at play at this time between the industry and the consumer, brought about not only by the soon to be enacted legislation, but also by to the effect of the economy on consumers and their experiences with health insurance. Starting with the first section of the report, the Executive Summary:

  • What are the stresses being experienced by consumers as concerns the economy and their health care? What do they think about wellness programs?
  • What are various strategies for boosting the success of wellness programs?
  • How are larger cultural trends impacting the health insurance industry and wellness programs in general?
  • How are people buying individual health policies, and what is the influence of the internet on these buying decisions?
  • What is the influence of the internet and the recession on the new product launches made by the industry?
  • What are the over-arching trends seen in current advertising efforts, and how do these show in specific examples from the Mintel Comperemedia database?

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Table of contents

  1. Scope and Themes

      • What you need to know
        • Data sources
          • Consumer survey data
            • Advertising and Promotions
              • Abbreviations and terms
                • Abbreviations
                  • Terms
                    • Companies mentioned in this report
                    • Executive Summary

                      • Industry overview
                        • Health insurance companies are having a very good year
                            • Figure 1: Stock performance of leading private insurance companies, October 27-December 21, 2009
                          • Stress flash points for consumers
                            • Half of consumers favor the Public Option
                              • Wellness programs are gaining traction
                                • Figure 2: Percentage of U.S. adult population that is overweight, obese and extremely obese, 1960-2006
                              • Advertising efforts focus on Medicare, preventive care
                              • Insights and Opportunities

                                • Key points
                                  • Preventive care is a must for the industry
                                    • What is individual health insurance?
                                      • Determine ways to cut spending
                                        • How will consumers fare if no Public Option?
                                        • Inspire Insights

                                            • Trend: A Simple Balance for Health
                                              • Trend: No Middleman
                                              • Market Size and Forecast

                                                • Key points
                                                  • NHE are growing at a faster pace than GDP
                                                    • Figure 3: Growth in NHE and GDP, 2003-18
                                                  • Premiums have more than doubled in the past 10 years
                                                    • Figure 4: Average annual health insurance premiums and worker contributions for family coverage, 1999-2009
                                                  • Most health dollars come from private insurance and Medicare
                                                    • Figure 5: Source of nation’s health care dollars, 2007
                                                  • Private health insurers have lost 1 million enrollees from 2007 to 2008
                                                    • Figure 6: Number of population uninsured and insured, 1999-2008
                                                • Competitive Context

                                                  • Key point
                                                    • Health care reform
                                                      • Figure 7: House and senate bills proposed, November 2009
                                                    • Pharmaceuticals – Part D gap closure likely, but reimportation out
                                                      • Call for Wellness programs
                                                        • Alternative care becoming legitimatized
                                                          • Preventive care vital to health
                                                            • Figure 8: Top 10 leading causes of death for U.S. women, February 2008
                                                            • Figure 9: Top 10 leading causes of death for U.S. males, 2004
                                                          • The Public Option
                                                            • Figure 10: Annual premium increases for employer-sponsored and FEHBP, 2000-09
                                                          • The Single-Payer System or “Medicare for all” – pros and cons
                                                          • Marketing Channels

                                                            • Key point
                                                              • Three ways individual health insurance is purchased
                                                                • Figure 11: How purchased individual health insurance, by gender, November 2009
                                                                • Figure 12: Trends in health insurance purchasing, 2007-2009
                                                              • About 50% who bought direct were web-influenced
                                                                • Figure 13: Online personal insurance activities, 2007
                                                            • Market Drivers

                                                              • Key points
                                                                • By 2015, 6.6 million Baby Boomers will be eligible for Medicare
                                                                  • Figure 14: U.S. population, by age, 2005-15
                                                                • High job losses take many out of employer-based plans
                                                                  • Figure 15: Total non-farm payroll losses in thousands, September 2007-December 2009
                                                                  • Figure 16: U.S. unemployment rate, by month, September 2007-December 2009
                                                              • Leading Companies

                                                                • Key points
                                                                  • The industry grew by 7% in 2008, with UnitedHealth Group in top position
                                                                    • Figure 17: Top 10 health insurance groups, by Direct Written Premium, 2008
                                                                  • Many health insurers report revenue gains for Q3 2009
                                                                    • Figure 18: Revenues and net income for largest publicly traded health insurers, Third Quarter, 2008 and 2009
                                                                • Brand Qualities

                                                                  • Key points
                                                                    • Blue Cross Blue Shield, Kaiser Permanente and Humana receive high marks
                                                                      • Figure 19: Results from J.D. Power & Associates 2009 National Health Insurance Study
                                                                    • But, consumers do not have confidence in health insurance companies
                                                                      • Figure 20: Level of confidence consumers have in various institutions, December 2009
                                                                  • Innovation and Innovators

                                                                    • Key points
                                                                      • United Healthcare’s Source4Women Community
                                                                        • The Aetna Health Connections Direct2YouSM
                                                                          • Aetna’s “15-Minute Health Insurance Guide”
                                                                            • Humana develops a social media tool combining Twitter search with mapping functions
                                                                              • Humana’s RealForMe.com for Baby Boomers
                                                                                • Humana’s Wellzone.org
                                                                                  • Kaiser Permanente’s “Healthy Eating in Hard Times”
                                                                                  • Advertising and Promotion

                                                                                    • Key points
                                                                                      • Overview
                                                                                        • Print advertising – Health insurance
                                                                                          • Figure 21: Aetna print ad, November 2009
                                                                                          • Figure 22: United Healthcare print ad, November 2009
                                                                                          • Figure 23: HumanaOne print ad, September 2009
                                                                                        • Direct mail – Medicare
                                                                                          • Figure 24: Humana, Medicare Gold Choice PFFS direct mail l ad, November 2009
                                                                                          • Figure 25: AARP United Healthcare Medicare supplement Plan, November 2009
                                                                                        • Direct mail – Health insurance
                                                                                          • Figure 26: Aetna health risk assessment direct mail ad, May 2009
                                                                                          • Figure 27: UnitedHealthOne direct mail ad, March 2009
                                                                                          • Figure 28: Anthem Blue Cross SmartSense Plan direct mail ad, November 2009
                                                                                          • Figure 29: Coventry HealthAmericaOne direct mail ad, November 2009
                                                                                        • Email – Health insurance
                                                                                          • Figure 30: Easier health insurance e-mail ad, December 2009
                                                                                          • Figure 31: Health insurance from consumer reward solutions email ad, December 2009
                                                                                        • TV commercials
                                                                                          • Figure 32: Excellus Blue Cross Blue Shield, Attention Employees, 2009
                                                                                          • Figure 33: Blue Shield 65+ Medicare Advantage HMO Plan, 2009
                                                                                          • Figure 34: Kaiser Permanente, Man Kayaks, 2009
                                                                                          • Figure 35: United HealthGroup, Woman on Bus, 2009
                                                                                          • Figure 36: CarePlus, An Apple, 2009
                                                                                      • The Consumer – Health Insurance Ownership

                                                                                        • Key points
                                                                                          • Health insurance ownership
                                                                                            • Figure 37: Percentage of adults who have health insurance, by age, November 2009
                                                                                            • Figure 38: Type of insurance products owned, by gender and age, November 2009
                                                                                            • Figure 39: Type of insurance products owned, by household income, November 2009
                                                                                          • Type of health insurance owned
                                                                                            • Figure 40: Type of health insurance owned, overall, November 2009
                                                                                            • Figure 41: Type of health insurance owned, by gender and age, November 2009
                                                                                            • Figure 42: Type of health insurance owned, by household income, November 2009
                                                                                            • Figure 43: Trends in types of health insurance owned, Spring 2003-Spring 2009
                                                                                          • Reasons consumers do not have health insurance
                                                                                              • Figure 44: Reasons why do not currently have health insurance, by gender and age, November 2009
                                                                                              • Figure 45: Reasons why do not currently have health insurance, by household income, November 2009
                                                                                          • The Consumer – Brands Owned

                                                                                            • Key points
                                                                                                • Figure 46: Brands of health insurance owned, among those with health insurance (not government plan), November 2009
                                                                                                • Figure 47: Brand(s) of health insurance owned, by gender and age, November 2009
                                                                                                • Figure 48: Brand(s) of health insurance owned, by region, November 2009
                                                                                              • Satisfaction with health insurance provider
                                                                                                • Figure 49: Satisfaction with health insurance provider, November 2009
                                                                                                • Figure 50: Overall satisfaction with health insurance, by gender and age, November 2009
                                                                                                • Figure 51: Overall satisfaction with health insurance, by region, November 2009
                                                                                              • Importance of components in choosing a provider
                                                                                                • Figure 52: Importance of components of health insurance, November 2009
                                                                                                • Figure 53: Importance of components of health insurance, by gender and age, November 2009
                                                                                                • Figure 54: Whether denied coverage for procedures, tests or surgeries during past two years, by gender and age, November 2009
                                                                                            • The Consumer – Health Care Reform

                                                                                              • Key points
                                                                                                  • Figure 55: Whether in favor of/oppose elements of health care reform legislation, November 2009
                                                                                                  • Figure 56: Whether in favor of/oppose elements of health care reform legislation, by gender and age, November 2009
                                                                                                  • Figure 57: Whether in favor of/oppose elements of health care reform legislation, by household income, November 2009
                                                                                              • The Consumer – Wellness Programs at Work

                                                                                                • Key points
                                                                                                  • Wellness programs gain traction
                                                                                                    • Figure 58: Whether have wellness program at work, November 2009
                                                                                                    • Figure 59: Types of health and wellness programs offered by employer, by gender and age, November 2009
                                                                                                    • Figure 60: Types of health and wellness programs offered by employer, by race/Hispanic origin, November 2009
                                                                                                    • Figure 61: Types of health and wellness programs offered by employer, by household income, November 2009
                                                                                                  • Participation in Wellness programs
                                                                                                      • Figure 62: Types of employer based health and wellness programs offered by employer and participated in during past year, november 2009
                                                                                                      • Figure 63: Types of employer based health and wellness programs participated in during past year, by gender and age, November 2009
                                                                                                      • Figure 64: Types of employer based health and wellness programs participated in during past year, by race/Hispanic origin, November 2009
                                                                                                      • Figure 65: Types of employer based health and wellness programs participated in during past year, by household income, November 2009
                                                                                                    • Health risk assessments
                                                                                                        • Figure 66: Among firms offering health benefits, percentage of firms that offer health risk assessments, 2009
                                                                                                        • Figure 67: Among firms offering health benefits and health risk assessments, percentage of firms that offer financial incentives to complete risk assessments, 2009
                                                                                                    • The Consumer – The Insured vs. the Uninsured

                                                                                                      • Key points
                                                                                                        • Attitudes and behaviors
                                                                                                          • Figure 68: Medical professionals consulted in last 12 months, Spring 2009
                                                                                                          • Figure 69: Attitudes towards health, percentage who agree with statement, Spring 2009
                                                                                                          • Figure 70: Attitudes towards health & medicine, percent who agree with statement, Spring 2009
                                                                                                        • Smoking cessation
                                                                                                          • Figure 71: Whether tried to stop smoking in last 12 months, Spring 2009
                                                                                                          • Figure 72: Methods employed to stop smoking during last 12 months, Spring 2009
                                                                                                        • Exercise programs
                                                                                                          • Figure 73: Whether have initiated an exercise program in last 12 months, Spring 2009
                                                                                                          • Figure 74: Where exercised in last 12 months, Spring 2009
                                                                                                          • Figure 75: How often exercise, if exercise regularly, Spring 2009
                                                                                                      • Cluster Analysis

                                                                                                          • Reform Advocates
                                                                                                            • Insurance Minimalists
                                                                                                              • Risk Averse
                                                                                                                • Characteristics tables
                                                                                                                  • Figure 76: Health insurance clusters, November 2009
                                                                                                                  • Figure 77: Type of insurance products owned, by cluster, November 2009
                                                                                                                  • Figure 78: Type of health insurance owned, by cluster, November 2009
                                                                                                                  • Figure 79: Overall satisfaction with health insurance, by cluster, November 2009
                                                                                                                  • Figure 80: Importance of components of health insurance, by cluster, November 2009
                                                                                                                  • Figure 81: Whether denied coverage for procedures, tests or surgeries during past two years, by cluster, November 2009
                                                                                                                  • Figure 82: Whether in favor of/oppose elements of health care reform legislation, by cluster, November 2009
                                                                                                                • Demographics tables
                                                                                                                  • Figure 83: Health insurance clusters, by gender, November 2009
                                                                                                                  • Figure 84: Health insurance clusters, by age, November 2009
                                                                                                                  • Figure 85: Health insurance clusters, by household income, November 2009
                                                                                                                  • Figure 86: Health insurance clusters, by race, November 2009
                                                                                                                  • Figure 87: Health insurance clusters, by Hispanic origin, November 2009
                                                                                                                • Cluster methodology
                                                                                                                • Appendix: Simmons Mosaic Analysis

                                                                                                                    • Key points
                                                                                                                      • Figure 88: Health insurance penetration, by Mosaic segment, Spring 2009
                                                                                                                      • Figure 89: How obtained health insurance, by Mosaic segment, Spring 2009
                                                                                                                      • Figure 90: How purchased health insurance, by Mosaic segment, Spring 2009
                                                                                                                  • Appendix: Trade Associations

                                                                                                                    Companies Covered

                                                                                                                    • Aetna Inc.
                                                                                                                    • American Association of Retired Persons (AARP)
                                                                                                                    • American Family Insurance Group
                                                                                                                    • American Medical Association (AMA)
                                                                                                                    • Facebook, Inc.
                                                                                                                    • Google, Inc.
                                                                                                                    • Greenfield Online
                                                                                                                    • Henry J. Kaiser Family Foundation
                                                                                                                    • Insurance Information Institute Inc.
                                                                                                                    • J.D. Power and Associates
                                                                                                                    • LinkedIn
                                                                                                                    • National Association of Insurance Commissioners (NAIC)
                                                                                                                    • National Cancer Institute (NCI)
                                                                                                                    • National Institutes of Health
                                                                                                                    • PhRMA Pharmaceutical Research and Manufacturers of America
                                                                                                                    • Twitter, Inc.
                                                                                                                    • U.S. Bureau of Labor Statistics
                                                                                                                    • Watson Wyatt & Company Holdings
                                                                                                                    • Weight Watchers International Inc.
                                                                                                                    • YMCA of the USA
                                                                                                                    • YouTube, Inc.
                                                                                                                    • YWCA of the U.S.A.

                                                                                                                    Health Insurance and Wellness Programs - US - February 2010

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