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Health Insurance - US - June 2014

“Now that the first open enrollment period for the ACA has ended, it is clear that it has been successful in reducing the ranks of the uninsured, including – and perhaps surprisingly – among young people. People are still searching for information, however, so continued communication from both the government and the individual companies will undoubtedly lead to additional enrollment next year.”

–    Robyn Kaiserman, Financial Services Analyst

This report looks at the following areas:

  • Has the ACA been successful in enrolling the uninsured?
  • Have younger people enrolled in the ACA?
  • How can insurers and employers increase the effectiveness of wellness programs?

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Table of contents

  1. Scope and Themes

    • What you need to know
      • Consumer survey data
        • Direct marketing creative
          • Abbreviations and terms
            • Abbreviations
              • Terms
              • Executive Summary

                  • The market
                    • Figure 1: Percentage of uninsured Americans, March of following year, 2002-12
                  • Market drivers
                    • Unemployment is down
                      • Figure 2: Unemployment in US, April 2010-April 2014
                    • The aging of America
                      • Figure 3: Percent change in US population, by age, 2015-35
                    • The consumer
                      • Figure 4: Type of health insurance coverage owned, April 2014
                      • Figure 5: How knowledgeable about ACA – Any knowledgeable, by gender, April 2014
                      • Figure 6: Preferred method for learning about health insurance plan, by age, April 2014
                      • Figure 7: Information sources have used in the past and will again, by age, April 2014
                    • What we think
                    • Issues and Insights

                        • Has the ACA been successful in enrolling the uninsured?
                          • Issues
                            • Implications
                              • Have younger people enrolled in the ACA?
                                • Issues
                                  • Implications
                                    • How can insurers and employers increase the effectiveness of wellness programs?
                                      • Issues
                                        • Implications
                                        • Trend Application

                                            • Trend: Without a Care
                                              • Trend: Guiding Choice
                                                • Trend: Prepare for the Worst
                                                • Market Size and Forecast

                                                  • Key points
                                                    • Fewer Americans are uninsured
                                                      • Figure 8: Number of insured/uninsured people in U.S., as of March of the following year, 2002-12
                                                      • Figure 9: Percentage of uninsured Americans, March of following year, 2002-12
                                                      • Figure 10: Percentage of uninsured in US population, by age, 2002, 2007 and 2012
                                                      • Figure 11: Percentage who selected ACA marketplace, by age, October 1, 2013-March 31, 2014
                                                  • Market Drivers

                                                    • Key points
                                                      • Unemployment continues to trend down
                                                        • Figure 12: Unemployment in US, April 2010-April 2014
                                                      • The aging of America
                                                        • Figure 13: Population estimates, by age, 2015, 2020, 2025, 2030 and 2035
                                                        • Figure 14: Age segments as a percentage of the population, 2015 and 2030
                                                    • Competitive Context

                                                      • Key points
                                                        • Private exchanges
                                                          • Concierge medicine continues to grow
                                                          • Innovations and Innovators

                                                            • Key points
                                                              • Technology is increasingly part of the solution
                                                                • Times Warner Cable Business Class/Cleveland Clinic
                                                                  • Samsung Galaxy 5S heart rate monitor
                                                                    • Oscar Health Insurance
                                                                      • Price transparency
                                                                        • Costco teams up with Aetna
                                                                        • Marketing Strategies

                                                                          • Key points
                                                                            • Marketing is increasingly important
                                                                              • Figure 15: Health insurer measured media ad spend, 2012 and 2013
                                                                            • Efforts have increased consumer knowledge
                                                                              • Figure 16: Change in knowledge of ACA provisions, 2013, 2014
                                                                            • Health insurance mailings have decreased
                                                                              • Figure 17: Health insurance direct mail volume, Q1 2012-Q4 2013
                                                                            • Top 10 mailers
                                                                              • Figure 18: Top ten medical plan mailers, 2012 vs. 2013
                                                                            • Internet most popular information source
                                                                              • Figure 19: Most popular sources of information about the ACA and health insurance options, April 2014
                                                                            • Overview of the brand landscape
                                                                              • Brand analysis: Aetna
                                                                                • Figure 20: Brand analysis of Aetna, 2014
                                                                              • Online initiatives
                                                                                • Videos
                                                                                  • Figure 21: Aetna “What’s Your Healthy” video introduction, 2013
                                                                                • Email
                                                                                  • Figure 22: Aetna wellness incentive email, 2014
                                                                                • Direct mail
                                                                                  • Figure 23: Aetna health coach direct mail letter, 2014
                                                                                  • Figure 24: Aetna direct mail members-only meeting invitation, 2014
                                                                                • Brand analysis: Cigna
                                                                                  • Figure 25: Brand analysis of Cigna, 2014
                                                                                • Online initiatives
                                                                                  • TV presence
                                                                                    • Figure 26: Cigna You Go commercial, 2013
                                                                                  • Direct mail
                                                                                    • Figure 27: Cigna’s online tool direct mail ad, 2014
                                                                                  • Online ads
                                                                                    • Figure 28: Cigna go you online ad, 2014
                                                                                  • Email
                                                                                    • Figure 29: Cigna open enrollment email ad, 2014
                                                                                  • Print
                                                                                    • Figure 30: Cigna healthy tips ad, 2014
                                                                                  • Brand analysis: Humana
                                                                                    • Figure 31: Brand analysis: Humana
                                                                                  • Online
                                                                                    • TV presence
                                                                                      • Figure 32: Humana’s “close the gap” tv ad, 2014
                                                                                      • Figure 33: Humana’s “care is protecting” tv ad, 2014
                                                                                    • Direct mail
                                                                                      • Figure 34: Humana community meeting invite, 2014
                                                                                      • Figure 35: Humana online classes direct mail ad, 2014
                                                                                    • Print
                                                                                      • Figure 36: Humana enrollment print ad, 2013
                                                                                    • Brand analysis: UnitedHealthcare
                                                                                      • Figure 37: Brand analysis: UnitedHealthcare
                                                                                    • Online
                                                                                      • YouTube
                                                                                        • Figure 38: UHC/Sesame Street healthy food choice video, 2013
                                                                                        • Figure 39: UHC Healthy LifeCycle video, 2012
                                                                                      • Direct mail
                                                                                        • Figure 40: UHC well-child checkup direct mail ad, 2014
                                                                                        • Figure 41: UHC 24/7 nurse line direct mail newsletter, 2014
                                                                                      • Online
                                                                                        • Figure 42: UHC Nutrition contest online ad, 2014
                                                                                        • Figure 43: UHC Innovations online ad, 2014
                                                                                      • Email
                                                                                        • Figure 44: UHC “MyPerks” email ad, 2014
                                                                                        • Figure 45: UHC Mobile app email, 2014
                                                                                      • Print
                                                                                        • Figure 46: UHC Simplicity print ad, 2014
                                                                                        • Figure 47: UHC Enrollment print ad, 2013
                                                                                    • Social Media – Health Insurance

                                                                                      • Key points
                                                                                        • Market overview
                                                                                          • Key social media metrics
                                                                                            • Figure 48: Key performance indicators, selected health insurance brands, May 26, 2013-May 25, 2014
                                                                                          • Brand usage and awareness
                                                                                            • Figure 49: Brand usage and awareness of health insurance brands, April 2014
                                                                                          • Interaction with brands
                                                                                            • Figure 50: Interaction with health insurance brands, April 2014
                                                                                          • Leading online campaigns
                                                                                            • Educating the uninsured
                                                                                              • Encouraging health literacy
                                                                                                • Personalized health insurance coverage
                                                                                                  • Targeting Millennials through influential celebrities
                                                                                                    • What we think
                                                                                                      • Online conversations
                                                                                                        • Figure 51: Online mentions, selected health insurance brands, May 26, 2013-May 25, 2014
                                                                                                      • Where are people talking about health insurance brands?
                                                                                                        • Figure 52: Mentions, by page type, selected health insurance brands, May 26, 2013-May 25, 2014
                                                                                                      • What are people talking about online?
                                                                                                        • Figure 53: Mentions, by topic of conversation, selected health insurance brands, May 26, 2013-May 25, 2014
                                                                                                    • Health Insurance Ownership

                                                                                                      • Key points
                                                                                                        • Half have employer-sponsored insurance
                                                                                                          • Figure 54: Type of health insurance coverage owned, by gender, April 2014
                                                                                                          • Figure 55: Type of health insurance coverage owned, by age, April 2014
                                                                                                          • Figure 56: Type of health insurance coverage owned, by gender and age, April 2014
                                                                                                          • Figure 57: Type of health insurance coverage owned, by household income, April 2014
                                                                                                          • Figure 58: Type of health insurance coverage owned, by race/Hispanic origin, April 2014
                                                                                                          • Figure 59: Type of health insurance coverage owned, by race and household income, April 2014
                                                                                                          • Figure 60: Type of health insurance coverage owned, by Hispanic and household income, April 2014
                                                                                                          • Figure 61: Type of health insurance coverage owned, by current medical insurance provider, April 2014
                                                                                                          • Figure 62: Type of health insurance coverage owned, by number of types of health insurance coverage owned, April 2014
                                                                                                      • Knowledge About Healthcare Reform

                                                                                                        • Key points
                                                                                                          • People are much more knowledgeable now
                                                                                                            • Figure 63: How knowledgeable about ACA – Any knowledgeable, by gender, April 2014
                                                                                                            • Figure 64: How knowledgeable about ACA – Any knowledgeable, by age, April 2014
                                                                                                            • Figure 65: How knowledgeable about ACA – Any knowledgeable, by gender and age, April 2014
                                                                                                            • Figure 66: How knowledgeable about ACA – Any knowledgeable, by household income, April 2014
                                                                                                            • Figure 67: How knowledgeable about ACA – Any knowledgeable, by race and household income, April 2014
                                                                                                            • Figure 68: How knowledgeable about ACA – Any knowledgeable, by Hispanic origin and household income, April 2014
                                                                                                            • Figure 69: How knowledgeable about ACA – Any knowledgeable, by current medical insurance provider, April 2014
                                                                                                            • Figure 70: How knowledgeable about ACA – Any knowledgeable, by number of types of health insurance coverage owned, April 2014
                                                                                                        • Health Insurance Shopping and Purchasing Behavior

                                                                                                          • Key points
                                                                                                            • One third have purchased insurance from a new provider
                                                                                                              • Figure 71: Health insurance shopping/purchasing behavior, by gender, April 2014
                                                                                                              • Figure 72: Health insurance shopping/purchasing behavior, by age, April 2014
                                                                                                          • Preferred Method of Learning About Health Plan

                                                                                                            • Key points
                                                                                                              • Overall, email is preferred
                                                                                                                • Figure 73: Preferred method for learning about health insurance plan, by gender, April 2014
                                                                                                                • Figure 74: Preferred method for learning about health insurance plan, by age, April 2014
                                                                                                                • Figure 75: Preferred method for learning about health insurance plan, by household income, April 2014
                                                                                                                • Figure 76: Preferred method for learning about health insurance plan, by race/Hispanic origin, April 2014
                                                                                                            • Use of Different Information Sources

                                                                                                              • Key points
                                                                                                                • Most have gotten – and will continue to get – information about the ACA from the internet
                                                                                                                  • Figure 77: Information sources have used in the past and will again, by gender, April 2014
                                                                                                                  • Figure 78: Information sources have used in the past and will again, by age, April 2014
                                                                                                                  • Figure 79: Information sources have used in the past and will again, by household income, April 2014
                                                                                                                  • Figure 80: Information sources have used in the past and will again, by current medical insurance provider, April 2014
                                                                                                                • Repeat conversations with insurance company representatives are of little interest
                                                                                                                  • Figure 81: Information sources have used in the past but will not use again, by gender, April 2014
                                                                                                                  • Figure 82: Information sources have used in the past but will not use again, by age, April 2014
                                                                                                                  • Figure 83: Information sources have used in the past but will not use again, by current medical insurance provider, April 2014
                                                                                                                • Interest in government-issued communications increases
                                                                                                                  • Figure 84: Information sources I have not used in the past but will use in the future, by gender, April 2014
                                                                                                                  • Figure 85: Information sources I have not used in the past but will use in the future, by age, April 2014
                                                                                                                  • Figure 86: Information sources I have not used in the past but will use in the future, by household income, April 2014
                                                                                                                  • Figure 87: Information sources I have not used in the past but will use in the future, by current medical insurance provider, April 2014
                                                                                                                  • Figure 88: Information sources I have not used in the past but will use in the future, by number of types of health insurance coverage owned, April 2014
                                                                                                                • Little interest in print media
                                                                                                                  • Figure 89: Information sources I have not used in the past and do not plan to use in the future, by gender, April 2014
                                                                                                                  • Figure 90: Information sources I have not used in the past and do not plan to use in the future, by age, April 2014
                                                                                                                  • Figure 91: Information sources I have not used in the past and do not plan to use in the future, by gender and age, April 2014
                                                                                                                  • Figure 92: Information sources I have not used in the past and do not plan to use in the future, by household income, April 2014
                                                                                                                  • Figure 93: Information sources I have not used in the past and do not plan to use in the future, by race/Hispanic origin, April 2014
                                                                                                                  • Figure 94: Information sources I have not used in the past and do not plan to use in the future, by current medical insurance provider, April 2014
                                                                                                              • Awareness of Wellness Programs

                                                                                                                • Key points
                                                                                                                  • Prescription drug discount programs most popular wellness program
                                                                                                                    • Figure 95: Aware of the program and use it, by gender, April 2014
                                                                                                                    • Figure 96: Aware of the program and use it, by age, April 2014
                                                                                                                    • Figure 97: Aware of the program and use it, by gender and age, April 2014
                                                                                                                    • Figure 98: Aware of the program and use it, by household income, April 2014
                                                                                                                    • Figure 99: Aware of the program and use it, by current medical insurance provider, April 2014
                                                                                                                  • Programs customers know about, but do not use
                                                                                                                    • Figure 100: Aware of the program but do not use it, by gender, April 2014
                                                                                                                    • Figure 101: Aware of the program but do not use it, by age, April 2014
                                                                                                                    • Figure 102: Aware of the program but do not use it, by gender and age, April 2014
                                                                                                                    • Figure 103: Aware of the program but do not use it, by household income, April 2014
                                                                                                                    • Figure 104: Aware of the program but do not use it, by current medical insurance provider, April 2014
                                                                                                                  • Programs customers would be interested in, if only they knew about them
                                                                                                                    • Figure 105: Don't know if program is offered but would be interested in it, by gender, April 2014
                                                                                                                    • Figure 106: Don't know if program is offered but would be interested in it, by age, April 2014
                                                                                                                    • Figure 107: Don't know if program is offered but would be interested in it, by gender and age, April 2014
                                                                                                                    • Figure 108: Don't know if program is offered but would be interested in it, by household income, April 2014
                                                                                                                    • Figure 109: Don't know if program is offered but would be interested in it, by current medical insurance provider, April 2014
                                                                                                                  • No interest in program even if offered
                                                                                                                    • Figure 110: Don't know if program is offered and wouldn't be interested in it, by gender, April 2014
                                                                                                                    • Figure 111: Don't know if program is offered and wouldn't be interested in it, by age, April 2014
                                                                                                                    • Figure 112: Don't know if program is offered and wouldn't be interested in it, by household income, April 2014
                                                                                                                • Appendix – Other Useful Consumer Tables

                                                                                                                  • Health insurance ownership
                                                                                                                    • Figure 113: Type of health insurance coverage owned, by marital/relationship status, April 2014
                                                                                                                  • Knowledge about health care
                                                                                                                    • Figure 114: How knowledgeable about ACA – Any knowledgeable, by race/Hispanic origin, April 2014
                                                                                                                  • Health insurance shopping and purchasing behavior
                                                                                                                    • Figure 115: Health insurance shopping/purchasing behavior, by number of types of health insurance coverage owned, April 2014
                                                                                                                  • Preferred method of learning about health plan
                                                                                                                    • Figure 116: Preferred method for learning about health insurance plan, by gender and age, April 2014
                                                                                                                    • Figure 117: Preferred method for learning about health insurance plan, by number of types of health insurance coverage owned, April 2014
                                                                                                                  • Use of different information sources
                                                                                                                    • Sources have used before and will again
                                                                                                                      • Figure 118: Information sources have used in the past and will again, by gender, April 2014
                                                                                                                      • Figure 119: Information sources have used in the past and will again, by number of types of health insurance coverage owned, April 2014
                                                                                                                    • Sources have used in the past but won’t in the future
                                                                                                                      • Figure 120: Information sources have used in the past but will not use again, by gender and age, April 2014
                                                                                                                      • Figure 121: Information sources have used in the past but will not use again, by household income, April 2014
                                                                                                                      • Figure 122: Information sources have used in the past but will not use again, by repertoire of type of health insurance coverage owned, April 2014
                                                                                                                    • Sources have not used in the past but will in the future
                                                                                                                      • Figure 123: Information sources I have not used in the past but will use in the future, by gender and age, April 2014
                                                                                                                    • Awareness of wellness programs
                                                                                                                      • Aware of program and use it
                                                                                                                        • Figure 124: Aware of the program and use it, by number of types of health insurance coverage owned, April 2014
                                                                                                                      • Unaware whether program is offered, but would be interested in it if it were
                                                                                                                        • Figure 125: Don't know if program is offered but would be interested in it, by number of types of health insurance coverage owned, April 2014
                                                                                                                      • Unaware of availability of program, but wouldn’t be interested, anyway
                                                                                                                        • Figure 126: Don't know if program is offered and wouldn't be interested in it, by gender and age, April 2014
                                                                                                                        • Figure 127: Don't know if program is offered and wouldn't be interested in it, by current medical insurance provider, April 2014
                                                                                                                    • Appendix – Social Media

                                                                                                                      • Brand analysis
                                                                                                                        • Figure 128: HCSC key social media indicators, May 2014
                                                                                                                        • Figure 129: Kaiser Permanente key social media indicators, May 2014
                                                                                                                        • Figure 130: Aetna key social media indicators, May 2014
                                                                                                                        • Figure 131: Humana key social media indicators, May 2014
                                                                                                                        • Figure 132: UnitedHealthcare key social media indicators, May 2014
                                                                                                                        • Figure 133: Cigna key social media indicators, May 2014
                                                                                                                        • Figure 134: WellPoint key social media indicators, May 2014
                                                                                                                      • Brand usage or awareness
                                                                                                                        • Figure 135: Brand usage or awareness, April 2014
                                                                                                                        • Figure 136: HCSC (ie BlueCross and BlueShield) usage or awareness, by demographics, April 2014
                                                                                                                        • Figure 137: United Healthcare usage or awareness, by demographics, April 2014
                                                                                                                        • Figure 138: Aetna usage or awareness, by demographics, April 2014
                                                                                                                        • Figure 139: Humana usage or awareness, by demographics, April 2014
                                                                                                                        • Figure 140: Kaiser Permanente usage or awareness, by demographics, April 2014
                                                                                                                        • Figure 141: WellPoint usage or awareness, by demographics, April 2014
                                                                                                                        • Figure 142: Cigna usage or awareness, by demographics, April 2014
                                                                                                                      • Activities done
                                                                                                                        • Figure 143: Activities done, April 2014
                                                                                                                        • Figure 144: HCSC (ie BlueCross and BlueShield) – Activities done – I have looked up/talked about this brand online on social media, by demographics, April 2014
                                                                                                                        • Figure 145: HCSC (ie BlueCross and BlueShield) – Activities done – I have contacted/interacted with the brand online on social media to, by demographics, April 2014
                                                                                                                        • Figure 146: HCSC (ie BlueCross and BlueShield) – Activities done – I have researched the brand on social media to, by demographics, April 2014
                                                                                                                        • Figure 147: United Healthcare – Activities done – I have looked up/talked about this brand online on social media, by demographics, April 2014
                                                                                                                        • Figure 148: United Healthcare – Activities done – I have researched the brand on social media to, by demographics, April 2014
                                                                                                                        • Figure 149: Aetna – Activities done – I have looked up/talked about this brand online on social media, by demographics, April 2014
                                                                                                                        • Figure 150: Aetna – Activities done – I have researched the brand on social media to, by demographics, April 2014
                                                                                                                        • Figure 151: Humana – Activities done – I have looked up/talked about this brand online on social media, by demographics, April 2014
                                                                                                                        • Figure 152: Humana – Activities done – I have researched the brand on social media to, by demographics, April 2014
                                                                                                                        • Figure 153: Kaiser Permanente – Activities done – I have looked up/talked about this brand online on social media, by demographics, April 2014
                                                                                                                        • Figure 154: Kaiser Permanente – Activities done – I have researched the brand on social media to, by demographics, April 2014
                                                                                                                        • Figure 155: Cigna – Activities done – I have looked up/talked about this brand online on social media, by demographics, April 2014
                                                                                                                        • Figure 156: Cigna – Activities done – I have researched the brand on social media to, by demographics, April 2014
                                                                                                                    • Appendix – Trade Associations

                                                                                                                      Companies Covered

                                                                                                                      To learn more about the companies covered in this report please contact us.

                                                                                                                      Health Insurance - US - June 2014

                                                                                                                      £3,277.28 (Excl.Tax)