Highly-Concentrated Vision Insurance Market Increasing

January 15, 2024

The fully-insured segment of the U.S. vision insurance market has been gradually increasing over the last five years, unlike the dental insurance industry.  According to an analysis done by Mark Farrah Associates (MFA), utilizing the latest data from its Health Coverage Portal ^TM product, fully-insured vision plans covered 48.2 million people on September 30, 2023, up from 42.4 million on September 30, 2019. The fully-insured vision insurance market, which is slightly more than half the size of the dental market, is highly concentrated, with the top vision insurer controlling nearly 71% of the market.

Vision Services Plan (VSP) Group is the largest vision benefits company in the U.S., covering nearly 71% of the market. In addition to other clients, it provides vision care to enrollees under the Federal Employees Dental and Vision Insurance Program. VSP reported 1.5 million of its 34.1 million total covered lives are through the Federal Employee Health Benefits Program (FEHBP), as of 3Q23. Year-to-date, through September 30, 2023 (3Q23), VSP reported $1.692 billion in premiums earned through its NAIC (National Association of Insurance Commissioners) filings [1]. Those premiums equate to $6.44 per member per month, and are down from $1.629 billion in earned premiums, or $6.47 per member per month, through 3Q22.

Vision insurance coverage is offered by specialty insurance companies, such as VSP, and under separate policies through medical insurers, such as Blue Cross Blue Shield (Blues) plans and their subsidiaries and non-Blues affiliated medical insurers. MFA’s Health Coverage Portal ^TM provides enrollment and financial data on both medical and specialty insurers, allowing for comparative analysis and tracking of these specialty or ancillary insurance plans. As illustrated below, the U.S. vision insurance market increased enrollment year-over-year (YOY) by 5.2%, between September 30, 2022, and September 30, 2023.

• Blues affiliated organizations, including subsidiaries of Elevance and Blue Cross Blue Shield of Michigan, provide vision insurance to 7.0 million people, as of September 30, 2023. This is a decrease of -1.4% over the 7.1 million people covered at the end of the same period in 2022. Combined, Blues organizations cover 14.5% of the total insured vision market.
   
• Specialty insurers such as Vision Benefits Group, Delta Dental of Wisconsin (Vision enrollment only is reported above), SightCare and EssilorLuxottica [2] combined, cover nearly 2.2 million, roughly 4.5% of the vision market, with all other specialty insurers covering 5.2% more.
   
• Non-Blues medical insurers, such as Humana and UnitedHealth, cover 5.2% of people with vision insurance.

About the Data

The data used in this analysis was obtained from Mark Farrah Associates' Health Coverage Portal™ database. Findings reflect enrollment reported by carriers with business in the U.S. and U.S. territories. Data sources include the National Association of Insurance Commissioners (NAIC) and the California Department of Managed Health Care (CA DMHC) statutory filings. Vision coverage can be offered by employers through both fully-insured and self-insured funding mechanisms, the above analysis excludes self-insured vision coverage.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal ^TM, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health^Plus, and Health Plans USA™. For more information about these and other data products, refer to the informational videos and brochures available under the Our Products section of the MFA website or call 724-338-4100.

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