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Highly-Concentrated Vision Insurance Market Increasing

 

January 12, 2023

 

Unlike the Dental Insurance industry[i], the fully-insured segment of the U.S. Vision Insurance market has been gradually increasing over the last five years. 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 45.6 million people on September 30, 2022, up from 40.4 million on September 30, 2018. The fully-insured Vision Insurance market, which is roughly half the size of the Dental market, is highly concentrated, with the top Vision insurer controlling 70% of the market.

 

 

Vision Services Plan (VSP) Group is the largest vision benefits company in the U.S., covering 70% of the market. In addition to other clients, it provides vision care to enrollees under the Federal Employees Dental and Vision Insurance Program (FEDVIP). VSP reported 1.4 million of its 31.9 million total covered lives are through the Federal Employee Health Benefits Program (FEHBP), as of 3Q22. Year-to-date, through September 30, 2022 (3Q22), VSP reported $1.629 billion in premiums earned through its NAIC (National Association of Insurance Commissioners) filings[ii]; those premiums equate to $6.47 per member per month, and are down from $1.631 billion in earned premiums, or $6.83 per member per month, through 3Q21.

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 4%, between September 30, 2021, and September 30, 2022.

 

 

  • Blues affiliated organizations, including subsidiaries of Elevance (formerly Anthem) and Blue Cross Blue Shield of Michigan, provide vision insurance to 7.2 million people, as of September 30, 2022. This is an increase of 3.3% over the 6.9 million people covered at the end of the same period in 2021. Combined, Blues organizations cover about 16% 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 combined, cover nearly 2.2 million, roughly 5% of the vision market, with all other Specialty insurers covering nearly 5% more.
  • Non-Blues medical insurers, such as Humana and UnitedHealth, cover 5% 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 HealthPlus, 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.

Healthcare Business Strategy is a FREE monthly brief that presents analysis of important issues and developments affecting healthcare business today. If you would like to be added to our email distribution list, please submit your email address to the "Subscribe to MFA Briefs" section at the bottom of this page.


[i] Vision Services Plan Group’s combined third quarter results in the NAIC’s Exhibit of Premiums, Enrollment and Utilization for 2021 and 2022, available in MFA’s Health Coverage Portal TM

 

[ii] See Mark Farrah Associates’ Healthcare Business Strategy monthly brief, Dental Insurance Enrollment Trends, April 21, 2022

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