A Profile of Maryland's Self-Insured Small Group Health Insurance Market

The percent of small employers, both nationally and in Maryland, that self-insure is relatively small (around 11% to 13%) and the trend has been flat. Although one study projected that adverse selection as a result of the increased incentive to self-insure in the small group market after the ACA is fully implemented would not be a "major threat" to the success of the Small Business Health Options Program exchanges, the Maryland Health Care Commission will continue to track self-insurance rates in the small group market and provide the information to state policy-makers.