Skilled nursing and residential care facilities by state
PlanOptica tracks 2,215 health and welfare plans sponsored by 1,857 skilled nursing and residential care facilities in the United States, covering 7,258,143 participants and $3.2B in reported insurance premiums (plan year 2024 to 2025 filings). The median plan has 201 participants, and the most common size is 100 to 249 participants (41% of plans). The funding mix is split: 50% of plans are self-funded or mixed and the rest are mainly fully insured.
Blue Cross Blue Shield of Massachusetts, Inc leads by premium with a 23% share, followed by Kaiser Foundation Health Plan, Inc at 13%. Marsh & McLennan Agency LLC is the broker of record on 206 plans, more than any other firm, ahead of Hub International Northeast Limited (164). 81% of plans report broker compensation on Schedule A; the median brokered plan pays $46K a year, about 7.1% of premium. NY, PA and TX have the most plans of any state.
Funding mix
- Fully insured1,086 · 49%
- Mixed722 · 33%
- Self-funded375 · 17%
- MEWA18 · 1%
- Unknown14 · 1%
Plan size (participants)
- Under 100387 · 17%
- 100 to 249910 · 41%
- 250 to 499387 · 17%
- 500 to 999245 · 11%
- 1,000 or more286 · 13%
Median plan: 201 participants. Median broker comp: 7.1% of premium across 1,804 brokered plans.
Top carriers, skilled nursing, the U.S.
- 1Blue Cross Blue Shield of Massachusetts, Inc$754M381 plans · 23.2%
- 2Kaiser Foundation Health Plan, Inc$414M145 plans · 12.8%
- 3Unitedhealthcare Insurance Company$284M196 plans · 8.7%
- 4Aetna Life Insurance Company$165M102 plans · 5.1%
- 5Cigna Health and Life Insurance Company$153M100 plans · 4.7%
- 6Metropolitan Life Insurance Company$128M281 plans · 3.9%
- 7Delta Dental of Pennsylvania$96M237 plans · 2.9%
- 8The Guardian Life Insurance Company of America$79M295 plans · 2.4%
- 9The Lincoln National Life Insurance Company$59M137 plans · 1.8%
- 10United Healthcare Insurance Company$55M33 plans · 1.7%
Top brokers, skilled nursing, the U.S.
- 1Marsh & McLennan Agency LLC206 plans$16M comp · 11.4%
- 2Hub International Northeast Limited164 plans$8.5M comp · 9.1%
- 3Usi Insurance Services LLC156 plans$9.5M comp · 8.6%
- 4Gallagher Benefit Services, Inc129 plans$15M comp · 7.2%
- 5Emerson Rogers LLC120 plans$3.4M comp · 6.7%
- 6Brown & Brown Insurance Services85 plans$5.0M comp · 4.7%
- 7Lockton Companies, LLC77 plans$8.5M comp · 4.3%
- 8Gis Benefits Inc65 plans$1.2M comp · 3.6%
- 9Alera Group, Inc61 plans$1.3M comp · 3.4%
- 10NFP Corporate Services NY LLC52 plans$2.4M comp · 2.9%
Largest skilled nursing and residential care facilities nationally
| Employer / plan | Location | Funding | Participants | Premium | Primary carrier |
|---|---|---|---|---|---|
| Sherrill House Sherrill House Employee Benefits PlanAll plans | Jamaica Plain, MA | Fully insured | 5,771,386 | $1.5M | Harvard Pilgrim Health Care |
| Rescare, Inc. D/B/a Brightspring Health Services Brightspring Health Services Welfare Benefit PlanAll plans | Louisville, KY | Fully insured | 41,936 | $29M | Delta Dental of California |
| Select Medical Corporation Select Medical Corporation Health and Welfare Benefit PlanAll plans | Mechanicsburg, PA | Fully insured | 36,550 | $47M | Metropolitan Life Insurance Company |
| Brookdale Senior Living Inc Brookdale Senior Living, Inc. Welfare PlanAll plans | Brentwood, TN | Fully insured | 36,348 | $16M | Metropolitan Life Insurance Company |
| Ensign Services, Inc Ensign Services, Inc. Comprehensive Health and Welfare Benefit PlanAll plans | San Juan Capistrano, CA | Fully insured | 35,555 | $30M | Kaiser Foundation Health Plan Inc |
| National Mentor Holdings, LLC Sevita Welfare Benefits PlanAll plans | Edina, MN | Fully insured | 28,546 | $25M | Reliance Standard Life Insurance Company |
| Life Care Centers of America, Inc Life Care Centers of America, Inc. Welfare Benefits PlanAll plans | Cleveland, TN | Fully insured | 22,086 | $21M | Hartford Life and Accident |
| Kindred Healthcare Operating, LLC Scionhealth Employee Medical and Welfare PlanAll plans | Louisville, KY | Fully insured | 18,765 | $27M | Kaiser Foundation Health Plan Inc |
| Genesis Administrative Services LLC Genesis Administrative Services LLC Health and Welfare PlanAll plans | Kennett Square, PA | Fully insured | 17,440 | $12M | Aetna Life Insurance Company |
| Pruitthealth, Inc. Insurahealth, Inc Pruitt Corporation Employee Welfare Benefit PlanAll plans | Norcross, GA | Mixed | 15,431 | $10.0M | Sun Life Assurance Company of Canada |
| LCMC Health LCMC Health Employee Benefits PlanAll plans | New Orleans, LA | Mixed | 15,417 | $16M | United Healthcare Insurance Company |
| 1199 SEIU/Greater New York Job Security 1199 SEIU/Greater New York Job Security FundAll plans | New York, NY | Unknown | 15,232 | - | - |
| Discovery SL Management LLC Discovery Senior Living Employee Benefits PlanAll plans | Bonita Springs, FL | Fully insured | 15,017 | $6.5M | Reliastar Life Insurance Company |
| Florida Health Sciences Center, Inc Florida Health Sciences Center, Inc. Group Welfare Benefits PlanAll plans | Tampa, FL | Mixed | 14,774 | $27M | The Lincoln National Life Insurance Company |
| Sunrise Senior Living Management, Inc Sunrise Senior Living Health and Welfare PlanAll plans | McLean, VA | Fully insured | 13,252 | $2.6M | Hartford Life and Accident |
Showing 15 of 1,857 employers. Filter the full list by size, funding, carrier and broker.
Plans by state
- New York188 plans
- Pennsylvania186 plans
- Texas168 plans
- California137 plans
- Ohio136 plans
- Florida98 plans
- Illinois98 plans
- Minnesota79 plans
- New Jersey79 plans
- Kentucky69 plans
- Missouri60 plans
- Wisconsin58 plans
- Iowa55 plans
- Maryland55 plans
- North Carolina53 plans
- Massachusetts52 plans
- Washington48 plans
- Tennessee47 plans
- Michigan44 plans
- Oregon44 plans
- Indiana41 plans
- Virginia40 plans
- Georgia36 plans
- Connecticut29 plans
- Colorado26 plans
- South Carolina23 plans
- Alabama22 plans
- Arizona21 plans
- Kansas21 plans
- Louisiana17 plans
- South Dakota17 plans
- Utah17 plans
- Hawaii15 plans
- Maine15 plans
- North Dakota15 plans
- New Hampshire14 plans
- Oklahoma14 plans
- West Virginia11 plans
- Nebraska10 plans
- Mississippi9 plans
- Rhode Island8 plans
- Arkansas7 plans
- Delaware7 plans
- Idaho5 plans
- New Mexico5 plans
- Vermont4 plans
- Nevada3 plans
- District of Columbia2 plans
- Alaska1 plans
- Montana1 plans
- Wyoming1 plans
Frequently asked questions
How many skilled nursing and residential care facilities offer an ERISA health plan?
2,215 health and welfare plans from 1,857 skilled nursing and residential care facilities appear in plan year 2024 to 2025 filings on Form 5500, covering 7,258,143 participants. Plans with fewer than 100 participants that are fully insured do not have to file, so small practices are under-counted.
Which insurance carriers cover the most skilled nursing and residential care facilities?
By Schedule A premium: Blue Cross Blue Shield of Massachusetts, Inc (23% of premium, 381 plans), Kaiser Foundation Health Plan, Inc (13% of premium, 145 plans) and Unitedhealthcare Insurance Company (9% of premium, 196 plans).
Which benefits brokers work with skilled nursing and residential care facilities?
By number of client plans: Marsh & McLennan Agency LLC (206 plans), Hub International Northeast Limited (164 plans) and Usi Insurance Services LLC (156 plans). 81% of plans report a broker.
How much do brokers earn on skilled nursing and residential care facilities health plans?
The median brokered plan reports $46K a year in broker commissions and fees, or 7.1% of premium. Figures come from Schedule A, Part I.
Are skilled nursing and residential care facilities health plans self-funded or fully insured?
Fully insured 49%, mixed 33% and self-funded 17%. Self-funded and mixed plans together make up 50%.
Where does this data come from?
U.S. Department of Labor Form 5500 filings and their Schedule A insurance attachments, latest filing per plan. Nursing and residential care facilities (Form 5500 code 623000, which also covers assisted living), plus healthcare employers whose name says nursing or skilled care.
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Other healthcare specialties
Source: U.S. Department of Labor Form 5500 and Schedule A, latest filing per plan (plan years 2024-2025). Nursing and residential care facilities (Form 5500 code 623000, which also covers assisted living), plus healthcare employers whose name says nursing or skilled care.