Competitive? In every job I've had it was basically the same 3-4 HMOs: Aetna, Bluecross, Cigna, and United Healthcare. If you are getting employer provided healthplans, as most Americans are, those are your options, 4. With so few options you aren't choosing the most competitive, you're choosing the lease worst.
That is because the messed up pre-tax benefit the US gives to big businesses so they have (another) advantage over small businesses, so you are buying from whoever your employer chooses to let you buy from.
Ideally, everyone in the US would have to buy health insurance from healthcare.gov, and can choose whoever they want with zero input from their employer.
I would prefer to buy my health insurance on the open market. But without the subsidies its pretty uneconomical. The fact that your employer offering it automatically locks you out of the best plans on the marketplace is anticompetitive and anti-labour.
Oscar I've never heard of but appears to be only available in NY/NJ and is operated by Cigna in other states. Kaiser operates primarily in the west coast. And Humana doesn't have much presence in Florida. They primarily do Medicare Advantage, AFAICT.
