Insurance companies will disagree with you as will their employees about group insurance. A company offering a group plan can get those who are uninsurable for X or y insured as it spreads the risk out. Group rates are based upon type of business (office vs assembly type, etc.) and claims/loss ratio. There are major benefits and advantages to group insurance. Insurance companies will always prefer healthy office workers vs. construction companies.
I’ve worked in insurance since ‘68, always in information and statistics, never in sales. True that BCBS, Anthem, UHC, Humana, Aetna, etal have business plans designed for the current government involvement.
But there is no reason why a State Farm which is small in insurance, or a new start up, can’t have a different business plan... a plan more like auto and homeowners insurance.
Somehow, the P&C companies are quite capable of spreading the risk without employer involvement. They could do the same for health insurance.
Somehow the medical sharing (non-insurance) groups that have sprung up under the ACA are quite capable of spreading the risk without employer involvement.
The current health insurance business model of BCBS types is built on government favoritism toward them. It is not an efficient business model.
The real difference is that people who are working at any job are more healthy than folks that aren't working, since many who aren't working have chronic illnesses. In reality, unless the employee groups are Walmart sized the insurance company isn't relying on any particular group as a risk pool. But they say they are since it allows the insurance company to set the pricing differently for each prospective customer.
If you have ever solicited insurance bids for a small group it is obvious that the price changes between bidders are based on competitive factors, not the demographics and risk profile of the group.