Checklist: Employer-based care

June 1, 2012

With health reform transforming the industry, a study from the Employee Benefit Research Institute (EBRI) shows the current realities of employer-based care.

Employer coverage is declining: More than 58% of U.S. adults under age 65 were covered by health benefits offered by an employer, down from 62% in 2008. Of all working adults, 68.6% were covered, while 35.3% of non-working adults were covered. Through a parent, coverage was also provided to 54.8% of children. But during the 13 year span of the EBRI study, the percentage of people with work-related health benefits dropped, particularly hurt by the recent recession.

Coverage varies by firm size: The size of the worker's firm had an effect on the number of workers offered coverage and the number of workers who used their employer's healthcare plans. In 2010, only 39.4% of small companies (with 24 employees or fewer) offered coverage, down by 8% from 1997. While the number of small companies offering benefits is low, 77.8% of employees at small firms were taking advantage of the offered coverage-a decline of 4% during the course of the study. Larger companies with 100 or more employees report a much greater coverage rate with 76.5% in 2010. But, even large companies, those with 100 or more employees, saw a 4% dip in offered coverage during the study's span. Employees in large companies were signing up for health benefits 84.9% of the time, down by 3% from 1997. Firms with 25 to 99 employees saw decreases of 2% for both offering and accepting coverage.

Men are more likely to enroll: Men were more likely (69.2%) to be offered healthcare coverage in the workplace than women (65.8%). But, over the study's 13 year tracking period, men saw a decrease in being offered coverage of 6%, and women 4%. When offered coverage, men were also more likely to enroll in the plan, at a rate of 87.2%, down 4% from 1997's numbers. Women chose to enroll 79.7% of the time, down only 1% from 1997.

Unions have an advantage: Being a part of a union also increased the likelihood of benefits. Only 64.4% of non-union employees were offered coverage, while 87.6% of union members got the opportunity. However, union employees saw a bigger decrease between 1997 and 2012 in offered coverage, losing 5%. Non-union workers saw coverage decline by 3%.

Why are employees uninsured? One of the biggest reasons that workers didn't have health coverage was because their employer didn't offer it. More than 58% of workers fell into this category. When coverage was offered to employees, more than 77% of those who remained uninsured stated that the cost was too much. Almost 6% said that they didn't take the offered coverage because they didn't need or want it.

-Miranda Hester

Source: Employee Benefit Research Insititute Issue Brief