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The Percent of Workers in Small Firms Offered Premium-free Health Insurance Has Changed Little Since 1998

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AHRQ News and Numbers

Release date: January 11, 2006

The percent of American workers offered no-premium contribution health plans has fallen since 1998 in large firms but has not changed much in small ones, according to the Federal Agency for Healthcare Research and Quality (AHRQ). Specifically, AHRQ's Medical Expenditure Panel Survey (MEPS) found that:

  • The proportion of workers eligible for employer-sponsored health insurance coverage who were offered at least one single-coverage plan that did not require them to contribute to the cost of their policy premium declined from 34.8 percent in 1998 to 28.4 percent in 2003 for firms as a whole.
  • The overall average decrease in offered plans with no employee premium contribution for both single and family coverage masked different trends for small (fewer than 50 workers) and large (more than 50 workers) firms.
    • The proportion of eligible employees working in large firms offering a single-coverage health plan that did not require them to pay part of the premium cost dropped by about one-fifth—from 28.1 percent in 1998 to 22.2 percent in 2003.
    • In contrast, the rate for single-coverage plans offered by small firms stayed roughly the same—55.9 percent in 1998 and 53.1 percent in 2003.
  • A similar pattern was found for large and small firms offering no-employee contribution family-coverage plans.
    • In large firms the proportion of eligible workers dropped from 14 percent to 10.4 percent.
    • But in small firms it barely moved (from 29.9 percent to 29.2 percent).
  • Actual enrollment declined for both family-coverage plans and single-person coverage plans—from 35 percent in 1998 to 27.3 percent in 2003 for single coverage, and from 18.7 percent to 14.2 percent for family coverage.

MEPS collects information each year from a nationally representative sample of U.S. households about their health care use, expenses, access to services, health status, and the quality of the health care they obtained. MEPS is a unique government survey because of the degree of detail of the data, as well as the ability to link its data on health services spending and health insurance to demographic, employment, health status, and other characteristics of individuals and their families.

This AHRQ News and Numbers is based on Statistical Brief No. 108: Trends in Employer-Sponsored Health Insurance Plans that Required No Employee Contribution to the Premium Cost, 1998-2003, online at [PDF Help].

For more information on this AHRQ News and Numbers, or to speak with a MEPS data expert about the findings, E-mail Bob Isquith in AHRQ's Office of Communications and Knowledge Transfer at or call (301) 427-1539.


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