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Where Americans Work Affects Their Health Insurance Plan Price Tag

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AHRQ News and Numbers

Release date: June 21, 2006

A new analysis by the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) revealed that workers in North Dakota with family coverage had average premiums for employer-sponsored health insurance plans that cost nearly $3,000 less than those of workers in the District of Columbia. This is just one example of how the economics of health insurance vary widely from State to State.

AHRQ's Medical Expenditure Panel Survey (MEPS) of employers found that:

  • In 2003, the national average for family coverage premiums of employer-sponsored health insurance plans was $9,249. The average premium for family coverage for workers in North Dakota was only $7,866—the lowest in the United States—while that for workers in the District of Columbia was the highest at $10,748.
  • The national average for single coverage premiums for employer-offered health insurance was $3,481.
  • In every State, more than 90 percent of employees in large firms worked where health insurance was offered. There was much more variation by State in small-firm offers.

MEPS also looked at State-by-State differences in what workers paid out of pocket for their health insurance premiums. The data show that:

  • Workers in Nebraska made the highest average contributions for single coverage ($875), while those in Hawaii made the lowest ($251).
  • Thirty-six States had average employee single-coverage contributions that did not differ from the national average of $606.
  • Of all employees working for small firms, those in Louisiana contributed the most to family coverage ($3,713), while those in West Virginia contributed the least ($1,153).
  • Among large firms, employees in Maine contributed the most ($2,853), while those in West Virginia contributed the least ($1,630).

For further findings, go to MEPS Chartbook No. 15: State Differences in Employer-Sponsored Health Insurance, 2003 at

For more information, or to arrange an interview with a MEPS researcher about the findings, please contact Bob Isquith at or call (301) 427-1539.


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