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Employer-SponsoredHealth InsuranceState and National EstimatesFrom the CENTERS FOR DISEASE CONTROL AND PREVENTION/National Center for Health StatisticsU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Disease Control and PreventionNational Center for Health StatisticsCENTERS FOR DISEASE CONTROLAND PREVENTION

Copyright informationAll material in this report is in the public domain and may be reproduced orcopied without permission; citation as to source, however, is appreciated.Suggested citationNational Center for Health Statistics. Employer-sponsored health insurance:State and national estimates. Hyattsville, Maryland. 1997.Library of Congress Cataloging-in-Publication DataEmployer-sponsored health insurance : state and national estimates.p. cm. — (DHHS publication : no. (PHS) 98-1005).ISBN 0-8406-0539-01. Insurance, Health—United States. 2. Employees—UnitedStates—Insurance requirements. I. National Center for Health Statistics (U.S.)II. Title: Vital and health statistics III. 21CIPFor sale by the U.S. Government Printing OfficeSuperintendent of DocumentsMail Stop: SSOPWashington, DC 20402-9328

Employer-SponsoredHealth InsuranceState and National EstimatesU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Disease Control and PreventionNational Center for Health StatisticsHyattsville, MarylandDecember 1997DHHS Publication No. (PHS) 98-1017

National Center for Health StatisticsEdward J. Sondik, Ph.D., DirectorJack R. Anderson, Deputy DirectorJack R. Anderson, Acting Associate Director forInternational StatisticsLester R. Curtin, Ph.D., Acting Associate Director forResearch and MethodologyJacob J. Feldman, Ph.D., Associate Director for Analysis,Epidemiology, and Health PromotionGail F. Fisher, Ph.D., Associate Director for DataStandards, Program Development, and ExtramuralProgramsEdward L. Hunter, Associate Director for Planning,Budget, and LegislationJennifer H. Madans, Ph.D., Acting Associate Director forVital and Health Statistics SystemsStephen E. Nieberding, Associate Director forManagementCharles J. Rothwell, Associate Director for DataProcessing and ServicesDivision of Health Care StatisticsW. Edward Bacon, Ph.D., DirectorThomas McLemore, Deputy DirectorGail S. Poe, M.P.H., Special Assistant

ContentsWhich employees have healthinsurance available at theirjob? . . . . . . . . . . . . . . . . . . . . . 14Eligibility for and enrollment inemployer’s plan . . . . . . . . . . . . 15State variation in employeeseligible for and enrolling inemployer’s plan . . . . . . . . . . 17Acknowledgments . . . . . . . . . VIAbstract . . . . . . . . . . . . . . . . . . . . VIISelected highlights . . . . . . . .1Who offers healthinsurance? . . . . . . . . . . . . . . . . .1Who self-insures whenoffering healthinsurance? . . . . . . . . . . . . . . . . .2What choice and type ofplans are offered? . . . . . . . . . . .23Introduction . . . . . . . . . . . . . . .4Methods . . . . . . . . . . . . . . . . . . .5Data source andcollection . . . . . . . . . . . . . . . . . .Estimation . . . . . . . . . . . . . . . . .55Data reliability . . . . . . . . . . . . .5Who offers employersponsored healthinsurance? . . . . . . . . . . . . . . . . .Type of Industry . . . . . . . . .Corporate structure . . . . . . .Age of firm . . . . . . . . . . . . . .Number and location ofestablishments in firm . . . . .Workforcecharacteristics . . . . . . . . . . . .State . . . . . . . . . . . . . . . . . . . .Self-insurance amongemployer-sponsored healthplans . . . . . . . . . . . . . . . . . . . .Prevalence of self-insuranceby State . . . . . . . . . . . . . . . . .Types of health plans offeredby employers . . . . . . . . . . . .Health insurance eligibilityrequirements . . . . . . . . . . . . .Retirees . . . . . . . . . . . . . . . . .Employees . . . . . . . . . . . . . . .Availability of health insuranceto employees . . . . . . . . . . . . . . .3.4.References . . . . . . . . . . . . . . . . . 18Technical notes . . . . . . . . . . . . 37Who are eligible andenrolled? . . . . . . . . . . . . . . . . . .Results . . . . . . . . . . . . . . . . . . . . .2.Sample design . . . . . . . . . . . . .Estimation . . . . . . . . . . . . . . . . .Firm-size adjustment ofestimates . . . . . . . . . . . . . . . . . .Reliability of theestimates . . . . . . . . . . . . . . . . . .Estimation of standarderrors . . . . . . . . . . . . . . . . . . . . .Standard errorapproximations . . . . . . . . . . . . .3738436.434344Hypothesis testing . . . . . . . . . . 46Nonsampling error . . . . . . . . . 48Definitions . . . . . . . . . . . . . . . . . 496How to obtain thedata . . . . . . . . . . . . . . . . . . . . . . . . . 506889A.910B.1112131314147.8.9.Text tables9115.Number and percentdistribution of privateestablishments and percentoffering health insurance, andnumber and percentdistribution of employees andpercent of employees inestablishments offering healthinsurance by firm size: UnitedStates, 1993 . . . . . . . . . . . . . . 1Percent of workers coveredby employer-sponsoredhealth plans: United States,1993 . . . . . . . . . . . . . . . . . . . . 1510.11.12.13.Text figures1.Percent of establishmentsoffering health insurance,employees working inestablishments that offerinsurance, and all employeeseligible and enrolled: UnitedStates, 1993 . . . . . . . . . . . . . . 114.Percent of establishmentsoffering health insurance:United States, 1993 . . . . . . . 2Percent of establishmentswith major health plans thatself-insure at least one majorplan by firm size: UnitedStates, 1993 . . . . . . . . . . . . . . 2Percent distribution ofestablishments and employeeseligible by number of majorplans offered: United States,1993 . . . . . . . . . . . . . . . . . . . . 3Percent of establishments withmajor health plans by types ofplans offered and firm size:United States, 1993 . . . . . . . 3Percent of full-time andpart-time employees eligibleand enrolled in employer’shealth plan: United States,1993 . . . . . . . . . . . . . . . . . . . . 3Percent of establishmentsoffering health insurance byestablishment and firm size:United States, 1993 . . . . . . . 7Percent distribution ofestablishments by firm size:United States, 1993 . . . . . . . 7Percent of establishmentsoffering health insurance byindustry group: United States,1993 . . . . . . . . . . . . . . . . . . . . 8Percent of for profitestablishments offering healthinsurance by incorporatedstatus and firm size: UnitedStates, 1993 . . . . . . . . . . . . . . 8Percent of establishmentsoffering health insurance bynumber and location withinfirm and firm size: UnitedStates, 1993 . . . . . . . . . . . . . . 9Percent of establishmentsoffering health insurance byworkforce characteristics:United States, 1993 . . . . . . . 9Percent of establishmentsoffering health insurance byState and firm size: UnitedStates, 1993 . . . . . . . . . . . . . . 10Percent of establishments withmajor health plans thatself-insure at least one majorplan by location and firm size:United States, 1993 . . . . . . . 11iii

15.16.17.18.19.20.21.22.Firm-size adjusted percent ofestablishments with majorhealth plans that offered fullyor self-insured plans by State:United States, 1993 . . . . . . . 12Percent distribution ofestablishments with majorhealth plans by number ofplans offered and firm size:United States, 1993 . . . . . . . 12Percent of establishments withmajor health plans offeringconventional and managed careplans by age of firm:United States, 1993 . . . . . . . 13Percent of establishments withhealth insurance that offeredmanaged care plans:United States, 1993 . . . . . . . 13Percent of establishmentsoffering health insurance andemployees working inestablishments that offerinsurance by firm size:United States, 1993 . . . . . . . 15Percent of employees eligibleand enrolled in theiremployer’s health plan byindustry group: United States,1993 . . . . . . . . . . . . . . . . . . . . 16Percent of full-time andpart-time employees eligible andenrolled in their employer’shealth plan by firm size:United States, 1993 . . . . . . . . 16Percent of employees enrolledin their employer-sponsoredhealth insurance plan,1993 . . . . . . . . . . . . . . . . . . . . 174.5.6.7.8.9.Detailed tables1.2.3.ivPercent of privateestablishments offering healthinsurance by firm size,according to selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 19Percent distribution of privateestablishments by firm size,according to selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 20Percent of privateestablishments offering healthinsurance by firm size, adjustedby firm size and State:United States, 1993 . . . . . . . 2110.11.12.Percent distribution of privateestablishments by firm sizeand State: United States,1993 . . . . . . . . . . . . . . . . . . . . 22Number of privateestablishments, percent offeringhealth insurance, and percentwith other selectedcharacteristics by State:United States, 1993 . . . . . . . 23Number of privateestablishments offering 1 ormore major health plans, andpercent self-insuring at least1 plan by firm size andselected characteristics:United States, 1993 . . . . . . . 24Percent of privateestablishments offering 1 ormore major health plans thatself-insure at least 1 majorplan by firm size, adjusted byfirm size and State:United States, 1993 . . . . . . . 25Number of privateestablishments offering 1 ormore major health plans,percent of establishmentsoffering a choice of majorplans, and percent offering atype of plan by selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 26Number of privateestablishments offering 1 ormore major health plans,percent of establishmentsoffering a choice of majorplans, and percent offering atype of plan by State:United States, 1993 . . . . . . . 27Number of privateestablishments offering healthinsurance and percent offeringhealth insurance to retirees,according to selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 28Number of privateestablishments offering healthinsurance and percent withemployee requirements forhealth benefits eligibility,according to selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 29Percent of private sectoremployees working in13.14.15.16.17.18.establishments offering healthinsurance by firm size,according to selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 30Percent distribution of privatesector employees by firm size,according to selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 31Percent of private sectoremployees working inestablishments offering healthinsurance by firm size and State:United States, 1993 . . . . . . . . 32Percent distribution of privatesector employees by firm sizeand State: United States,1993 . . . . . . . . . . . . . . . . . . . . 33Number of private sectoremployees, and percent eligibleand enrolled in employer’splan by work schedule andselected establishmentcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 34Percent of private sectoremployees eligible foremployer’s health plan by firmsize and State: United States,1993 . . . . . . . . . . . . . . . . . . . . 35Percent of private sectoremployees enrolled inemployer’s health plan by firmsize and State: United States,1993 . . . . . . . . . . . . . . . . . . . . . 36Technical note figuresI.II.Standard errors forestablishment-relatedtotals . . . . . . . . . . . . . . . . . . . . 46Standard errors foremployee-related totals . . . . 46Technical note tablesI.II.III.Number of private establishments by firm size, according toselected characteristics:United States, 1993 . . . . . . . . 39Number of private establishments by firm size and State:United States, 1993. . . . . . . . 40Number of private sectoremployees by firm size,according to selectedcharacteristics: United States,1993 . . . . . . . . . . . . . . . . . . . . 41

IV.Number of private sectoremployees by firm size andState: United States,1993 . . . . . . . . . . . . . . . . . . . . 42V.Standard errors for firm sizeadjusted percent of privateestablishments offering healthinsurance, and for firm sizeadjusted percent ofestablishments that selfinsure when offering healthinsurance . . . . . . . . . . . . . . . . 44VI. Standard errors for averagewaiting days required for anemployee to be eligible forhealth insurance inestablishments with suchrequirement, according toselected characteristics: UnitedStates, 1993 . . . . . . . . . . . . . . 45VII. Coefficients for use in theapproximate standard errorequations for establishmentand employee estimates fromthe National Employer HealthInsurance Survey by type ofestimate: United States,1993 . . . . . . . . . . . . . . . . . . . . . 46VIII. Private sector establishment unitresponse rates by firm size andState: National Employer HealthInsurance Survey . . . . . . . . . 47IX. Private sector item responserates for selected establishmentvariables: National EmployerHealth Insurance Survey. . . 48v

AcknowledgmentsThe National Employer HealthInsurance Survey (NEHIS) wassponsored by the U.S. Department ofHealth and Human Services andconducted by the National Centerfor Health Statistics in partnershipwith the Agency for Health CarePolicy and Research and the HealthCare Financing Administration. Thisreport was prepared by the NCHSNEHIS team: (in alphabetical order)Karen Allen, Esther Hing,Christopher Moriarity, Abigail Moss,Christina Park, Gail Poe, and ArleneSiller. Other members of the teamwere James Massey, formerly withNCHS; and David Chapman andDale Sanders, Klemm AnalysisGroup. This report was edited byThelma Sanders, graphics and coverdesign by Patricia Vaughan, andtypeset by Zung Le of thePublications Branch, Division ofData Services.vi

AbstractObjectivesThis report examines theavailability of employer-sponsoredhealth insurance in the privatesector, coverage levels, characteristicsof coverage offered, andcharacteristics of employersassociated with whether coverage isoffered. National and State estimatesare presented. State-level findingsare presented to allow State healthpolicymakers to monitor Stateprograms as well as to compare theirstatus with other States.MethodsEstimates in this report are basedon the National Employer HealthInsurance Survey (NEHIS) conductedin 1994. NEHIS is the first federallysponsored survey designed toproduce State estimates ofemployer-sponsored healthinsurance. Data are based onresponses from 34,604 privateestablishments (business locations)obtained in computer-assistedtelephone interviews. Data on theprovision of health insurance andemployee coverage were collectedretrospectively as of the end of 1993.ResultsAt the end of 1993, 52 percent ofprivate sector establishmentssponsored group health insuranceand 58 percent of employeesparticipated in their health plans.Sponsorship of health insuranceincreased with the firm size ofestablishments and this relationshipheld true regardless of othercompany characteristics examined.Hawaii had the highest prevalenceof employer-sponsored healthinsurance in the Nation, measured interms of employers offering andemployees enrolled in healthinsurance. This finding is notsurprising since Hawaii is the onlyState with an employer mandate.National and State prevalence dataare presented on other related topicssuch as self-insurance, provision ofchoice in plans to employees,provision of indemnity comparedwith managed care plans, retireehealth benefits, and employeeeligibility requirements.Keywords:u National Employer Health InsuranceSurveyu Employee coverageu Private establishmentsu State estimatesvii

Selected highlightsWho offers healthinsurance?u At the end of 1993, 52 percent ofprivate sector establishmentsemploying 83 percent of all privateworkers offered health insurance totheir employees (table A). Of allprivate sector employees,68 percent were eligible for healthbenefits and 58 percentparticipated in theiremployer-sponsored health plans(figure 1).u Firm size was one of the mostimportant determinants of whethera business offered healthinsurance. One-third ofestablishments that belong to firmswith less than 10 employeesoffered health insurance comparedwith 96 percent of establishmentsin firms with 100 or moreemployees.u Hawaii’s employer sponsorship ofhealth insurance—86 percent ofestablishments offered healthinsurance and 75 percent ofworkers enrolled—far exceededthose of other States. These highrates coupled with the lowestself-insurance rate when offeringhealth insurance (7 percent) can beattributed to Hawaii’s employermandate, which was enacted in1974. The next highest was theDistrict of Columbia where66 percent of establishmentsoffered health insurance and69 percent of workers enrolled.Table A. Number and percent distribution of private establishments andpercent offering health insurance, and number and percent distributionof employees and percent of employees in establishments offering healthinsurance by firm size: United States, 1993Firm size2Private establishments1PercentofferingNumber ofPercenthealthestablishments distribution insuranceTotalPrivate employeesNumber ofemployeesPercent workingin establishmentsPercent that offer healthdistributioninsurance(United States) 6,276,800100.051.698,323,100100.083.1Less than 10 400500-9991,000 or more 8.699.31Establishments are defined as single business locations.2Number of employees nationwide as reported by respondent.NOTE: Estimates in this table are based on a December 31, 1993, reference period. Figures maynot add to totals because of rounding.SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics,National Employer Health Insurance Survey.Figure 1. Percent of establishments offering health insurance,employees working in establishments that offer insurance, andall employees eligible andenrolled: United States, Establishments58EmployeesSOURCE: Centers for Disease Control andPrevention, National Center for HealthStatistics, National Employer HealthInsurance Survey.1

u The percent of establishmentsoffering health insurance at theend of 1993 varied widely by State,ranging from 40 percent inMontana to 86 percent in Hawaii(figure 2). Most of the variationacross States occurred amongestablishments that belong to firmswith less than 50 employees.Figure 2. Percent of establishments offering health insurance:United States, 1993DCWho self-insures whenoffering health insurance?u Among establishments sponsoringhealth insurance, 21 percentself-insured at least one of thehealth plans offered (figure 3).While 6 percent of establishmentsthat belonged to firms with lessthan 100 employees self-insured,64 percent of establishments infirms with 100 or more employeesdid so.u The percent of establishments withhealth insurance that self-insuredvaried from 7 percent in Hawaii to34 percent in Louisiana.What choice and type ofplans are offered?u Four out of five establishmentsoffering health insurance sponsoredonly one health plan. Amongestablishments with healthinsurance, the percent offering twoor more plans increased with firmsize, 12 percent in establishmentswith firm size less than 50employees, and 33 percent inestablishments with firm size of 50or more employees.Percent(Number of States)60-66 (7)55-59 (6)50-54 (15)45-49 (14)40-44 (8)86 (Hawaii)SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics,National Employer Health Insurance Survey.Figure 3. Percent of establishments with major health plansthat self-insure at least one majorplan by firm size: United States,19938035216TotalLess 100-499 500 orthan 100moreFirm sizeSOURCE: Centers for Disease Control andPrevention, National Center for HealthStatistics, National Employer HealthInsurance Survey.2

u Although only 19 percent ofestablishments sponsoring healthinsurance offered a choice of twoor more plans to employees,43 percent of all private sectorworkers eligible for healthinsurance were in establishmentsthat offered a choice (figure 4).Twenty percent of eligibleemployees were in establishmentsoffering two health plans and23 percent were in establishmentsoffering three or more plans.u More than one-half (56 percent) ofestablishments sponsoring healthinsurance offered managed careplans; 26 percent offered a healthmaintenance organization (HMO),and 35 percent a preferredprovider organization (PPO) plan(figure 5).u Among establishments offeringhealth insurance, 70 percent of newbusinesses operating less than 2years offered a managed care planto employees, compared with55 percent of businesses operating25 years or more.u About one-half of establishmentssponsoring health insurance inHawaii, Massachusetts, andCalifornia offered HMO’s toemployees compared with lessthan 5 percent in Alaska andWyoming.Who are eligible andenrolled?u Among establishments sponsoringhealth insurance, 20 and 23 percentoffered health benefits, beyond theConsolidated Omnibus BudgetReconcilation Act of 1985 (COBRA)provisions, to retirees aged 65 orover and to retirees under 65 yearsof age.u In 74 percent of privateestablishments that offered healthinsurance in the United States,there was a requirement thatemployees work, on average, aminimum of 32 hours per week tobe eligible for health benefits.Figure 4. Percent distribution of establishments and employees eligible bynumber of major plans offered: United States, 1993Establishments withmajor health plans613Number of major plans123 or moreEmployees eligible23572081SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics,National Employer Health Insurance Survey.Figure 5. Percent of establishments with major health plans by types ofplans offered and firm size: United States, 1993Fee for service52Health maintenanceorganizationPreferred providerorganization52514235Total32322623Less than 50Firm size50 or moreSOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics,National Employer Health Insurance Survey.u Although 82 percent of full-timeemployees were eligible for healthbenefits in the United States, only18 percent of part-time employeeswere eligible (figure 6). Also,71 percent of full-time workers and10 percent of part-time workersenrolled in their employersponsored plan.u The percent of employees eligibleand participating in theiremployer-sponsored health plansranged from 52 and 41 percent inMontana to 83 and 75 percent inHawaii.Figure 6. Percent of full-time andpart-time employees eligible andenrolled in employer's healthplan: United States, CE: Centers for Disease Control andPrevention, National Center for HealthStatistics, National Employer HealthInsurance Survey.3

IntroductionEmployer-sponsored healthinsurance is a major source ofprivate health care coverage in theUnited States. In 1993, 69 percentof workers acquired healthinsurance through employers.However, not all workers havehealth insurance coverage throughtheir job. In 1993 almost two-thirdsof the 41 million persons withouthealth insurance of any kind werein families headed by workers;56 percent of the uninsured wereworking adults (1).Since comprehensive reform hasnot been enacted at the Federallevel, focus has shifted to health carereform efforts by the States andprivate markets. As of 1995, 45States passed legislation regulatingthe small-employer health insurancemarket and 44 States includedpremium rate restrictions as part ofreforms (2). Almost all reformsincluded portability of healthinsurance and preexisting conditionlimitations. Since passage of the 1996Health Care Portability andAccountability Act,1 such reformsapply to all States (3). Other Statelevel efforts include State-subsidizedinsurance to poor individuals andfamilies not eligible for Medicaid ormoving Medicaid beneficiaries intomanaged care plans and makingthese plans available to theuninsured (4).States are hampered inimplementing reforms by the lackof adequate State-specific data onsmall group markets formonitoring change and assessingimpacts of specific health reforms(5). State policymakers have notbeen able to easily identify which1Most uninsured workers will not beaffected by the Health Care Portability andAccountability Act of 1996. This recentlyenacted legislation guarantees healthinsurance coverage for workers who switchjobs or have preexisting conditions. Accordingto a recent study, only 1 percent of adultswithout health insurance are uninsuredbecause of preexisting conditions (3).4workers are without healthinsurance coverage (6).During the development of the1993 Health Security Act, majorinformation gaps onemployer-sponsored healthinsurance were identified by thePresident’s Task Force on HealthCare Reform. The NationalEmployer Health Insurance Survey(NEHIS) was developed to providepreviously unavailable data forpolicymakers and researchers to usein developing and evaluatingalternative health care policies. Themajor objectives of NEHIS were tomeasure State and national levels ofhealth insurance spending byemployers, to describe and toprovide baseline data for monitoringtrends in the employment-basedhealth insurance system, and toprovide data for input in prospectivepolicy analysis of the effects ofhealth care reform.This report focuses only on theprivate sector. NEHIS found that99 percent of public employees hadhealth insurance available at theirjobs compared to only 83 percent inthe private sector. In addition, recentlegislation particularly at the Statelevel, was designed to correctproblems with the small-grouphealth insurance market (2).Subsequent reports will presentinformation on all employers, publicand private.This report seeks to fill gaps inemployer health insurance data bypresenting previously unavailableState and national estimates ofprivate employers offering healthinsurance to employees, as well asestimates of employees covered bythese plans. The NEHIS data add toinformation presented from anemployer survey in 10 States(Colorado, Florida, Minnesota, NewMexico, New York, North Dakota,Oklahoma, Oregon, Vermont, andWashington) commissioned by theRobert Wood Johnson Foundation(RWJF) in 1993 (7). Most other majoremployer surveys, such as theBureau of Labor Statistics EmployeeBenefit Survey and commercialsurveys of employer healthinsurance, were not designed toproduce State estimates and did notcollect information from employerswho did not offer health insurance.The report examines whichprivate employers offered healthinsurance and which workers haveemployment-based health insurancecoverage. The process by whichemployees obtain health insurancecoverage on the job depends first onwhether their employer offers healthbenefits, secondly on whether anemployee is eligible for healthbenefits, and finally on whether theemployee participates in theemployer-sponsored plan. In orderto examine this process, this reportis organized in sections that roughlymirror this process. The first sectionfocuses on which private businessesoffer health insurance to employees.This section also examines Statevariations in establishments offeringhealth insurance; the prevalence ofself-insurance among establishmentsoffering insurance, includingprevalence of self-insurance byState; and the choice and types ofplans offered by employers. Thesecond section addressesconstraints employers put onemployee coverage. The lastsection examines the availability ofjob-based health insurance toemployees working inestablishments offering healthinsurance, including employeeeligibility and enrollment at thenational and State levels.This report is the first in a seriesof publications planned for releasingthe NEHIS data. Future reportsbased on NEHIS, in addition toproviding information on the publicsector, will compare characteristics ofhealth insurance plans offered bydifferent types of employers such aslarge compared with smallbusinesses. Plan characteristics willinclude premiums and employeecontributions, deductibles,coinsurance, and coveredservices.

MethodsData source and collectionNEHIS surveyed a probabilitysample of all U.S. employers in eachState in the private and public sectors.The sampling unit was theestablishment, defined as ‘‘aneconomic unit, generally at a singlephysical location, where business isconducted or where services orindustrial operations are performed’’(8). A major reason that establishmentsrather than firms (that is, a businessorganization or entity consisting ofone domestic establishment or moreunder common ownership or control)were sampled in NEHIS is thatestablishments are confined withinState borders, enabling State estimates.Three sample frames were usedto ensure coverage of all types ofemployers. The Dun’s MarketIdentifiers file2 was used to sampleprivate establishments, the Census ofGovernments file, maintained by theBureau of Census, was used forpublic sector entities, and theNational Health Interview Surveysample was used to selectself-employed individuals with noemployees (SENE’s). The privatesector establishments were sampled,stratified by State, and then by across-classification of firm andestablishment size.Data were collected by Westat,Inc., from April to December 1994.The primary mode of data collectionwas computer-assisted telephoneinterviews (CATI). Interviews wereconducted with respondentsidentified during prescreening as themost knowledgeable about healthbenefits. Approximately 39,000employers completed interviews. Ofthese, 34,604 interviews wereobtained from private sectorestablishments excluding SENE’s ata response rate of 71 percent, whichserved as the population basis ofthis report.2A national census of employmentestablishme

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Employer Health Insurance Survey. Less than 10 10-24 25-99 100-499 500-999 1,000 or more Total (United States) 6,276,800 3,914,400 870,800 596,400 313,400 93,400 488,400 Number of establishments Firm size2 Number of employees Percent distribution .File Size: 804KBPage Count: 60