Enrollment in Health Insurance Plans Fully Paid by Employers
- Presenter:
Chair: David Bradford; Discussant: David Bradford Wed June 7, 2006 8:00-9:30 Room 213
Rationale: In 2003, 44% of establishments in the U.S. offered at least one health insurance plan that required no contribution from the employee for single coverage. However, not all eligible employees enrolled in these plans. Some eligible employees might want family coverage, while only single coverage is fully paid, or perhaps these plans are unattractive.
Objective: The objective of this study is to examine health insurance enrollment in establishments that pay 100% for at least one plan and to study the plans that employees were enrolled in.
Methodology: We analyze data from the 1997-2003 MEPS-IC (Medical Expenditure Panel Survey - Insurance Component), which surveyed a nationally representative sample of establishments about health insurance plans offered to employees. Data includes premiums, contributions by employers and employees, and benefit characteristics. The MEPS-IC also provides information on employer characteristics (e.g., size, ownership, and industry) and workforce characteristics (e.g., percent female, unionization, and wages).
Bivariate analysis is used to look at the percent enrolled at both the establishment and plan level. We look at employers offering only one plan and more than one plan, further subsampled into those that paid 100% of the premium cost and those that did not.
To help explain why all eligible employees do not enroll in fully paid plans, we will compare enrollment in plans where single coverage is fully paid, but family coverage is not, and enrollment in plans with both single and family coverage fully paid. This will help identify whether eligible employees may not be enrolling in fully paid single coverage plans because they want family coverage.
To examine the impact of a plan’s attractiveness on enrollment in fully paid plans and those that are not, we compare their characteristics. We focus on attributes that might make a plan more attractive to some employees, such as provider choice, coverage for pre-existing conditions, and no gatekeeper. Multivariate analysis will also be done to explain the impact of multiple dimensions of attractiveness on enrollment and compare the plans paid 100% with those that are not. Here we will focus only on plans from establishments offering more than one plan, in order to control for workforce characteristics.
Results: In 2003, only 87% of eligible employees in establishments that offered only one plan, with fully paid single coverage, enrolled in the plan. At the same time, only 33% of eligible employees in establishments that offered more than one plan enrolled in plans that had fully paid single coverage. Plans that were paid 100 percent by employers generally had gatekeepers, did not cover pre-existing conditions or outpatient prescriptions, and had the highest out-of-pocket expense limits.
Conclusions: Preliminary results indicate that some eligible employees may not be enrolling in fully paid health plans because the plans are not attractive to them. Further analysis will be done to examine whether employees do not opt for plans with fully paid single coverage because they want family coverage.
