Employer Based Health Coverage

Healthy Workers and Employee Retention

Employers want healthy workers, and that providing them with the access and resources needed means to support good health, seek preventative care, treat illnesses and injuries, and take their prescribed medication. Health benefits that provide access to affordable care and medication are also powerful employee retention tools. This is why employer-based health insurance is foundational to American health care as well as our economy.​

There are at least 177 million Americans with employer-based health coverage, compared with 120 million with other coverage and 28 million uninsured.​

Employer-based health insurance can be either fully-insured or self-funded.

Fully-Insured Plans & Self-Funded Plans

Both fully-insured and self-funded plans are used by employers to support good health among employees and as a job recruitment and retention tool.

FULLY - INSURED PLANS

In a fully-insured health plan, the employer pays a premium to a health insurance company. The health insurance company administers the plan and assumes the risk for large claims.

• Potentially higher costs for employers
• Less risk to employers

SELF-FUNDED PLANS

In a self-funded health plan, an employer uses its own funds to provide health coverage. A self-funded plan can reduce costs to an employer, especially if employees are relatively healthy and do not use the plan benefits very much. It also assumes a level of risk for the employer. Of the 177 million Americans receiving employer-based health coverage, over 60% are on self-funded plans.

• Potentially lower costs for employers
• More risk for employers