Park CH; Association for Health Services Research. Meeting.
Abstr Book Assoc Health Serv Res Meet. 1997; 14: 46.
National Center for Health Statistics, Hyattsville, MD 20782, USA.
RESEARCH OBJECTIVES: To describe the extent of private sector establishments self-funding or self-insuring their health plans and employees enrolled in these plans by state and to examine state and establishment characteristics related to the prevalence of self-funded health insurance. STUDY DESIGN: Preliminary data from the National Employer Helath Insurance Survey (NEHIS) based on a samples of 34,604 private sector establishments are analyzed. The NEHIS is a survey of a nationally representative sample of all U.S. employers in each state in both the private and public sectors. Data on the provision of health insurance and employee coverage as well as establishment characteristics were colected retrospectively as of the end of 1993 from business owners and/or benefits managers through computer-assested telephone interviews. PRINCIPAL FINDINGS: About three and a quarter million (53 percent) private sector establishments in the U.S. offered health insurance to their employees in 1993. Of these, 22 percent self-insured at least one health plan, ranging from 8 percent in Hawaii to 34 percent in Louisiana. However, since larger companies are more likely than small companies to self-insure, the percentages of employees enrolled in self-insured health plans were higher - 40 percent for the nation, ranging from 10 percent in Hawaii to 65 percent in Mississippi. Most of the states with more than half of the workers enrolled in self-insured plans were in the South Census Division while states with less than quarter of the workers enrolled in self-insured plans were California, Rhode Island, Oregon, Washington, and Hawaii. Establishment characteristics that are strongly related to self-insurance were number of employees in the firm as a whole, whether the firm has establishments in multiple states or not, and the likelihood of offering HMO plans. CONCLUSIONS: Much variation exists among the states in the percent of employees covered by empolyer's self-funded health plans. Factors that explain such variation include distribution of small to large companies, presence of HMOs, employee wage levels, and state's health insurance related policy and mandates. RELEVANCE TO POLICY: Unlike fully-insured health plans that are subject to state laws, self-insured health plans are exempt from state premium taxation, regulation, and mandated benefits. The prevalence of self-insurance at state level has important implications to state health care reform efforts as state governments have little control over these plans and in ensuring adequate health care coverage for all persons within state. State-level data on self-insured health plans and thier characteristics will provide important information for state health policy makers.
Publication Types:
Keywords:
- California
- Data Collection
- Hawaii
- Health Care Reform
- Health Maintenance Organizations
- Insurance, Health
- Louisiana
- Mississippi
- Oregon
- Private Sector
- Public Sector
- Rhode Island
- Salaries and Fringe Benefits
- State Government
- Taxes
- United States
- Washington
- economics
- hsrmtgs
Other ID:
UI: 102233479
From Meeting Abstracts