Contributions to Health Insurance Premiums: 

When Does the Employer Pay 100 Percent? 

Alice M. Zawacki and Amy K. Taylor 

January 2005 

ABSTRACT

We identify the characteristics of establishments that paid 100 percent of health insurance 

premiums and the policies they offered from 1997-2001, despite increased premium

costs. Analyzing data from the MEPS-IC, we see little change in the percent of

establishments that paid the full cost of premiums for employees. Most of these 

establishments were young, small, single-units, with a relatively high paid workforce. 

Plans that were fully paid generally required referrals to see specialists, did not cover preexisting conditions or outpatient prescriptions, and had the highest out-of-pocket expense 

limits. These plans also were more likely than plans not fully paid by employers to have 

had a fee-for-service or exclusive provider arrangement, had the highest premiums, and 

were less likely to be self-insured. 

Alice M. Zawacki 

Economist 

U.S. Census Bureau 

Center for Economic Studies 

4700 Silver Hill Road, Stop 6300 

Washington, DC 20233-6300 

Alice.M.Zawacki@census.gov

Amy K. Taylor 

Senior Economist 

Division of Social and Economic Research 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 

E-mail: ataylor@ahrq.gov 

2 
INTRODUCTION 

While the health care sector experienced low inflation during the mid-1990s, in 

2001 health care spending per capita rose 10 percent, which represented the largest 

increase in a decade.1 These rising medical care costs are associated with an increase in

health insurance premiums.

2

 Higher insurance costs create budgetary concerns for 

employers, since health insurance benefits represent such a large component of employee 

compensation. 

Employers are the major source of health insurance in this country, and they often 

try to pass some of the increased insurance costs on to employees through higher 

copayments, coinsurance, and deductibles3

 and/or higher employee contributions for 

health insurance premiums.

4

 Employer contribution levels vary across firms, and tight 

labor markets, unionization, and political pressures have often influenced the share of 

premiums paid by employers and employees.5

 The exclusion of employer paid health 

insurance from employee taxable income is another factor that influences employer 

contributions to health insurance premiums.6

 This paper will examine those 

establishments that continued to pay 100 percent of health insurance premiums for their 

employees, despite increased medical care and insurance costs. Research has shown that 

workers are more sensitive to out-of-pocket than total health insurance premiums,7

 so that 

100 percent payment by employers would be particularly valued. While employee 

contributions are rising8

 and although economists debate the share of employer paid 

premiums that are ultimately shifted back to workers in the form of reduced wages, the 

goal of this analysis is to identify the characteristics of those establishments that paid 100 

percent of health insurance premiums and the policies they offered. 

3 
We analyze data from 1997 through 2001 from the Medical Expenditure Panel 

Survey – Insurance Component (MEPS-IC), which collects establishment level data on 

the health insurance plans offered to employees, as well as establishment and workforce 

characteristics. We focus on establishments that offered health insurance and contributed 

100 percent of the premium cost for at least one of the plans they offered. This paper 

begins by looking at the percent of establishments in the United States that offered health 

insurance at no cost to their employees for the period 1997 through 2001. Next, we 

describe the characteristics of those establishments that contributed 100 percent of the 

premium cost for employees. Finally, we examine the characteristics of plans with 

premiums entirely paid by employers and compare these to the characteristics of plans 

not fully paid by the employers. 

DATA AND METHODS 

The Medical Expenditure Panel Survey (MEPS) Insurance Component (IC) is a 

survey of employers that is done annually, and covers state and local governmental units 

as well private-sector establishments. It is sponsored by the Agency for Healthcare 

Research and Quality and is conducted by the U.S. Census Bureau. First conducted in 

1996, the MEPS – IC provides estimates of employer-sponsored insurance at both the 

national and the State level for 40 states in any given year. 

In this survey establishment refers to a particular workplace or location, while a 

firm is a business entity consisting of one or more business establishments under 

common ownership or control.9

 Because the unit of analysis in the MEPS – IC is the

establishment, the analysis in this paper is establishment-based. In addition, laws that

4 
regulate health insurance vary by state and this can result in establishments within the 

same firm offering different benefits. In fact we find that establishments within the same

firm do not always make the same level of contributions. The MEPS – IC provides data 

on employer characteristics, including measures for establishment size, establishment 

ownership type, industry, location, and the age of the firm. Information on the percent of 

the workforce that is female, over the age of 50, unionized, and earning low/medium/high 

wages is also included. 

Each establishment or reporting unit in the MEPS – IC provides information 

about the health insurance plans they offer. These plans represent insurance contracts 

that provide coverage for health care services to an employee and/or retiree for an agreedupon fee (premium) for a defined benefit period. Some plans have self-insured 

indemnification, which means that the employer is assuming the risk for the employees’ 

medical expenses. This is in contrast to purchased plans in which the health insurance 

company assumes the financial risk for the enrollee’s medical claims.

10 Some plans may 

offer single coverage that only covers the employee. When the employee and the 

employee’s family are covered, the plan is said to offer family coverage.

11 The MEPS – 

IC collects data on premiums for single and family coverage, contributions by employers 

and employees, provider type, plan enrollment, deductibles, and copayments. 

For this analysis, we used the MEPS – IC data on private-sector establishments 

from 1997 to 2001. The sample size was between 25,000 and 30,000 units for each of the 

five years. The estimates were weighted to be nationally representative, and tests of 

statistical significance accounted for the survey design of the MEPS – IC. All differences 

discussed in this article were statistically significant at the .05 level. 

5 
RESULTS 

Employer – Sponsored Health Insurance: Establishments. We begin by looking at 

the percent of establishments that paid the full premium cost for either single coverage 

and/or family coverage. We separated establishments into those that offered only one 

health insurance plan and those that offered more than one plan. As Figure 1 shows, both 

types of establishments were significantly more likely to pay 100 percent for single 

coverage than for family coverage. We also see that the percent of establishments paying 

the full cost changed very little from 1997 to 2001. 

It is important to keep in mind here that the distribution of establishments is not 

the same as the distribution of workers. Because many establishments are single-units 

and small in terms of the number of persons employed, the health benefit decisions made 

by these employers impact a small percentage of the workforce. For example, in 1997 

almost 60 percent of establishments that offered one plan paid 100 percent of the 

premium cost for single coverage, but only 40 percent of employees at these 

establishments had fully paid single coverage plans (data not shown).12 Similar to 

findings for establishments, a significantly higher percentage of workers in all years 

(1997 through 2001) had premiums fully paid by employers for single coverage than for 

family coverage (data not shown).13 

Next, we describe the characteristics of the establishments that paid 100 percent 

of premium costs. First, organizational characteristics of employers, including size, nonprofit status, industry, location of the establishment and age of the firm, were examined. 

6 
Second, we focused on characteristics of the establishment’s workforce, including the 

percent of workers that were low wage earners, part-time workers, and unionized. 

Figure 2 shows that while larger establishments were more likely to offer

insurance, smaller establishments were more likely to pay the full premium cost for 

single and for family coverage if they offered health insurance at all. We found that 

single-unit establishments were also more likely to pay 100 percent than multi-unit 

establishments (data not shown).14 The percent of establishments that paid 100 percent 

by establishment characteristics for 1997 through 2001 is shown in Table 1. 

Establishments that are part of firms operating for less than 5 years were significantly 

more likely to pay 100 percent for at least one plan than establishments in firms 

operating for more than 20 years. We also found that nonprofit establishments were 

more likely than for-profit establishments to pay 100 percent of the premium cost for at 

least one plan. 

It is also interesting to look at the characteristics of the workforce in 

establishments paying the full premium cost of health insurance for their employees 

(Table 1). Establishments with 50 percent or more of their workforce earning a low wage 

were significantly less likely to pay 100 percent for at least one plan than establishments 

with a higher paid workforce. Low wages were defined in the MEPS – IC as less than 

$6.50 per hour in 1997 through 1999 and less than $9.50 per hour in 2000 and 2001. 

Establishments with a higher percentage of part-time workers were less likely to pay 100 

percent for family coverage. Finally, in establishments that offered more than one plan, 

those that were more unionized were more likely to pay 100 percent of the premiums for 

7 
both single and family coverage than establishments with less than 25 percent of their 

employees belonging to a union. 

Establishments in the agriculture/fishing/forestry and construction industries were 

less likely to offer insurance than those in other industries (data not shown).15 

Establishments in these industries, however, were more likely to pay 100 percent when 

they did offer insurance. This was true for both single and family coverage. 

Establishments in the retail industry were least likely to pay 100 percent for single or 

family coverage. We found that establishments in the retail and financial industries that 

offered more than one plan were less likely to pay 100 percent for health insurance than 

establishments in other industries. 

The percent of establishments that paid 100 percent of health insurance premiums

also varied by location (data not shown).16 Establishments in the south were less likely 

than those in than other regions to have paid 100 percent for single or family coverage, 

whether the establishment offered one plan or more than one plan. Establishments in the 

west that offered one plan with single coverage were significantly more likely to pay 100 

percent than establishments in other regions. Establishments located in the northeast, 

which offered only one plan, were significantly more likely to pay 100 percent for family 

coverage than those in the rest of the U.S. 

Employer – Sponsored Health Insurance: Plans 

The previous section looked at establishments that offered health insurance and 

paid 100 percent of the premiums for at least some of the plans that they offered. We

now look at the characteristics of the plans that were fully paid by employers. These 

8 
characteristics included the plan’s provider type arrangement, whether referrals were 

required, self-insured indemnification, coverage for pre-existing conditions, coverage for 

outpatient prescriptions, premiums, and out-of-pocket expenses. 

 This analysis considered three different types of plans characterized by provider 

type arrangements17 as identified in the MEPS – IC survey. The first category of plans 

included health maintenance organizations (HMO), independent physicians associations 

(IPA), and exclusive provider organizations (EPO). This type of plan required that 

enrollees go to providers associated with the plan for all non-emergency care in order for 

the costs to be covered. The second category of provider arrangements included most 

fee-for-service plans. If enrollees may go to providers of their choice with no cost 

incentives to use a particular group of providers, this was considered a plan with any 

provider. Preferred provider organizations (PPO) and point-of-service plans fell into the 

third category, which was a mixture of preferred and any provider. 

Figure 3 shows provider type by employer contributions for single coverage in 

2001. The findings are very similar for family coverage. The majority of plans offered at 

establishments providing health insurance had a mixed provider type arrangement. 

However, fully paid plans were more likely to have exclusive provider or any provider 

arrangements than plans which were not paid 100 percent. 

Table 2 shows health plan characteristics by employer contributions for 2001. 

First, we looked at premiums for single and family coverage, which were categorized as 

low, medium, or high. Premiums in the low category were greater than $0 and less than 

or equal to $2000 for single coverage and greater than $0 and less than or equal to $5000 

for family coverage. Premiums in the middle category fell between $2000 and $5000 for 

9 
single coverage and $5000 and $10,000 for family coverage. Premiums in the high 

category were greater than $5000 for single coverage and greater than $10,000 for family 

coverage. We found that all plans that were paid 100 percent were more likely to have 

premiums in the highest group. 

Table 2 also shows that plans that were fully paid by employers were less likely to 

be self-insured. Next, we looked at whether plans required a referral to see a specialist. 

Plans that were paid 100 percent by the employer were more likely to require referrals to 

see a specialist than plans that were not fully paid. 

 We then looked at whether plans covered pre-existing conditions or outpatient 

prescriptions. Some health insurance plans restrict coverage for medical or health 

conditions which exist prior to enrollment in the plan.18 Plans that were paid 100 percent 

were less likely to cover pre-existing conditions than plans requiring employee 

contributions towards premiums, except for fully paid family plans offered by 

establishments offering more than one plan. Plans with either single or family coverage 

that were paid 100 percent at establishments offering only one plan were less likely to 

cover outpatient prescriptions than other plans. 

Finally, we looked at maximum annual out-of-pocket expenses for the health 

insurance plans. Annual limits on these expenses were categorized as low, medium, or 

high. Maximum expense limits that were greater than zero and less than $1000 were 

categorized as low. If these expense limits were more than $1000 and less than or equal 

to $5000, they were grouped in the medium category. The high category included 

maximums that were greater than $5000. Fully paid plans were more likely to be in the 

highest category than other plans. 

10 
DISCUSSION/SUMMARY 

 

Today’s headlines reflect concerns over rising health care costs, employers’ 

struggles with containing the growing cost of health insurance premiums, and the number 

of working Americans without health insurance. Despite these concerns many employers 

continued to pay the full cost of health insurance for their employees from 1997 to 2001. 

We found that the provision of employer-sponsored health insurance at no cost to 

employees varied according to specific organizational, workforce, and plan 

characteristics. Most of these establishments that paid 100 percent of premium costs for 

their employees were young, small, single-units, with a higher paid workforce. Across 

plans at all establishments offering one or more plan, those that were fully paid were 

more likely than plans not fully paid by employers to have a fee-for-service or any 

provider arrangement, had the highest premiums, and were less likely to be self-insured. 

Plans that were fully paid by employers tended to be less generous in terms of benefits. 

Plans that were paid 100 percent by employers generally required referrals to see 

specialists, did not cover pre-existing conditions or outpatient prescriptions, and had the 

highest out-of-pocket expense limits. 

Finding that small establishments were more likely to pay 100 percent of 

premium costs for at least one health plan and that fully paid plans were more likely to 

have the highest premium costs may relate to insurers’ and employers’ worries regarding 

adverse selection. Insurers charge higher premiums for plans with a low percentage of 

the workforce enrolled, because they are concerned that only the sickest employees with 

the highest health care costs are participating in the plan.19 Small establishments, 

11 
therefore, may encourage enrollment by fully contributing towards the cost of the plan in 

order to lower premium costs. Paying the full cost of an employee’s insurance premiums

provides an incentive to participate in the firm’s health insurance plan. Researchers have 

shown that employee cost sharing affects enrollment in health plans. 20 Further, small 

establishments might not have a choice because some insurers require that all workers be 

covered as a condition of offering insurance at all.21 In addition, state laws relating to the 

sale of small employer health insurance policies sometimes allow insurers to establish 

employer contribution rules in order to meet minimum participation requirements.22

We have seen that the percent of establishments that paid the full cost of health 

insurance premiums for employees changed very little between 1997 and 2001. As 

health care costs inevitably rise in the future, it will be interesting to see if this behavior

continues. In future research, we also will be pursuing the issue of what is happening to 

the characteristics of fully paid health insurance plans and the impact of state laws 

regulating the market for small employer health insurance. We will continue to monitor 

the benefits to employees and see whether health insurance is becoming more costly in

terms of higher copayments, coinsurance, and deductibles when employers pay 100 

percent of the premium cost. 

12 
Table 1. Percent of Establishments that Pay 100 Percent by 

Establishment Characteristics (2001)

% of Estabs 

Offering 1 

Plan that Pay 

100% for 

Single 

Coverage 

% of Estabs 

Offering 1 

Plan that Pay 

100% for 

Family 

Coverage 

% of Estabs 

Offering >1 

Plan that Pay 

100% for 

Single 

Coverage for 

at Least 1 Plan 

% of Estabs 

Offering >1 

Plan that 

Pay 100% 

for Family 

Coverage 

for at Least 

1 Plan 

Age of firm

 < 5 years 

 5-9 years 

 10-20 years 

 > 20 years 

61 

58 

59 

53 

45 

44 

42 

35 

56 

55 

55 

36 

36 

33 

33 

22 

Non-profit status 

 Non-profit 

 For profit 

63 

53 

42 

36 

49 

32 

28 

19 

Low wage earners 

 > 50% of workforce 

 < 50% of workforce 

46 

61 

33 

41 

26 

47 

15 

28 

Part-time workers 

 > 50% of workforce 

 < 50% of workforce 

49 

55 

37 

36 

21 

36 

14 

21 

Union 

 > 25% of workforce 

 <25% of workforce 

65 

54 

54 

36 

60 

32 

48 

17 

Source: Medical Expenditure Panel Survey-Insurance Component (List Sample), 

sponsored by the Agency for Healthcare Research and Quality. 

13 
Table 2. Health Plan Characteristics by Employer Contributions (2001)

One Plan More Than One Plan 

Single Coverage Family Coverage Single Coverage Family Co

Emplo

yer 

Payin

g 

100% 

Employer 

Not 

Paying 

100% 

Employer 

Paying 

100% 

Employer 

Not 

Paying 

100% 

Employer 

Paying 

100% 

Employer 

Not 

Paying 

100% 

Employer 

Paying 

100% 

E

N

Percent of Plans 

Premiums Low  Medium High 

18 

72* 10* 

18 76 

6 

17* 63* 20* 

14 70 16 

16 

75* 

9* 

15 82 

3 

12 

72* 16* 

Self-insured 13* 29 13* 27 33* 53 38* Referral not required 53* 57 53* 58 46* 56 45* Cover pre-existing conditions 

54* 60 54* 60 69* 74 71 

Cover outpatient Rx 93* 96 93* 96 95 96 95 Maximum out-of-pocket expenses  Low  Medium High 

25 

38* 37* 

27 41 32 

10* 39* 51* 

7 

49 44 

21 

39* 

40 

18 44 38 

5 

36* 59* 

* Difference between employer paying 100 percent and not paying 100 percent is significant at the .05 level Source: Medical Expenditure Panel Survey-Insurance Component (List Sample), sponsored by the Agency for HResearch and Quality. 

 14 
Figure 1. Percent of Establishments that Pay

100% of Premium for at Least One Plan

0

10

20

30

40

50

60

70

1997 1998 1999 2000 2001

Percent of Establishments

% of Estabs Offering 1 Plan that

Pay 100% for Single Coverage

% of Estabs Offering 1 Plan that

Pay 100% for Family Coverage

% of Estabs Offering >1 Plan

that Pay 100% for Single

Coverage for at Least 1 Plan

% of Estabs Offering >1 Plan

that Pay 100% for Family

Coverage for at Least 1 Plan

Source: Medical Expenditure Panel Survey-Insurance Component (List Sample), sponsored by the 

Agency for Healthcare Research and Quality.

Figure 2. Percent of Establishments that 

Pay 100% by Size (2001)

0

20

40

60

80

100

120

<10 10-24 25-99 100-999 >1000

Number of Employees

P e r cen t o f E s ta b lis h m e n t

% s of Estabs Offering Health Insurance

with Single Coverage

% of Estabs Offering 1 Plan that Pay

100% for Single Coverage

% of Estabs Offering >1 Plan that Pay

100% for Single Coverage for at Least 1

Plan

0

20

40

60

80

100

120

<10 10-24 25-99 100-999 >1000 

Number of Employees

P e r cen t o f E s t a b l i s h m e n t s

% of Estabs Offering Health Insurance with Family

Coverage

% of Establishments Offering 1 Plan that Pay 100%

for Family Coverage

% of Establishments Offering >1 Plan that Pay 100%

for Family Coverage for at Least 1 Plan

Source: Medical Expenditure Panel Survey-Insurance Component (List Sample), sponsored by the Agency for 

Healthcare Research and Quality.

15 
Figure 3. Provider Type by Employer 

Contributions for Single Coverage (2001)

% of Plans from Estabs Offering 1 Plan and Employer is Paying

100% for Single Coverage

31%

15%

54%

Exclusive Provider

Any Provider

Mixed Provider

% of Plans from Estabs Offering 1 Plan and Employer not Paying

100% for Single Coverage

28%

9% 63%

Exclusive Provider

Any Provider

Mixed Provider

% of Plans from Estabs Offering >1 Plan and Employer is not Paying

100% for Single Coverage for Any Plan

36%

10%

54%

Exclusive Provider

Any Provider

Mixed Provider

100% Not 100%

% of Plans from Estabs Offering >1 Plan and Employer is Paying 100% for Single Coverage for at

Least 1 Plan

38%

17%

Exclusiv e Provider 45%

Any Provider

M ixed Prov ide r

Source: Medical Expenditure Panel Survey-Insurance Component (List Sample), sponsored by the Agency for Healthcare

Research and Quality.

16 
NOTES

 

1

 Strunk, B.C., P.B. Ginsburg, J.R. Gabel, “Tracking Health Care Costs: Growth Accelerates Again in 

2001,” Health Affairs Web Exclusives (2002): W299. 2

 Gabel, J., L. Levitt, J. Pickreign, H. Whitmore, E. Holve, D. Rowland, K. Dhont, S. Hawkins, “Job-Based 

Health Insurance in 2001: Inflation Hits Double Digits, Managed Care Retreats,” Health Affairs 20 (2001): 

180-186. 

3

 Robinson, J.C., “Renewed Emphasis on Consumer Cost Sharing In Health Insurance Benefit Design,” 

Health Affairs Web Exclusive (2002): W139-W154. Trude, S., J.B. Christianson, C.S. Lesser, C. Watts, 

A.M. Benoit, “Employer-Sponsored Health Insurance: Pressing Problems, Incremental Changes,” Health 

Affairs 21 (2002): 66-75. Marquis M.S. and S.H. Long, “Prevalence of Selected Employer Health 

Insurance Purchasing Strategies in 1997,” Health Affairs 20 (2001a): 220-230. 4

 Schiff, M., M. Schuster, S. Bachman, A. Lischko, “Employee Input and Health Care Cost-Containment 

Strategies,” Managed Care Interface (2003): 20-24. Gabel, J., L. Levitt, E. Holve, J. Pickreign, H. 

Whitmore, K. Dhont, S. Hawkins, D. Rowland, “Job-Based Health Benefits in 2002: Some Important 

Trends,” Health Affairs 21: (2002): 143-151. Gabel, J., G. Claxton, E. Holve, J. Pickreign, H. Whitmore, 

K. Dhont, S. Hawkins, D. Rowland, “Health Benefits in 2003: Premiums Reach Thirteen-Year High as 

Employers Adopt New Forms of Cost Sharing,” Health Affairs 22: (2003): 117. 5

 Buchmueller, J.C., J. DiNardo, R.G. Valletta, “Union Effects on Health Insurance Provision and 

Coverage in the United States,” Industrial and Labor Relations Review 55 (2002): 610-627. Montagne, C, 

“Bargaining Health Benefits in the Workplace: An Inside View,” The Milbank Quarterly 80 (2002): 547-

567. Marquis M.S. and S.H. Long, “Employer Health Insurance and Local Labor Market Conditions,” 

International Journal of Health Care Finance and Economics 1 (2001b): 273-292. Rossiter, L.F. and A.K. 

Taylor, “Union Effects on the Provision of Health Insurance,” Industrial Relations 21 (1982): 167-177. 6

 Taylor, A.K. and G.R. Wilensky, “The Effect of Tax Policy on Expenditures for Private Health 

Insurance,” Market Reform and Health Care: Current Issues, New Directions and Strategic Decisions, Jack 

Myer, Editor. American Enterprise Institute, 1983.

7

 Cooper, P. and J. Vistnes, “Workers’ Decisions to Take-Up Offered Health Insurance Coverage: 

Assessing the Importance of Out-of-Pocket Premium Costs,” Medical Care Vol. 41, No. 7 (July 2003): p. 

35-43. 

8

 Crimmel, B.L. “Employee Contributions to Employer-Sponsored Health Insurance Coverage, 1997 v. 

2002.” Statistical Brief No. 55, September 2004, Agency for Healthcare Research and Quality, Rockville, 

MD. http://meps.ahrq.gov/mepsweb/data_files/publications/st55/stat55.pdf 9

 Branscome, J.M. and B.L. Crimmel, “Changes in Job-Related Health Insurance, 1996-99,” Rockville 

(MD): Agency for Healthcare Research and Quality (2002), MEPS Chartbook No. 10, AHRQ Publication 

No. 02-0030. Cohen, J.W., et al., “The Medical Expenditure Panel Survey: A National Health Information 

Resource,” Inquiry 33 (Winter 1996/97): 373-389. 10 Academy Health, Glossary of Terms Commonly Used in Health Care, 2003 Edition. 11 Branscome, J.M. and B.L. Crimmel, 2002. 

12 Zawacki, A. and A.K. Taylor, “ Contributions to Health Insurance Premiums: When Does the Employer 

Pay 100 Percent?” Presented at Academy Health’s 2004 Annual Research Meeting, San Diego, June 2004. 

13 Ibid. 

14 Ibid. 

15 Ibid. 

16 Ibid. 

17 Academy Health, 2003. 

18 Ibid. 

19 Gabel, J.R., J.D. Pickreign, “Risky Business: When Mom and Pop Buy Health Insurance for Their 

Employees,” New York (NY): The Commonwealth Fund (2004), Issue Brief #772. Cave, D.G. and L.J. 

Tucker, “How Will Employers Manage Employee Risk Selection Among Health Plans in the 1990s?” 

Benefits Quarterly 6 (1990): 1-13. 

17 
 20 Cutler, D.M., “Employee Costs and the Decline in Health Insurance Coverage,” Cambridge (MA): 

National Bureau of Economic Research (2002), NBER Working Paper Series 9036. Gabel, J.R., J.D.

Pickreign, H.H. Whitmore, C. Schoen, “Embraceable You: How Employers Influence Health Plan 

Enrollment,” Health Affairs 20 (2001): 196-208. Rice, T., K. Desmond, N. Purat, “Dark Clouds in

Pleasantville: Trends in Job-Based Health Insurance, 1996-1998,” Presentation at the Association of Health

Services Research annual meeting, Chicago, June 1999. Cooper, P.F. and B.S. Schone, “More Offers, 

Fewer Takers for Employment-Based Health Insurance: 1987 and 1996,” Health Affairs 16 (1997): 142-

149. 21 Blumberg, L.J., “Who Pays for Employer-Sponsored Health Insurance?” Health Affairs 18, no. 6 (1999):

58-61. 22 http://www.dmhc.ca.gov/library/statutes/knoxkeene/html/__1357_03_marketing_of_plans_to_small_employers_participation.htm; 

http://oci.wi.gov/sm_emp/h_reqsmemp.htm

18