Agency for Healthcare 

Medical Expenditure Panel Survey Research and Quality 

STATISTICAL BRIEF #53 

September 2004 

Employee Copays and Deductibles for 

Employer-Sponsored Health Insurance 

in 1999 and 2002 

John Sommers, PhD 

Introduction 

While the percentage of workers covered by employer-sponsored 

health insurance has declined in recent years, such insurance 

continues to be one of the primary sources of health coverage in the 

United States. According to data from the Insurance Component of 

the 2002 Medical Expenditure Panel Survey (MEPS-IC), 55.1 percent of private sector employees were enrolled in health insurance 

sponsored by their employer. 

Using data from the 1999 and 2002 MEPS-IC, this Statistical Brief 

examines the values of copays and deductibles for employersponsored health insurance. Private sector and public sector (state 

and local government) employers are examined separately and 

within each sector by size of employer. Small employers are defined 

as those having fewer than 50 employees; large employers are those 

with 50 or more employees. Only those differences that are statistically significant at the 0.05 significance level are discussed in the 

text. 

Findings 

From 1999 to 2002, the percentage of all enrollees in employersponsored health insurance who had a plan with a deductible 

increased from 43.91 percent to 46.63 percent (data not shown). The 

average single deductible per single enrollee with a deductible increased from $335 to $409 per enrollee over this time period (figure 

1). Single deductibles in 2002 were highest within each economic 

sector (public, private) for small employers. In 2002, in the private 

sector for single enrollees with a deductible, the average single 

deductible was $597 in small firms versus $374 in large firms. For 

the comparably sized employer in the public sector, the single 

deductible for single enrollees with a deductible was lower: $364 for 

small governments and $322 for large governments. 

During the 1999 to 2002 time period, the average family deductible 

per family enrollee in employer-sponsored health insurance 

increased from $772 to $920 (figure 2). A significant increase in 

family-level deductibles was experienced by enrollees in all the 

Highlights 

� From 1999 to 2002, the 

average single deductible per 

single enrollee with a deductible increased from $335 to 

$409. Although there was 

significant variation in the 

average single deductible by 

size of employer and economic sector (public, private), 

the average single deductible 

increased for employees in 

all these employer groups. 

� The average family deductible per family enrollee 

with a deductible increased 

from $772 to $920 during the 

period 1999 to 2002. There 

were significant differences 

in the level of this deductible 

by size of employer and 

economic sector (public, 

private), family deductibles 

increased for employees in 

all these employer groups. 

� From 1999 to 2002, the 

percentage of enrollees in 

employer-sponsored health 

insurance who had no dollar 

or percentage copay for a 

physician office visit fell from 

7.9 percent to 5.1 percent. 

There were significant reductions across economic 

sectors (public, private) and 

small and large employers. 

� The average dollar copay for 

a physician office visit increased from $13.30 to 

$15.01 over the period 1999 

to 2002. This copay varied 

significantly by type of employer but increased for each 

economic sector (public, private) and size of employer. 
employer groups. As in the case for single deductibles, the average family deductibles were lower in 2002 

for family enrollees in the public sector than the private sector and, within these sectors, large employers 

required lower family deductibles. The average family deductibles were $1,371 and $864 for small and 

large employers, respectively, in the private sector versus $1,003 and $686 for small and large 

employers, respectively, in the public sector. 

The percentage of enrollees who had neither a copay nor coinsurance for a physician office visit dropped 

from 7.9 percent to 5.1 percent during the period 1999 to 2002. These percentages dropped for all four 

groups of employers studied (figure 3). In 2002, the values ranged from 2.5 percent for small governments to 8.0 percent for large governments. 

From 1999 to 2002, for those enrollees with a copay for a physician office visit, the average copay per 

enrollee per visit rose from $13.30 to $15.01 (figure 4). These copays rose for all four groups of employers. Within economic sectors, these copays were lower in 2002 for enrollees in large employer plans than 

for enrollees in small employer plans. In the private sector, average copays for large employers in 2002 

were $15.10 versus $16.54 for small employers. In the public sector, the copays were $12.79 for large 

employers versus $15.86 for small employers. 

Data Source 

This Statistical Brief summarizes data from the 1999 and 2002 MEPS-IC. The data are available on the

MEPS Web site (www.meps.ahrq.gov) or have been produced using special computation runs on the 

confidential MEPS-IC data available at the U.S. Bureau of the Census.

Definitions 

Employer 

An employer is defined as a private sector firm or a state or local government. The Federal government is 

not included. A private sector firm is defined as a business entity that controls one or more business 

establishments or locations. Thus, an employer can have multiple work locations. For example, a large 

multi-location auto maker is an employer and a single production plant is not. 

Copay 

A copay is a fixed dollar amount that an enrollee pays when medical service is received, regardless of the 

total charge for the service. 

Coinsurance 

Coinsurance is a fixed percentage that an enrollee pays for medical expenses after the deductible 

amount, if any, is paid. 

Deductible 

A deductible is a fixed dollar amount during the benefit period (usually a year) that an insured person 

pays before the insurer starts to make payments for covered medical services. 

About MEPS-IC 

MEPS-IC is a survey of business establishments and governments that collects information on employersponsored health insurance, such as whether insurance is offered, enrollments, types of plans, and 

premiums. The survey is conducted annually by the U.S. Bureau of the Census under the sponsorship of 

the Agency for Healthcare Research and Quality. The yearly response rate has averaged 78 percent for 

in-scope sample units. Approximately 4 percent of the original sample has been out-of-scope in a typical 

year. A total sample of 42,000 establishments was selected for the 2002 survey, prior to accounting for 

losses due to non-response and out-of-scope cases. 

For more information on MEPS-IC, see MEPS Methodology Reports 6, 8, and 10 under MEPS 

publications at http://www.meps.ahrq.gov/mepsweb/data_stats/publications.jsp and the MEPS-IC Technical 

Appendix at http://www.meps.ahrq.gov/mepsweb/survey_comp/ic_technical_notes.jsp. 
Suggested Citation 

Sommers, J. Employee Copays and Deductibles for Employer-Sponsored Health Insurance in 1999 and 

2002. Statistical Brief #53. September 2004. Agency for Healthcare Research and Quality, Rockville, MD. 

http://www.meps.ahrq.gov/papers/st53/stat53.pdf 
Source: 

Panel Survey, 1999 and 2002 

sponsored health plans with a deductible, by sector and size, 

1999 and 2002 

480 

350 

279 

364 

230 

322 

409 

335 

597 

374 

0 

100 

200 

300 

400 

500 

600 

700 

1999 2002 

Small governments Large governments National average 

Small private sector Large private sector 

Dollars 

Source: 

Panel Survey, 1999 and 2002 

sponsored health plans with a deductible, by sector and size, 

1999 and 2002 

716 

563 

1003 

577 

686 

772 

920 

1063 

1371 

864 

0 

200 

400 

600 

800 

1000 

1200 

1400 

1600 

1999 2002 

Small governments Large governments National average 

Small private sector Large private sector 

Dollars 

Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure 

Figure 1. Average single deductible per single enrollee in employerCenter for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure 

Figure 2. Average family deductible per family enrollee in employer-
Source: 

Panel Survey, 1999 and 2002 

by sector and size, 1999 and 2002 

2.5 

18.4 

8.0 

12.4 

7.9 

5.1 

6.8 

9.6 

4.1 

6.3 

0 

2 

4 

6 

8 

10 

12 

14 

16 

18 

20 

1999 2002 

Small governments Large governments National average 

Small private sector Large private sector 

Percent 

Source: 

Panel Survey, 1999 and 2002 

plans with a copay, by sector and size, 1999 and 2002 

13.09 

15.86 

9.88 

12.79 

15.01 

13.30 13.98 

16.54 

13.78 

15.10 

0 

2 

4 

6 

8 

10 

12 

14 

16 

18 

1999 2002 

Small governments Large governments National average 

Small private sector Large private sector 

Dollars 

Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure 

Figure 3. Percentage of enrollees in employer-sponsored health 

plans without a copay or coinsurance for a physician office visit, 

Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure 

Figure 4. Average copays for enrollees in employer-sponsored health