U.S. Department of Labor

Alexis M. Herman, Secretary

Bureau of Labor Statistics

Katharine G. Abraham, Commissioner

April 1998

Bulletin 2496

Employee Benefits in Medium and

Large Private Establishments, 1995
U.S. Department of Labor

Alexis M. Herman, Secretary

Bureau of Labor Statistics

Katharine G. Abraham, Commissioner

April 1998

Bulletin 2496

Employee Benefits in

Medium and Large Private

Establishments, 1995
This bulletin presents results of a 1995 Bureau of Labor

Statistics (BLS) survey of the incidence and detailed

provisions of selected employee benefit plans in medium and

large private establishments. The survey provides representative data for 40 million employees in the Nation’s private

nonagricultural industries. Appendix A provides a detailed

description of the coverage and statistical procedures used

in the survey.

The 1995 Employee Benefits Survey (EBS) reports on

benefits provided to employees in establishments with 100

or more workers in all private nonfarm industries. Between

1979 and 1986, the survey provided benefits data on fulltime employees in medium and large estabishments, those

with either 100 or 250 employees or more, depending on the

industry; coverage in the services industries was limited. The

1987 survey examined benefits provided to full-time employees in State and local governments with 50 employees or

more. In 1988, 1989, 1991, and 1993, expanded surveys of

medium and large establishments covered full-time employees in establishments employing 100 workers or more in

all private industries.

Beginning in 1990, the Employee Benefits Survey included both full-time and part-time employees in all private industries and State and local governments. In 1992 and

1994, the survey covered small private establishments and

State and local governments. Currently, small private establishments are surveyed in even-numbered years, and medium

and large private establishments are surveyed in oddnumbered years.

The 1995 Employee Benefits Survey bulletin provides a

“survey highlights” section (chapter 1) with a number of key

findings for major benefits, such as time-off; disability;

medical, dental, and vision care; life insurance; and defined

benefit and defined contribution plans. Individual chapters

provide general information and details describing the

benefit provisions, along with the respective tables for each

benefit.

Preface

Data for this bulletin were compiled and analyzed in the

Division of Compensation Data Analysis and Planning by

Cathy Baker, Kenneth Elliott, Mahin Eslami, Ann Foster,

Jef Foster, Avy Graham, Jake Kane, Jonathan Kelinson,

Marc Kronson, James Moore, Hilery Simpson, Cynthia

Thompson, Jerline Thompson, and Arthur Williams, under

the direction of Allan Blostin and John Morton. Cathy

Baker, James Moore, and Albert Schwenk prepared most of

the tables. Natalie Kramer and James Houff prepared the

survey analysis.

Other table preparation, computer programming, and

systems design for the survey were provided by Mary

Constable, Aholivah Maier, Lien Nham, Pat O’Brian, and

Cheryl Sims of the Division of Directly Collected Periodic

Surveys, under the direction of Leslie Chappel. Christina L.

Harpenau, Thomas Kelly, and Charlotte Mueller of the

Statistical Methods Group (Office of Compensation and

Working Conditions) were responsible for the sample design, nonresponse adjustments, sample error computations,

and other statistical procedures, under the direction of Terry

Burdette. Fieldwork for the survey was directed by the

Bureau’s Assistant Regional Commissioners for Operations.

Material in this publication is in the public domain and,

with appropriate credit, may be reproduced without permission.

The public may access Employee Benefits Survey data

through the Bureau of Labor Statistics’ World Wide Web site

at: http://stats.bls.gov/ebshome.htm

Questions on data in this publication should be referred to the staff of the Employee Benefits Survey at (202)

606-6222 or via E-mail: ocltinfo.bls.gov Sensory impaired

individuals may obtain information in his publication upon

request. Voice phone: (202) 606-STAT; TDD phone: (202)

606-5897; TDD Message Referral phone: 1-800-326-2577.

Pictured on the cover of this bulletin is Catching the Big

One by Norman Rockwell, (c) 1929, The Curtis Pubishing

Company.

iii
Contents

Chapter 1. Results of the 1995 survey ............................................................................................................................ 1

Work schedules, paid time off, and family leave ...................................................................................................... 1

Disability benefits ..................................................................................................................................................... 1

Medical, dental, and vision care ............................................................................................................................... 2

Life insurance ........................................................................................................................................................... 3

Defined benefit and defined contribution plans ........................................................................................................ 3

Flexible benefits plans and reimbursement accounts ................................................................................................

Other benefits ........................................................................................................................................................... 

Plan administration ...................................................................................................................................................

Chapter 2. Work schedules, paid time off, and family leave .......................................................................................... 14

Work schedules ......................................................................................................................................................... 14

Paid time off ............................................................................................................................................................. 14

Holidays .............................................................................................................................................................. 14

Vacations ............................................................................................................................................................. 14

Personal leave ..................................................................................................................................................... 14

Funeral leave, jury-duty leave, and military leave .............................................................................................. 14

Family leave.............................................................................................................................................................. 15

Chapter 3. Disability benefits ......................................................................................................................................... 23

Paid sick leave .......................................................................................................................................................... 23

Short-term disability coverage .................................................................................................................................. 23

Long-term disability insurance ................................................................................................................................. 24

Chapter 4. Medical, dental, and vision care ................................................................................................................... 38

Medical care ............................................................................................................................................................. 

Fee-for-service plans ............................................................................................................................................. 38

Health maintenance organizations ......................................................................................................................... 39

Preferred provider organizations ........................................................................................................................... 39

Cost containment ................................................................................................................................................... 39

Hospital coverage .................................................................................................................................................. 40

Alternatives to hospitalization ............................................................................................................................... 40

Surgical coverage................................................................................................................................................... 40

Outpatient physicians visits and diagnostic services .............................................................................................

Prescription drug benefits ......................................................................................................................................

Mental health coverage and substance abuse treatment ........................................................................................ 

Other medical benefits ........................................................................................................................................... 42

Participation requirements ..................................................................................................................................... 42

Pre-existing condition limitation ........................................................................................................................... 42

Coverage for retired workers ................................................................................................................................. 42

Dental care ................................................................................................................................................................... 42

Vision care ................................................................................................................................................................... 43

v

 Page

4

4

4

38

41

41

41
Chapter 5. Life insurance ................................................................................................................................................ 92

Types and amounts of benefit formulas ..................................................................................................................... 92

Coverage for retirees ................................................................................................................................................. 92

Related protection ...................................................................................................................................................... 92

Service requirements ................................................................................................................................................. 92

Accidental death and dismemberment ....................................................................................................................... 92

 Survivor income benefits ........................................................................................................................................... 92

Chapter 6. Defined benefit plans .................................................................................................................................... 100

Benefit formulas ........................................................................................................................................................ 100

Private benefits and Social Security payments .......................................................................................................... 101

Methods of payments ................................................................................................................................................. 101

Maximum and minimum benefit provisions .............................................................................................................. 101

Survivor annuities ...................................................................................................................................................... 101

Preretirement surviors benefits .................................................................................................................................. 102

Normal retirement ...................................................................................................................................................... 102

Early retirement ......................................................................................................................................................... 102

Disability retirement .................................................................................................................................................. 103

Vesting ....................................................................................................................................................................... 103

Portability .................................................................................................................................................................. 104

Postretirement pension increases ............................................................................................................................... 104

Employee contributions ............................................................................................................................................. 104

Participation requirements ......................................................................................................................................... 104

Chapter 7. Defined contribution plans ............................................................................................................................ 119

Plan types ................................................................................................................................................................... 119

Savings and thrift plans.............................................................................................................................................. 119

Employee contributions ........................................................................................................................................ 120

Employer-matching contributions ........................................................................................................................ 120

Investment decisions ............................................................................................................................................. 120

Withdrawals and loans .......................................................................................................................................... 120

Distribution ........................................................................................................................................................... 120

Participation requirements .................................................................................................................................... 120

Vesting .................................................................................................................................................................. 120

Deferred profit-sharing plans ..................................................................................................................................... 121

Money purchase pension plans .................................................................................................................................. 121

Stock plans ................................................................................................................................................................. 121

Cash or deferred arrangements .................................................................................................................................. 121

Chapter 8. Flexible benefits plans and reimbursement accounts .................................................................................... 143

Chapter 9. Benefits by selected characteristics ............................................................................................................... 146

Geographic region ..................................................................................................................................................... 146

Industry ...................................................................................................................................................................... 146

Union status ............................................................................................................................................................... 146

Part-time employees .................................................................................................................................................. 146

Appendixes:

A. Technical note ....................................................................................................................................................... 162

B. Survey response .................................................................................................................................................... 165

C. Availability of survey data .................................................................................................................................... 172

Contents—Continued

vi

Page
Tables:

Full-time employees in medium and large private establishments, 1995:

1. Selected benefits: Percent participating ................................................................................................................. 7

2. Selected benefits: Number participating ................................................................................................................ 9

3. Other benefits: Percent eligible ............................................................................................................................. 11

4. Other benefits: Number eligible ............................................................................................................................ 12

5. Insurance and retirement plans: Type of plan sponsor........................................................................................... 13

Work schedules:

 6. Hours scheduled per week and per day ................................................................................................................ 16

7. Type of work schedule .......................................................................................................................................... 16

Paid time off:

8. Holidays and vacations: Average number of days ................................................................................................. 16

9. Holidays: Number of days provided each year ...................................................................................................... 17

Vacations:

10. Number of days provided for selected periods of service ................................................................................ 17

11. Length of service required to take vacation ...................................................................................................... 19

12. Unused vacation policy .................................................................................................................................... 19

13. Average number of days by length of service and unused vacation policy ...................................................... 19

14. Personal leave: Number of days provided per year .............................................................................................. 20

15. Funeral leave: Number of days available per occurrence ..................................................................................... 20

16. Jury-duty leave: Number of days available per occurrence .................................................................................. 21

17. Military leave: Number of days available per year ............................................................................................... 21

Family leave:

18. Duration of benefits ............................................................................................................................................... 22

Paid sick leave:

19. Type of provision ................................................................................................................................................... 25

20. Number of days ..................................................................................................................................................... 26

21. Average number of days at full pay ....................................................................................................................... 28

22. Annual plans: Unused sick leave policy and carryover provisions ....................................................................... 28

23.Annual plans: Average number of days at full pay by unused sick leave policy .................................................... 29

24. Length-of-service requirements for participation .................................................................................................. 29

25. Other uses of sick leave ......................................................................................................................................... 30

Short-term disability insurance:

26. Method of funding ................................................................................................................................................. 30

27. Method of payment ................................................................................................................................................ 30

28. Flat dollar amounts ................................................................................................................................................ 31

29. Fixed percent of earnings amounts ........................................................................................................................ 31

30. Maximum benefits based on percent of earnings formulas ................................................................................... 32

31. Minimum benefits based on percent of earnings formulas .................................................................................... 32

32. Type of waiting period ........................................................................................................................................... 33

33. Length of waiting period........................................................................................................................................ 33

34. Duration of benefits ............................................................................................................................................... 34

35. Eligibility requirements ......................................................................................................................................... 34

Long-term disability insurance:

36. Benefit waiting period .......................................................................................................................................... 35

37. Method of payment ................................................................................................................................................ 35

vii

Contents—Continued

Page
38. Maximum benefits based on percent of earnings formulas ................................................................................... 36

39. Duration of payments ............................................................................................................................................ 36

40. Eligibility requirement ........................................................................................................................................... 37

Medical care:

 41. Summary of selected features ................................................................................................................................ 45

Coverage for:

42. Selected services, by type of plan ....................................................................................................................... 46

43. Selected services in non-HMO’s ........................................................................................................................ 47

44. Alternatives to hospital care in non-HMO’s ....................................................................................................... 48

45. Mental health and substance abuse treatment in non-HMO’s ............................................................................. 49

46. Selected services in HMO’s ................................................................................................................................ 50

47. Alternatives to hospital care in HMO’s .............................................................................................................. 50

48. Mental health and substance abuse treatment in HMO’s .................................................................................... 51

49. Fee arrangement and financial intermediary .......................................................................................................... 52

50. Selected features in HMO’s ................................................................................................................................... 53

51. Amount of individual deductibles in non-HMO’s ................................................................................................. 54

52. Relationship of individual and family deductibles in non-HMO’s ........................................................................ 55

53. Coinsurance rates in non-HMO’s .......................................................................................................................... 56

54. Out-of-pocket expense provisions in non-HMO’s ................................................................................................. 57

55. Maximum benefit provisions in non-HMO’s ......................................................................................................... 59

56. Averages for major medical provisions ................................................................................................................. 60

57. Summary of selected features in preferred provider organizations ....................................................................... 61

58. Coinsurance rate comparison of PPO plans with traditional fee-for-service plans ............................................... 61

59. Availability of managed care benefits.................................................................................................................... 62

60. Availability of selected cost containment features ................................................................................................. 62

61. Prehospitalization certification requirements ........................................................................................................ 63

62. Second surgical opinion provisions ....................................................................................................................... 63

63. Extent of coverage for hospital room and board in non-HMO’s ........................................................................... 64

64. Type of limitations on hospital room and board in non-HMO’s ............................................................................ 64

65. Copayment provisions for hospital room and board.............................................................................................. 65

66. Extent of coverage for extended care facilities in non-HMO’s ............................................................................. 66

67. Limitations on extended care facilities in non-HMO’s .......................................................................................... 66

68. Limitations on days in extended care facilities in non-HMO’s.............................................................................. 67

69. Extent of coverage for extended care facilities in HMO’s ..................................................................................... 68

70. Types of limitations for physician’s office visits in HMO’s .................................................................................. 68

71. Extent of coverage for surgical services in non-HMO’s ........................................................................................ 69

72. Summary of coverage for outpatient prescription drug benefits............................................................................ 69

73. Brand name drug provisions in non-HMO’s .......................................................................................................... 70

74. Brand name drug provisions in HMO’s ................................................................................................................. 70

75. Relationship of mental health benefits to other coverages .................................................................................... 71

Limits on:

76. Mental health care coverage ............................................................................................................................... 71

77. Mental health care coverage in HMO’s .............................................................................................................. 72

78. Mental health care coverage in non-HMO’s ....................................................................................................... 72

79. Relationship between provisions for alcohol and drug treatment benefits ............................................................ 73

80. Relationship of substance abuse benefits to other coverages ................................................................................ 73

Limits on:

81. Alcohol treatment benefits .................................................................................................................................. 74

82. Drug treatment benefits ...................................................................................................................................... 75

viii

Contents—Continued

Tables—Continued

Page
Limits on:

83. Alcohol treatment benefits in HM0’s ............................................................................................................... 76

84. Drug treatment benefits in HMO’s ................................................................................................................... 77

85. Alcohol treatment benefits in non-HMO’s ....................................................................................................... 78

86. Drug treatment benefits in non-HMO’s ............................................................................................................ 79

87. Application of out-of-pocket provisions to mental health and substance

abuse treatment benefits .................................................................................................................................... 80

88. Eligibility requirements ........................................................................................................................................ 81

89. Pre-existing condition provisions ......................................................................................................................... 81

90. Effect of retirement on coverage .......................................................................................................................... 82

Dental Care:

91. Eligibility requirements ........................................................................................................................................ 82

92. Fee arrangement and financial intermediary ......................................................................................................... 83

 93. Coverage for selected services ............................................................................................................................. 84

 94. Percent of charges paid by plan for selected services........................................................................................... 86

95. Amount of individual deductible .......................................................................................................................... 88

96. Relationship of yearly family deductibles to individual deductibles .................................................................... 88

97. Services covered by deductible provisions ........................................................................................................... 89

 98. Maximum benefit provision.................................................................................................................................. 89

99. Maximum benefit provisions for orthodontia care ............................................................................................... 90

100. Pretreatment authorization .................................................................................................................................... 90

Vision care:

 101. Coverage for selected services ............................................................................................................................. 91

Life insurance:

102. Summary of provisions ......................................................................................................................................... 94

103. Method of determining basic coverage................................................................................................................. 94

104. Flat dollar benefit amounts ................................................................................................................................... 95

105. Multiple of earnings benefit amounts ................................................................................................................... 95

106. Maximum benefits placed on multiple of earnings formulas................................................................................ 96

107. Minimum benefits placed on multiple of earnings formulas ................................................................................ 97

108. Retiree coverage ................................................................................................................................................... 98

109. Reduction in benefits for retirees.......................................................................................................................... 98

110. Supplemental coverage ......................................................................................................................................... 98

111. Dependent coverage .............................................................................................................................................. 99

112. Eligibility requirement .......................................................................................................................................... 99

Defined benefit plans:

113. Summary of plan provisions ................................................................................................................................. 106

114. Primary formula and availability of alternative formula ....................................................................................... 106

115. Terminal earnings formula .................................................................................................................................... 107

116. Definition of terminal earnings ............................................................................................................................. 107

117. Types of earnings included in earnings-based formulas ....................................................................................... 108

118. Dollar amount formula .......................................................................................................................................... 108

119. Integration with Social Security ............................................................................................................................ 109

120. Maximum benefit provisions ................................................................................................................................ 109

121. Availability of lump sum benefits at retirement .................................................................................................... 110

122. Postretirement survivor benefits ........................................................................................................................... 110

ix

Contents—Continued

Tables—Continued

Page
123. Preretirement survivor benefits........................................................................................................................... 111

124. Requirements for normal retirement ................................................................................................................... 112

125. Requirements for early retirement ...................................................................................................................... 113

126. Early retirement reduction .................................................................................................................................. 114

127. Method of calculating disability retirement benefits .......................................................................................... 114

128. Requirements for disability retirement ............................................................................................................... 115

129. Vesting requirements .......................................................................................................................................... 115

130. Provisions for early receipt of deferred vested benefits ..................................................................................... 116

131. Portability provisions.......................................................................................................................................... 116

132. Postretirement pension increases ........................................................................................................................ 117

133. Employee contribution requirements .................................................................................................................. 117

134. Eligibility requirements ...................................................................................................................................... 118

Savings and thrift plans:

135. Summary of provisions ....................................................................................................................................... 123

136. Transfer and rollover provisions ......................................................................................................................... 123

137. Maximum employee contributions ..................................................................................................................... 124

138. Method of determining pretax contribution ........................................................................................................ 124

139. Maximum pretax employee contributions .......................................................................................................... 125

140. Method of employer matching contributions...................................................................................................... 125

141. Employee contributions by employer specified matching percentage ................................................................ 126

142. Discretionary profit-sharing contributions.......................................................................................................... 126

143. Investment choices.............................................................................................................................................. 127

144. Types of investments allowed in plans permitting employees to choose investments ........................................ 128

145. Method of allocating contributions to investment options in plans permitting employees

 to choose investments ..................................................................................................................................... 129

146. Frequency of investment changes in plans permitting employees to choose investments .................................. 130

147. Withdrawal availability....................................................................................................................................... 131

148. Withdrawal requirements in plans permitting withdrawals ................................................................................ 131

149. Maximum amount that may be withdrawn in plans permitting withdrawals ...................................................... 131

150. Penalties imposed upon withdrawals of funds in plans permitting withdrawals................................................. 131

151. Loan availability ................................................................................................................................................. 132

152. Loan requirements in plans permitting loans ...................................................................................................... 132

153. Maximum amount that may be borrowed in plans permitting loans ................................................................... 132

154. Repayment provisions in plans permitting loans ................................................................................................ 133

155. Method of distribution ........................................................................................................................................ 134

156. Service requirements .......................................................................................................................................... 134

157. Vesting provisions............................................................................................................................................... 135

Deferred profit-sharing plans:

158. Employer contributions ...................................................................................................................................... 135

159. Allocation of employer contributions to individual employee accounts ............................................................ 136

160. Selected plan features ......................................................................................................................................... 136

161. Service requirements .......................................................................................................................................... 137

162. Vesting provisions............................................................................................................................................... 137

401(k) salary reduction plans:

163. Maximum pretax employee contributions .......................................................................................................... 138

164. Service requirements .......................................................................................................................................... 138

165. Investment choices.............................................................................................................................................. 139

x

Contents—Continued

Tables—Continued

Page
Page

166. Vesting provisions............................................................................................................................................... 140

167. Transfer and rollover provisions ......................................................................................................................... 141

168. Withdrawal availability....................................................................................................................................... 141

169. Loan availability ................................................................................................................................................. 142

170. Methods of distribution ...................................................................................................................................... 142

Flexible benefits plans:

171. Reimbursement accounts: Eligibility by expenses covered ................................................................................ 145

Benefits for full-time employees by geographic region:

172. Summary: Participation in selected employee benefit programs ........................................................................ 148

173. Other benefits: Eligibility for specified benefits................................................................................................. 150

Benefits for full-time employees by industry:

174. Summary: Participation in selected employee benefit programs, goods-producing industries .......................... 151

175. Other benefits: Eligibility for specified benefits, goods-producing industries ................................................... 153

176. Summary: Participation in selected employee benefit programs, service-producing industries ......................... 154

177. Other benefits: Eligibility for specified benefits, service-producing industries ................................................. 156

Benefits for full-time employees by union status:

178. Summary: Participation in selected employee benefit programs ........................................................................ 157

179. Other benefits: Eligibility for specified benefits................................................................................................. 158

Benefits for part-time employees:

180. Summary: Participation in selected employee benefit programs ........................................................................ 159

181. Other benefits: Eligibility for specified benefits................................................................................................. 161

Appendix tables:

A1. Survey scope: Full-time employees ..................................................................................................................... 167

A2. Survey scope: Part-time employees ..................................................................................................................... 168

Variances:

A3. Average number of holidays and vacation days ............................................................................................... 169

A4. Average number of vacation days by unused vacation policy ........................................................................ 169

A5. Average number of sick leave days .................................................................................................................. 170

A6. Average number of sick leave days by unused sick leave policy ..................................................................... 171

A7. Average other leave durations .......................................................................................................................... 171

Charts:

A1. .............................................................................................................................................................................. 166

xi

Contents—Continued

Tables—Continued
1

The Bureau’s 1995 survey of medium and large

 establishments in private industry provides data on

employee work schedules and develops information

on the incidence and detailed characteristics of employee

benefits paid for, at least in part, by the employer.1 These

benefits include holidays, vacations, and personal, funeral,

jury-duty, military, parental, and sick leave; short-term disability plans; long-term disability and life insurance; medical, dental, and vision care; and private retirement plans. Because the survey data are limited to formal plans, this bulletin

may understate the extent of such benefits as personal leave.

Data are also collected on the incidence of several other

benefits, including severance pay, child-care assistance,

wellness programs, employee assistance programs, and educational assistance. In addition, the survey obtained information on flexible benefits plans, reimbursement accounts,

and unpaid family leave.

This chapter presents the major highlights of the survey.

Detailed information on the provisions of the benefits studied appears in chapters 2 through 8.

For the 1995 survey of benefits in medium and large private establishments, BLS collected information for both fulltime and part-time employees. Employees were classified as

either full-time or part-time workers in accordance with their

employers’ practices. Part-time workers typically are scheduled to work fewer hours per week than full-time workers

engaged in the same type of work activity. In addition, data

were also collected on the incidence of employee benefits by

union status, broad industry groupings, and broad geographic

regions.

Among the most frequently observed benefits provided to

full-time employees in medium and large private establishments in 1995 were: Medical care, outpatient prescription

drugs, dental care, life insurance, defined benefit and defined

contribution plans, holidays, vacations, paid sick leave and

short-term disability plans; the majority of full-time workers

received these benefits (tables 1-2). In contrast, benefits such

as paid family leave, personal leave, and long-term disability

insurance were less prevalent.

Highlights

Work schedules, paid time off, and family leave

Eighty-three percent of full-time employees had weekly

work schedules of 40 hours, based on five 8-hour days. All

but 5 percent of the full-time employees were on a fixed work

schedule. (See chapter 2.)

Paid vacations, provided to most full-time employees,

averaged 9.6 days after 1 year of service, 16.9 days after 10

years of service, and 22.0 days after 30 years of service. Many

full-time employees covered by vacation plans were required

to work a specified period of time before being allowed to

take a vacation, most commonly 1 year. Just over one-third

were allowed to carry-over at least some of their unused

vacation days into the following year; one-fifth could cash in

some or all of their vacation days at the end of the year. Some

employees were allowed to do both.

When other types of leave were provided, covered employees received, on average:

• 9 holidays2 per year;

• 3 days of funeral leave per occurrence;

• Jury duty leave as needed;

• 3 personal leave days per year;

• 15 days of paid military leave per year.

Unpaid family leave was available to 84 percent of fulltime employees; paid family leave plans were almost nonexistent.

Disability benefits

Employees may be protected from loss of income during

short-term illnesses or injuries by sick leave, short-term disability, or both.3 (See chapter 3.) For longer term or permanent disabilities, employees may have long-term disability

insurance to replace their incomes. Paid sick leave was provided to 58 percent of full-time workers, and short-term disability benefits to 53 percent. Forty-two percent of full-time

employees were covered by long-term disability (LTD) insurance. Paid sick leave and LTD insurance were more prevalent among white-collar workers.

Survey data on paid sick leave indicate 9 out of 10 covered

full-time workers were allowed a fixed number of days per

year, with the average being 11.5 days after 1 year of service,

17.6 days after 5 years, 23.6 days after 15 years, and 27.7

days after 25 years. About half of full-time employees covered by annual sick leave plans were in plans that allowed

them to carry over and accumulate unused sick leave from

year to year.

Chapter 1.

Results of the 1995 Survey
2

Of those workers in plans with carry-over provisions, 80

percent had limits. Of the workers with short-term disability

benefits:

• 86 percent of the full-time employees with short term disability benefits were in funded plans, usually self-insured

or insured by a commercial carrier;

• Just over half (54 percent) of those with funded shortterm disability had their benefits determined by a fixed

percentage of earnings, usually 50, 60, or 67 percent;

• Those with earnings-based benefits typically had a dollar

limit on the amount of the weekly benefits, averaging

$470;

• A flat dollar amount per week was commonly provided; the

average was $170;

• 57 percent of those in funded plans had an eligibility requirement before they could join, usually less than 5

months.

Ninety-one percent of full-time workers with long-term disability protection, received their benefit as a fixed percent of

predisability earnings, the most common benefit being 60

percent. Most workers in plans that based benefits on percent

of earnings benefits had them limited to a monthly dollar

maximum, averaging $7,277 per month. Other LTD features

included:

• 42 percent of participants had to wait 6 months after the

onset of disability before they received LTD payment;

• Two-thirds had to meet an eligibility requirement, usually

between 1 and 12 months.

Medical, dental, and vision care

Seventy-seven percent of full-time workers in medium and

large private establishments participated in medical care plans.

(See chapter 4.) However, only 57 percent of full-time employees participated in a dental care plan, and 24 percent had

vision care coverage. Sixty-one percent of participants in

medical care plans were covered by non-traditional plans, that

is, health maintenance organizations (HMO’s) or preferred

provider organizations (PPO’s). HMO’s covered 27 percent

of full-time workers with medical care benefits while PPO’s

covered 34 percent.

For full-time employees participating in medical care plans:

• Nine out of 10 participants in traditional fee-for-service

plans were subject to an annual deductible for their meddical care coverage; the average was $264;

• The percentage of expenses paid by the plan varied between traditional fee-for-service plans and PPO’s; traditional fee-for-service plans normally paid 80 percent, while

PPO’s frequently paid 80 to 90 percent;

• 83 percent of participants in non-HMO plans had an individual limit on out-of-pocket expenses; the averge limit

was $1,358;

• 70 percent of non-HMO participants had a lifetime maximum apply to their benefits, most frequently $1,000,000.

Coverage for selected medical services varied:

• All participants in medical care plans had coverage for hospital room and board; most medical care participants were

also covered by physicians visits, surgery, and diagnostic

x-ray and laboratory services;

• Coverage for alternatives to hospitalization, such as stays

in an extended care facility and home health care, was

 available to about three-fourths of all medical participants;

these two alternatives to hospitalization were more

 commonly covered under HMO’s than non-HMO’s.

A variety of managed care features were included in

medical care plans. For example, 65 percent of workers in

non-HMO plans were required to get preadmission certification before hospitalization. Second surgical opinion provisions applied to 53 percent of the non-HMO participants; in

many cases, penalties were assessed for not obtaining second

opinions. Nine out of 10 PPO participants who had coverage

for hospital room and board, surgery, and physicians in-hospital visits received higher reimbursements for their expenses

if care was received at specified hospitals; outpatient prescription drugs were not usually subject to an incentive for

using preferred providers.

Prescription drug coverage was provided to most workers

in medical care plans.

• Four out of 10 prescription drug plan participants received

higher reimbursement for obtaining generic rather than

brand name prescriptions;

• Mail order drug programs were available to about onethird of prescription drug coverage participants;

• Prescription drugs were usually not fully covered.

Mental health care and alcohol and drug abuse treatments

were subject to more restrictive provisions than medical treatment for other ailments. The majority of those with coverage

for inpatient health benefits had more restrictive hospital

coverage for mental illness than for other ailments; outpatient mental health care coverage was even more restrictive.

Other medical features reveal:

• 64 percent of full-time participants were required to

 complete an eligibility requirement before being able to

 join, usually 3 months or less;

Results of the 1995 Survey
3

• 54 percent of non-HMO participants were in plans with a

“pre-existing condition” clause;

• 46 percent of participants were in plans that provided meddical care coverage after retirement; the employer usually

paid at least part of the cost.

Among dental care participants:

• Virtually all had coverage for preventive and restorative and surgical dental procedures, and just over 70 percent had coverage for orthodontia;

• The overwhelming majority of participants were reimbursed a percent of the usual, customary, and reasonable charge for all dental procedures;

• 59 percent of workers were in plans that required annual

deductible, most commonly $50, to be paid before plan

benefits would begin;

• 82 percent of participants were in plans that specified an

annual maximum benefit; the most prevalent was $1,000;

• Among participants with orthodontic services, 83 percent were in plans imposing a separate lifetime maximum

benefit, usually $1,000 or more.

Data for vision care coverage reveal:

• All participants had eyeglass coverage; with a few exceptions, vision care participants had coverage for eye examinations and contact lenses;

• The overwhelming majority of participants in vision care

plans were subject to limitations, often a scheduled dollar

allowance per benefit.

Life insurance

In 1995, life insurance protection was available to 87 percent of full-time employees in medium and large establishments. (See chapter 5.) Among full-time employees with life

insurance protection:

• 56 percent were covered by a fixed multiple-of-earnings

formula, usually one or two times earnings; this formula was

more prevalent among white-collar workers than blue-collar workers;

• A flat dollar amount of insurance, regardless of earnings,

covered 43 percent of participants; this type of benefit was

more common among blue-collar workers than white-collar workers;

• 59 percent of participants had supplemental coverage although in most cases the employee paid the full cost;

• About half of the participants had dependent life insurance protection; two-thirds had to pay the full cost of

coverage;

• 37 percent of participants were in plans that provided retiree coverage, with the employer usually paying the full cost.

Accidental death and dismemberment insurance was available to 67 percent of full-time employees. This insurance provides additional benefits if a worker dies or loses an eye or a

limb in an accident.

Defined benefit and defined contribution plans

Eighty percent of all full-time workers were covered by at

least one retirement plan in 1995. Defined benefit plans, which

specify a formula for determining future benefits, were available to half of full-time employees in medium and large establishments. (See chapter 6.)

Seventy percent of participants in traditional defined benefit pension plans were in plans with formulas based on earnings. The most common formula was based on earnings during the final years of employment (terminal-earnings formulas), such as 5 consecutive years during the last 10 years of

employment.

Sixty-two percent of participants in plans with terminalearnings formulas had benefits that varied by service, earnings, or by both; most of the remaining participants in these

plans received a flat percent of earnings, averaging 1.45 percent per year of service.

White-collar participants normally were covered by plans

with earnings-based formulas, and usually had benefits integrated with Social Security. Blue-collar workers, in contrast, were more often covered by formulas that specified a

dollar amount to be paid for each year of service, and were

less likely to have their benefits integrated with Social

Security. Dollar amount formulas, averaging about $28.47 a

month per year of service, applied to benefits of nearly onefourth of pension plan participants.

Other key findings for defined benefit participants include:

• Common eligibility requirements for a normal, or unreduced, pension were: Age 65 with no specified length of service, age 65 with 5 years of service, and age 62 with 10

years of service;

• 83 percent of covered workers could retire with a reduced

pension at age 55 or earlier, most often after 5 or 10 years

of service;

• 73 percent of pension plan participants were covered by

some type of disability retirement, often with provisions for

immediate unreduced benefits;

• 87 percent of pension plan participants could become vestted or had a guaranteed right to their accrued pension

 benefits after working 5 years;

• 8 percent of covered workers were in plans that allowed the

Results of the 1995 Survey
4

portability or transfer of pension credits from one employer

to another.

Defined contribution plans specify employer and employee

contributions but do not guarantee future benefits. Such plans

can be vehicles for financing retirement benefits if funds can

not be withdrawn easily, or they may be shorter term capital

accumulation plans if periodic withdrawals are allowed. Defined contribution plans were available to 55 percent of the

full-time workers and were more prevalent among white-collar than blue-collar workers. (See chapter 7.)

The most common types of defined contribution plans were

savings and thrift plans and deferred profit-sharing plans.

Forty-one percent of full-time workers were enrolled in a

savings and thrift plans, while 13 percent of full-time workers were covered by a deferred profit-sharing plan. Principal

findings include:

• The most common employer-matching rate in a savings and

thrift plan was 50 percent up to the first 6 percent of earnings saved by the employee;

• Three out of 4 participants in savings and thrift plans could

choose how they wanted their own contributions invested;

3 out of 5 could choose how they wanted employer contributions invested;

• Prior to normal payout at retirement, disability, or termination of employment, 43 percent of the participants in

savings and thrift plans were allowed to withdraw all or a

portion of employer contributions;

• 44 percent of participants in savings and thrift plans were

allowed to borrow from their accounts, usually at any time;

• 62 percent of the participants in deferred profit-sharing

plans were in plans that had employer contributions based

on a specific formula; the remainder were in discretionary

employer contributions plans;

• Two-thirds of participants in savings and thrift plans had to

meet a service requirement before beginning to accumulate benefits, and three-fourths of deferred profit-sharing plan

participants had to meet such requirements, normally 1

year.

A large majority of employees enrolled in one or more

defined contribution plans were allowed to choose between

receiving taxable income currently or placing the money in a

retirement account and deferring taxation. These cash or deferred arrangements, known as 401(k) plans, usually took the

form of salary reduction plans with employer contributions.

(See table 1.) Key findings include:

• 401(k) plan features usually cover participants in savings

and thrift plans;

• 83 percent of employees participating in 401(k) salary reduction plans could make contributions based on their

earnings, commonly 10, 15, and 16 percent of earnings; maximum pretax contributions averaged 13.1 percent;

• 38 percent of employees in 401(k) salary reduction plans

were allowed to transfer or “rollover” distributions received

from a former employer.

Flexible benefits plans and reimbursement accounts

Employees may receive benefits independently or as part

of a package, complete with options, known as a flexiblebenefits or cafeteria plan. (See chapter 8.) Among full-time

employees, 12 percent had flexible-benefits plans, and 38 percent were covered by separate employer-sponsored reimbursement accounts.

Reimbursement accounts allow employees to use pretax

dollars to pay for certain expenses not covered by benefit

plans. Expenses include premiums for insurance benefits, typically health care benefits. Such plans, frequently referred to

as premium conversion plans, covered 5 percent of the fulltime employees. In addition:

• Just over three-fourths of employees eligible for reimbursement accounts could allocate funds for medical

care deductibles, coinsurances, and other health expenses

not covered by their medical plan;

• 77 percent could use money from these accounts to pay for

dependent care expenses.

Other benefits

The survey estimated the incidence of 14 other benefits

in addition to the major benefits just described (tables 3-4).

These data show the percent of workers eligible for a specific

benefit, but not the proportion of employees actually taking

advantage of that benefit.

Of these benefits, data reveal the following for full-time

employees:

• About two-thirds were eligible for job-related educational

assistance;

• Non-job related educational assistance was only offered to

about one-fifth of workers;

• 34 percent were eligible to be in employee wellness programs;

• Employee assistance programs were available to 58 percent of the workers;

• Such benefits as long-term care insurance, and child-care

benefits, were offered to less than 1 out of 10 workers.

Plan administration

In addition to collecting the data on individual benefit plans,

Results of the 1995 Survey
5

the survey looked at how insurance and retirement benefits

were administered (table 5). At least nine-tenths of full-time

participants were in single-employer plans for life insurance,

medical care, defined benefit pensions, and savings and thrift

plans. Four-fifths of short-term disability and long-term dis1 There are a few exceptions to this general rule. The survey provides

estimates on the availability of postretirement medical care and life insurance, dependent life insurance, supplemental life insurance, and long-term

care insurance even if an employee or retiree must pay for such coverage fully. This is because the guarantee of insurability and availability

of coverage at group premium rates can be considered a benefit. In addition, reimbursement accounts, salary reduction plans, and family leave plans

are tabulated even if the employer bears no cost beyond administrative

expenses. 2 The method used to calculate the average number of paid holidays has

been revised to count partial days more precisely. Average holidays in 1995

are not comparable to those reported in the 1991 and 1993 surveys of

medium and large private establishments.

3 The definitions of paid sick leave and short-term disability (previously,

sickness and accident insurance) were changed for the 1995 survey. Paid

sick leave now only includes plans that either specify a maximum number

of days per year or unlimited days. Short-term disability now includes all

insured, self-insured, and state-mandated plans available on a per-disability basis as well as the unfunded per disability plans previously reported as

sick leave. Sickness and accident insurance, reported in years prior to this

survey, only included insured, self-insured, and state-mandated plans

providing per disability benefits at less than full pay.

Results of the 1995 Survey

ability insurance participants were in single-employer plans.

Most of the remaining employees with short-term disability

benefits were covered by mandated benefits such as State

temporary disability insurance plans in New York and New

Jersey.

—ENDNOTES—
6

 A Note on the Table

The majority of the tables presented throughout this bulletin indicate the percent of all

employees, or of a selected group of employees, covered by particular benefits and benefit

features. The key to using these tables is understanding the group of employees about

whom data are presented; this information is contained in the first row of each table. Some

tables indicate the percent of all employees covered by the survey who have a certain

benefit; other tables show the percent of employees covered by a certain benefit who have

a certain plan feature.

For example, table 1 indicates that 77 percent of all full-time employees were covered

by a medical care plan. In chapter 4, most of the tables present data on the percent of

workers with medical care who have certain provisions. Workers with medical care equal

100 percent in these tables, with smaller percentages indicating the availability of plan

features. For example, in table 49, 100 percent refers to those workers with medical care

plans, and 37 percent indicates those workers with medical care covered by a fee-forservice plan.

Another type of table estimate presented throughtout the bulletin displays average

benefit values rather than perecentages of workers. These averages are presented for all

covered workers; averages exclude workers without the plan provision.

Appendix A discusses all of these data calculations in more detail.

 Results of the 1995 Survey
Table 1. Summary: Participation1 in selected employee benefit programs,

full-time employees, medium and large private establishments, 1995

(In percent)

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Paid time off:

Holidays .................................. 89 88 93 88

Vacations ................................ 96 97 99 94

Personal leave ........................ 22 24 34 15

Funeral leave .......................... 80 83 85 75

Jury duty leave ....................... 85 91 89 79

Military leave ........................... 44 59 45 35

Family leave ........................... 2 3 2 1

Unpaid family leave .................. 84 89 86 80

Disability benefits2:

Paid sick leave ...................... 58 74 78 39

Short-term disability .............. 53 48 52 57

Long-term disability

insurance ............................ 42 60 53 26

Survivor benefits:

Life insurance ..................... 87 93 89 83

Accidental death and

dismemberment ................ 67 70 66 65

Survivor income benefits .... 6 6 4 6

Health care benefits:

Medical care ....................... 77 80 76 75

Dental care ......................... 57 66 57 51

Vision care .......................... 24 29 23 22

Outpatient prescription drug

coverage ........................... 74 77 74 73

See footnotes at end of table.
Table 1. Summary: Participation1 in selected employee benefit programs,

full-time employees, medium and large private establishments, 1995

(In percent) — Continued

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Retirement income benefits:

All retirement3 ......................... 80 87 85 73

Defined benefit ................... 52 53 55 50

Defined contribution4 .......... 55 67 64 45

Savings and thrift ............ 41 50 47 32

Deferred profit sharing .... 13 14 15 10

Employee stock

ownership ..................... 5 5 7 4

Money purchase pension 7 13 6 5

Stock bonus .................... 2 1 4 5 ( )

Cash or deferred

arrangements (401(k) plans):

With employer contributions 45 55 50 37

Salary reduction .............. 44 54 49 35

Savings and thrift6 ...... 37 46 41 29

Deferred profit sharing 5 4 6 5

Other ........................... 2 3 1 2

Deferral of profit sharing

allocation ...................... 2 1 1 2

No employer contributions .. 9 13 8 7

1 Participants are workers covered by a paid time off, insurance, or retirement plan. 

Employees subject to a minimum service requirement before they are eligible for benefit

coverage are counted as participants even if they have not met the requirement at the time of

the survey. If employees are required to pay part of the cost of a benefit, only those who elect

the coverage and pay their share are counted as participants. Except for family leave, benefits

for which the employee must pay the full premium are outside the scope of the survey. Only

current employees are counted as participants; retirees are excluded. 2 The definitions for paid sick leave and short-term disability (previously sickness and

accident insurance) were changed for the 1995 survey. Paid sick leave now only includes

plans that either specify a maximum number of days per year or unlimited days. Short-term

disability now includes all insured, self-insured, and state-mandated plans available on a per

disability basis as well as the unfunded per disability plans previously reported as sick leave. 

Sickness and accident insurance, reported in years prior to this survey, only included insured,

self-insured, and state-mandated plans providing per disability benefits at less than full pay. 3 Includes defined benefit pension plans and defined contribution retirement plans. The

total is less than the sum of the individual items because many employees participated in both

types of plans. 4 The total is less than the sum of the individual items because some employees

participated in more than one type of plan. 5 Less than 0.5 percent. 6 Participants in savings and thrift plans usually are allowed to make pretax contributions. 

In the 1995 survey, provisions governing pretax contributions were not determinable for about

one-tenth of the employees with savings and thrift plans.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no data were reported.
Table 2. Summary: Participation1 in selected employee benefit programs, full-time employees,

medium and large private establishments, 1995

Benefit All

employees

Professional,

technical, and

related

employees

Clerical and

sales employees

Blue-collar

and

service

employees

Total number of employees ...... 33,373,969 9,366,025 8,104,860 15,903,083

Paid time off:

Holidays .................................. 29,780,582 8,199,894 7,543,495 14,037,193

Vacations ................................ 31,913,506 9,038,279 7,999,339 14,875,888

Personal leave ........................ 7,372,202 2,253,258 2,752,675 2,366,268

Funeral leave .......................... 26,715,290 7,813,598 6,927,456 11,974,236

Jury duty leave ....................... 28,353,739 8,566,393 7,250,328 12,537,018

Military leave ........................... 14,807,099 5,543,483 3,673,529 5,590,086

Family leave ........................... 545,816 273,932 168,972 102,913

Unpaid family leave .................. 28,033,237 8,315,225 6,954,574 12,763,438

Disability benefits2:

Paid sick leave ...................... 19,466,591 6,906,477 6,312,139 6,247,975

Short-term disability .............. 17,808,848 4,498,877 4,205,061 9,104,910

Long-term disability

insurance ............................ 14,143,790 5,663,673 4,306,796 4,173,320

Survivor benefits:

Life insurance ..................... 29,078,205 8,720,570 7,227,177 13,130,457

Accidental death and

dismemberment ................ 22,240,709 6,549,858 5,322,154 10,368,697

Survivor income benefits .... 1,878,078 543,578 305,654 1,028,846

Health care benefits:

Medical care ....................... 25,545,758 7,466,514 6,157,920 11,921,324

Dental care ......................... 18,866,181 6,217,109 4,603,174 8,045,898

Vision care .......................... 8,021,332 2,687,678 1,846,239 3,487,416

Outpatient prescription drug

coverage ........................... 24,770,279 7,199,337 6,020,336 11,550,606

See footnotes at end of table.
Table 2. Summary: Participation1 in selected employee benefit programs, full-time employees,

medium and large private establishments, 1995 — Continued

Benefit All

employees

Professional,

technical, and

related

employees

Clerical and

sales employees

Blue-collar

and

service

employees

Retirement income benefits:

All retirement3 ......................... 26,662,168 8,130,015 6,910,422 11,621,730

Defined benefit ................... 17,416,552 4,986,905 4,450,283 7,979,365

Defined contribution4 .......... 18,486,281 6,242,248 5,156,842 7,087,190

Savings and thrift ............ 13,561,579 4,701,837 3,787,741 5,072,001

Deferred profit sharing .... 4,204,640 1,306,157 1,234,543 1,663,940

Employee stock

ownership ..................... 1,706,270 498,842 551,911 655,517

Money purchase pension 2,474,377 1,255,413 491,500 727,465

Stock bonus .................... 504,408 128,915 311,138 64,354

Cash or deferred

arrangements (401(k) plans):

With employer contributions 15,156,177 5,186,660 4,057,042 5,912,475

Salary reduction .............. 14,646,034 5,056,350 3,978,947 5,610,737

Savings and thrift5 ...... 12,267,339 4,302,794 3,359,361 4,605,184

Deferred profit sharing 1,605,503 394,481 493,810 717,212

Other ........................... 680,198 301,621 102,314 276,262

Deferral of profit sharing

allocation ...................... 510,143 130,310 78,095 301,738

No employer contributions .. 3,093,795 1,250,668 662,016 1,181,111

1 Participants are workers covered by a paid time off, insurance, or retirement plan. Employees subject to a minimum

service requirement before they are eligible for benefit coverage are counted as participants even if they have not met the

requirement at the time of the survey. If employees are required to pay part of the cost of a benefit, only those who elect

the coverage and pay their share are counted as participants. Except for family leave, benefits for which the employee

must pay the full premium are outside the scope of the survey. Only current employees are counted as participants;

retirees are excluded. 2 The definitions for paid sick leave and short-term disability (previously sickness and accident insurance) were

changed for the 1995 survey. Paid sick leave now only includes plans that either specify a maximum number of days per

year or unlimited days. Short-term disability now includes all insured, self-insured, and state-mandated plans available on

a per disability basis as well as the unfunded per disability plans previously reported as sick leave. Sickness and accident

insurance, reported in years prior to this survey, only included insured, self-insured, and state-mandated plans providing

per disability benefits at less than full pay. 3 Includes defined benefit pension plans and defined contribution retirement plans. The total is less than the sum of the

individual items because many employees participated in both types of plans. 4 The total is less than the sum of the individual items because some employees participated in more than one type of

plan. 5 Participants in savings and thrift plans usually are allowed to make pretax contributions. In the 1995 survey,

provisions governing pretax contributions were not determinable for about one-tenth of the employees with savings and

thrift plans.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no data

were reported.
Table 3. Other benefits: Eligibility for specified benefits, full-time

employees, medium and large private establishments, 1995

(In percent)

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Income continuation

plans:

Severance pay .......... 35 47 43 24

Supplemental

unemployment

benefits ................... 4 1 1 6

Family benefits:

Employer assistance

for child care1 ......... 8 15 7 3

Employer provided

funds ................... 4 7 4 2

On-site child care .. 3 8 2 1

Off-site child care .. 1 2 1 2 ( )

Adoption assistance 11 18 12 6

Long-term care

insurance ................ 6 8 9 4

Flexible workplace .... 2 5 2 1

Health promotion

programs:

Wellness programs ... 34 47 32 27

Employee assistance

programs ................ 58 72 60 49

Fitness center ........... 19 31 16 13

Miscellaneous benefits:

Job-related travel

accident insurance .. 41 58 47 28

Nonproduction

bonuses .................. 39 40 37 38

Subsidized

commuting .............. 5 8 5 3

Education assistance:

Job-related ............ 65 79 65 56

Not job-related ...... 18 25 17 15

Section 125 cafeteria

benefits3: .................... 55 77 66 37

Flexible benefit plans 12 20 15 7

Reimbursement plans 38 53 46 25

Premium conversion

plans ....................... 5 4 5 5

1 Occupations may have access to more than one type of assistance for child

care. Not all types of assistance are shown separately. Therefore, the sums of

individual items may not equal the totals. 2 Less than 0.05 percent. 3 Includes all types of plans under Internal Revenue Code Section 125. Flexible

benefits plans include reimbursement account features.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates that no data were reported.
Table 4. Other benefits: Eligibility for specified benefits, full-time employees, medium and

large private establishments, 1995

Benefit All

employees

Professional,

technical, and

related

employees

Clerical and

sales employees

Blue-collar

and

service

employees

Total number of

employees ............ 33,373,969 9,366,025 8,104,860 15,903,083

Income continuation

plans:

Severance pay .......... 11,752,594 4,423,922 3,461,884 3,866,788

Supplemental

unemployment

benefits ................... 1,175,113 101,441 104,119 969,553

Family benefits:

Employer assistance

for child care1 ......... 2,527,212 1,398,635 593,543 535,033

Employer provided

funds ................... 1,279,502 675,469 355,384 248,648

On-site child care .. 1,144,119 758,681 201,732 183,705

Off-site child care .. 423,804 229,519 116,388 77,896

Adoption assistance 3,588,606 1,650,480 988,992 949,133

Long-term care

insurance ................ 2,087,765 747,466 751,016 589,283

Flexible workplace .... 705,761 439,358 180,619 85,784

Health promotion

programs:

Wellness programs ... 11,288,509 4,425,556 2,568,610 4,294,343

Employee assistance

programs ................ 19,323,683 6,769,726 4,825,605 7,728,352

Fitness center ........... 6,180,117 2,871,018 1,294,394 2,014,705

Miscellaneous benefits:

Job-related travel

accident insurance .. 13,758,934 5,476,248 3,774,010 4,508,677

Nonproduction

bonuses .................. 12,919,404 3,777,467 3,020,092 6,121,845

Subsidized

commuting .............. 1,547,130 749,648 393,235 404,247

Education assistance:

Job-related ............ 21,563,913 7,361,142 5,291,165 8,911,606

Not job-related ...... 6,077,329 2,317,889 1,365,224 2,394,216

Section 125 cafeteria

benefits2: .................... 18,421,559 7,178,193 5,370,399 5,872,968

Flexible benefit plans 4,086,002 1,842,611 1,202,510 1,040,882

Reimbursement plans 12,686,085 4,975,847 3,738,134 3,972,104

Premium conversion

plans ....................... 1,649,472 359,735 429,755 859,981

1 Occupations may have access to more than one type of assistance for child care. Not all types of assistance

are shown separately. Therefore, the sums of individual items may not equal the totals. 2 Includes all types of plans under Internal Revenue Code Section 125. Flexible benefits plans include

reimbursement account features.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates that

no data were reported.
Table 5. Plan administration: Type of plan sponsor for selected employee benefit programs,

full-time employees, medium and large private establishments, 1995

(In percent)

Plan sponsor Medical

care

Life

insurance

Short-term

disability

Long-term

disability

insurance

Defined

benefit

pension

Savings

and thrift

All participants

Total ................................ 100 100 100 100 100 100

Single employer .................... 95 95 82 86 90 99

Multiemployer1 ...................... 5 4 6 3 9 2 ( )

Mandated benefits3 .............. – 2 ( ) 12 – 2 ( ) –

Employer association4 .......... 2 ( ) 2 ( ) – 1 2 ( ) 1

Not determinable .................. – 2 ( ) – 10 – –

Professional, technical, and

related

Total ................................ 100 100 100 100 100 100

Single employer .................... 98 99 85 89 96 99

Multiemployer1 ...................... 1 1 1 2 ( ) 3 2 ( )

Mandated benefits3 .............. – 2 ( ) 14 – 1 –

Employer association4 .......... 1 1 – 1 2 ( ) 1

Not determinable .................. – 2 ( ) – 10 – –

Clerical and sales

Total ................................ 100 100 100 100 100 100

Single employer .................... 97 98 80 90 93 99

Multiemployer1 ...................... 3 2 3 1 7 2 ( )

Mandated benefits3 .............. – 2 ( ) 16 – – –

Employer association4 .......... 2 ( ) 2 ( ) – 1 2 ( ) 1

Not determinable .................. – 2 ( ) – 8 – –

Blue-collar and service

Total ................................ 100 100 100 100 100 100

Single employer .................... 92 92 81 77 86 99

Multiemployer1 ...................... 8 8 9 9 14 1

Mandated benefits3 .............. – – 10 – – –

Employer association4 .......... 2 ( ) – – 2 ( ) 2 ( ) 2 ( )

Not determinable .................. – 2 ( ) – 13 – –

1 Individual employers in the same or in a related industry contributing a negotiated amount to a trust fund providing

benefits for employees covered under a collective bargaining agreement. 2 Less than 0.05 percent. 3 The majority of the participants with mandated short-term disability benefits were covered by State temporary

disability insurance plans. The remaining employees were covered by the Railroad Unemployment Insurance Act. 

Mandated defined benefit pension plan participants were covered by Railroad Retirement Tier 2. 4 Band of medium and large employers in a common trade or business, for example, savings and loan associations. 

The plan sponsored by the association is not negotiated with the employees.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates that no data

were reported.
Most full-time employees work a 40-hour week. Time

off with pay is available to employees in several

different forms__from daily personal leave to annual vacations of several weeks per year. EBS covers the following paid time-off benefits: Holidays and vacations; personal, funeral, jury-duty, and military leave. Paid and unpaid family leave are also surveyed. (Information on paid sick

leave is discussed under Disability Benefits and appears in

chapter 3.)

Work schedules

Work schedules of 40 hours per week are predominant

among the full-time employees covered by this survey. However, alternatives, such as 35 or 371/

2 hours per week, are

found among white-collar workers. A large majority of the

workforce is scheduled to work five 8-hour days (table 6).

A small number of workers studied have formal flexible

work arrangements, which give employees the opportunity to

begin and end work within a range of hours (table 7). Limits

on the amount of flexibility vary from plan to plan but, generally, employees have to be at work during midday core hours.

A few other workers have a specified rotating work cycle or a

non-fixed work schedule.

Paid time off

Paid holidays. Paid holidays, approximately 9 days per year,

are provided to most full-time employees. Floating holidays

and “personal holidays,” such as employee birthdays, are included in the holiday plans reported (tables 8-9).

Paid holidays generally commemorate patriotic, cultural,

or religious events. Among the paid holidays are:

New Year’s Day;

Memorial Day;

Independence Day;

Labor Day;

Thanksgiving Day; and

Christmas Day.

When a holiday falls on a scheduled day off, such as

Saturday or Sunday, another day off is often substituted.

Paid vacations. Paid vacations are provided to almost all fulltime employees. Usual vacation pay provisions for all employees are 5 or 10 days at 1 year of service, 15 or 20 days at

10 years, and 20 to 30 days at 20 years or more (table 10).

Plan covering white-collar employees, on average, provide

slightly more vacation days than those covering blue-collar

employee (table 8).

Most employees covered by vacation plans were required

to complete a specified period of time before being able to

take a vacation (table 11). The most prevalent length-of-service requirements are 6 months or 1 year.

The survey also examines carryover and cash-in provisions

for unused vacation time (tables 12-13). Many full-time workers are allowed to carry over at least some of their unused

vacation days into the next year; others can cash in some or

all of their vacation days at the end of the year. Workers without carryover and cash-in coverage lose unused vacation days

at the end of the year. White-collar workers are more likely to

have carryover provisions than blue-collar workers, who, in

turn, are more likely to receive cash-in provisions.

Paid personal leave. Although nearly all employers provide

paid vacations, few provide formal personal leave (table 14).

Such leave allows employees to be absent from work with

pay for a variety of reasons not covered by other specific

leave plans. Most commonly, employees granted personal

leave are eligible for 1 to 5 days per year. A few employees

are provided as much personal leave as needed.

Paid funeral leave, jury-duty leave, and military leave. The

majority of full-time workers are eligible for paid leave to

attend funerals of family members (table 15). Eligible employees usually receive a set number of days, such as 3 days,

per occurrence. However, some plans vary the number of days

off by family relationship to the deceased. For example, a

plan may provide 3 days off for the death of a spouse, parent,

or child, but only 1 day off for the death of other relatives.

For employees who do not have a formal funeral leave plan,

some employers may provide an informal benefit or allow

employees to use other types of paid leave, such as paid sick

leave days, to attend a funeral.

Most workers are eligible for paid leave while serving as a

juror (table 16). Paid time off for jury duty is usually provided “as needed”; employer payments commonly make up

the difference between the employee’s regular pay and the

court’s jury allowance.

Military leave, providing pay for absence from work to

fulfill military training or duty commitments, is available in

Chapter 2.

Work Schedules, Paid

Time Off, and Family Leave

14
many establishments (table 17). A common provision is 2

weeks off per year, but some workers were establishments

allowing them to take paid leave as needed. Pay for military

leave is either regular pay or the difference between regular

pay and military pay.

Family leave

The Employee Benefits Survey measures the incidence of

formal family leave benefits (table 18). Previously, the

survey of medium and large private establishments estimated

Disability Benefits

15

parental leave, generally in the form of maternity and

paternity leave. The passage of the Federal Family and

Medical Leave Act of 1993 requires employers to provide

employees with up to 12 weeks of unpaid leave during any

12-month period for vaarious family matters, including the

birth or adoption of a child and for family illnesses (employee,

child, spouse, or parent). Generally, these provisions apply to

employees with at least 1 year of service who work 1,250

hours during the year and who are employed by companies

with 50 or more workers.

Paid family leave is rare.
Table 6. Work schedule: Percent of full-time employees by

hours scheduled per week and per day,1 medium and large

private establishments, 1995

Work schedule

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollarand

service

employees

Number (in thousands) with

work schedule ..................... 33,374 9,366 8,105 15,903

Percent

Total .................................... 100 100 100 100

Hours per week:

Under 35 ........................... 2 2 1 3

35 ...................................... 4 5 5 3

Over 35 and under 37.5 .... 1 1 1 2 ( )

37.5 ................................... 5 6 7 3

Over 37.5 and under 40 ... 2 2 3 2

40 ...................................... 83 81 81 85

Over 40 ............................. 3 3 1 3

Hours per day:

Under 7 ............................. 2 2 1 2

7 ........................................ 4 5 5 3

Over 7 and under 8 ........... 7 8 11 4

8 ........................................ 83 80 82 84

Over 8 and under 9 ........... 2 ( ) 1 2 ( ) 2 ( )

9 ........................................ 1 2 2 ( ) 1

Over 9 and under 10 ......... 2 ( ) 2 ( ) 2 ( ) 2 ( )

10 ...................................... 1 1 2 ( ) 1

Over 10 ............................. 2 1 2 ( ) 4

1 Work schedule data includes paid lunch and paid rest periods. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 7. Work schedule: Percent of full-time employees by

type of work schedule, medium and large private

establishments, 1995

Work schedule

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Participants (in thousands) 33,374 9,366 8,105 15,903

Percent

 Total ............................... 100 100 100 100

With fixed work schedule ...... 95 94 96 96

With flexible work schedule .. 1 2 2 1 ( )

With rotating work schedule 1 1 1 ( ) 2

With non-fixed work schedule 1 2 2 1

Other ..................................... 1 ( ) 1 ( ) - 1 ( )

Data not available ................. 1 1 1 1

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 8. Paid holidays and vacations: Average number of

days for full-time employees, medium and large private

establishments, 1995

Item

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Paid holidays ............................ 9.1 9.7 8.8 9.0

Paid vacation by minimum

length of service requirement:1

At 1 year2 ............................ 9.6 12.5 9.8 7.6

At 3 years ........................... 11.5 13.5 11.3 10.3

At 5 years ........................... 13.9 16.3 14.0 12.3

At 10 years ......................... 16.9 19.1 17.0 15.5

At 15 years ......................... 18.9 21.2 19.3 17.3

At 20 years ......................... 20.4 22.5 20.4 19.1

At 25 years ......................... 21.7 23.7 22.0 20.4

At 30 years3 ........................ 22.0 24.0 22.3 20.7

1 Employees are either granted a specific number of days after

completion of the indicated length of service, or accrue days during the next

12-month period. The total number of days are assumed available for use

immediately upon completion of the described length-of-service interval. 2 Employees receiving vacation days, but none at 1 year of service, were

included only for the service periods for which they receive vacations. 3 The average (mean) was essentially the same for longer lengths of

service.

NOTE: Computation of average included partial days and excluded workers

with zero holidays or vacation days. Methods used to calculate the average

number of paid holidays have been revised, to count partial holidays more

precisely. The average holidays in this table are not comparable to those

reported in the 1991 and 1993 surveys of medium and large private

establishments.
Table 9. Paid holidays: Percent of full-time employees by

number of paid holidays provided each year, medium and

large private establishments, 1995

Number of days

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid holidays ....................... 29,663 8,200 7,521 13,942

Percent

Total with paid holidays ........ 100 100 100 100

Less than 6 days .............. 5 2 5 7

6 days ............................... 12 7 17 13

6.1-6.9 days ...................... 1 ( ) 1 ( ) 1 ( ) 1 ( )

7 days ............................... 8 5 9 9

7.1-7.9 days ...................... 1 ( ) 1 ( ) 1 1 ( )

8 days ............................... 10 12 9 9

8.1-8.9 days ...................... 1 1 1 ( ) 1

9 days ............................... 12 13 11 11

9.1-9.9 days ...................... 1 ( ) 1 ( ) 1 ( ) 1 ( )

10 days ............................. 21 21 26 19

10.1-10.9 days .................. 1 ( ) 1 ( ) 2 –

11 days ............................. 14 17 11 14

11.1-11.9 days .................. 1 2 1 1 ( )

12 days ............................. 8 11 5 8

12.1-12.9 days .................. 1 ( ) 1 ( ) 1 ( ) 1 ( )

13 days ............................. 4 4 1 5

13.1-13.9 days .................. 1 ( ) 1 ( ) – 1 ( )

14 days ............................. 1 1 ( ) 1 ( ) 1

More than 14 days ............ 2 2 1 3

Number of days not

available ..................... 1 ( ) 1 1 ( ) 1 ( )

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals.

Where applicable, dash indicates no employees in this category.
Table 10. Paid vacations: Percent of full-time employees by

number of paid vacation days provided for selected periods of

service, medium and large private establishments, 1995

Vacation policy

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid vacations ..................... 31,914 9,038 7,999 14,876

Percent

Total with paid vacations1 ......... 100 100 100 100

Vacation days by minimum

length-of-service

requirement2

After 1 year of service:

Under 5 days ................ 2 1 1 3

5 days ........................... 32 8 23 53

Over 5 and under 10

days ........................ 2 1 1 4

10 days ......................... 43 52 59 29

Over 10 and under 15

days ........................ 4 7 3 2

15 days ......................... 4 9 3 2

Over 15 and under 20

days ........................ 1 2 1 3 ( )

20 days ......................... 2 7 3 ( ) 3 ( )

Over 20 days ................ 5 10 5 3

After 3 years of service:

Under 5 days ................ 3 ( ) 1 3 ( ) 3 ( )

5 days ........................... 5 1 3 9

Over 5 and under 10

days ........................ 3 2 1 5

10 days ......................... 65 52 75 68

Over 10 and under 15

days ........................ 7 7 5 8

15 days ......................... 7 15 6 3

Over 15 and under 20

days ........................ 1 2 1 1

20 days ......................... 3 8 2 1

Over 20 days ................ 6 11 5 3

After 5 years of service:

Under 5 days ................ 3 ( ) 3 ( ) 0 3 ( )

5 days ........................... 1 3 ( ) 1 2

Over 5 and under 10

days ........................ 2 1 1 3

10 days ......................... 39 23 36 51

Over 10 and under 15

days ........................ 5 6 3 6

15 days ......................... 34 38 45 27

Over 15 and under 20

days ........................ 3 5 2 1

20 days ......................... 5 10 4 2

Over 20 days ................ 8 15 7 3

After 10 years of service:

Under 5 days ................ 3 ( ) 3 ( ) 0 0

5 days ........................... 1 3 ( ) 1 2

See footnotes at end of table.
Table 10. Paid vacations: Percent of full-time employees by

number of paid vacation days provided for selected periods of

service, medium and large private establishments, 1995 —

Continued

Vacation policy

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

After 10 years of service:

Over 5 and under 10

days ........................ 1 1 3 ( ) 2

10 days ......................... 8 3 5 12

Over 10 and under 15

days ........................ 2 1 1 3

15 days ......................... 50 38 59 52

Over 15 and under 20

days ........................ 6 5 3 8

20 days ......................... 19 29 20 13

Over 20 and under 25

days ........................ 3 8 2 1

25 days ......................... 2 4 1 3 ( )

Over 25 days ................ 6 10 6 3

After 15 years of service:

5 days ........................... 1 3 ( ) 1 2

Over 5 and under 10

days ........................ 1 3 ( ) 3 ( ) 1

10 days ......................... 7 3 4 11

Over 10 and under 15

days ........................ 1 1 1 2

15 days ......................... 22 14 20 28

Over 15 and under 20

days ........................ 4 4 2 5

20 days ......................... 47 49 59 40

Over 20 and under 25

days ........................ 4 8 2 2

25 days ......................... 3 6 3 2

Over 25 and under 30

days ........................ 2 3 2 1

30 days ......................... 2 4 1 3 ( )

Over 30 days ................ 4 7 4 2

After 20 years of service:

5 days ........................... 1 3 ( ) 1 2

Over 5 and under 10

days ........................ 3 ( ) 3 ( ) 3 ( ) 1

10 days ......................... 7 3 4 11

Over 10 and under 15

days ........................ 1 1 3 ( ) 2

15 days ......................... 12 6 14 15

Over 15 and under 20

days ........................ 1 1 1 2

20 days ......................... 45 46 55 39

Over 20 and under 25

days ........................ 5 9 3 4

25 days ......................... 14 15 12 15

Over 25 and under 30

days ........................ 3 5 2 2

30 days ......................... 2 4 1 1

Over 30 days ................ 5 8 5 3

See footnotes at end of table.
Table 10. Paid vacations: Percent of full-time employees by

number of paid vacation days provided for selected periods of

service, medium and large private establishments, 1995 —

Continued

Vacation policy

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

After 25 years of service:

5 days ........................... 1 3 ( ) 1 2

Over 5 and under 10

days ........................ 3 ( ) 3 ( ) 3 ( ) 1

10 days ......................... 7 3 4 11

Over 10 and under 15

days ........................ 1 1 3 ( ) 2

15 days ......................... 12 6 14 15

Over 15 and under 20

days ........................ 1 1 1 1

20 days ......................... 30 32 33 27

Over 20 and under 25

days ........................ 4 7 3 3

25 days ......................... 28 29 32 26

Over 25 and under 30

days ........................ 2 3 2 1

30 days ......................... 6 9 4 6

Over 30 days ................ 5 8 5 3

After 30 years of service4

5 days ........................... 1 3 ( ) 1 2

Over 5 and under 10

days ........................ 3 ( ) 3 ( ) 3 ( ) 1

10 days ......................... 7 3 4 11

Over 10 and under 15

days ........................ 1 1 3 ( ) 2

15 days ......................... 12 6 14 15

Over 15 and under 20

days ........................ 1 1 1 1

20 days ......................... 29 31 33 26

Over 20 and under 25

days ........................ 4 7 2 3

25 days ......................... 25 25 29 22

Over 25 and under 30

days ........................ 2 3 2 1

30 days ......................... 10 14 7 9

Over 30 days ................ 6 8 7 4

Vacation policy not available .... 2 2 1 3

1 Employees receiving no paid vacations in their early years of service

are included in the overall percentage of workers provided paid vacations;

however, they are disregarded in computing the distributions by

length-of-service up to the service period at which they become eligible for

vacations. 2 Employees either are granted a specific number of days after

completion of the indicated length-of-service, or accrue days during the next

12 month period. The total number of days are assumed available for use

immediately upon completion of the described length-of-service interval. 3 Less than 0.5 percent. 4 Provisions were virtually the same after longer years of service.

NOTE: Because of rounding, sums of individual items may not equal totals.

Where applicable, dash indicates no employees in this category.
Table 11. Paid vacations: Percent of full-time employees by

length of service required to take vacation, medium and large

private establishments, 1995

Length-of-service requirement

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid vacations ..................... 31,914 9,038 7,999 14,876

Percent

Total with paid vacations .......... 100 100 100 100

With service requirement ...... 88 81 91 89

1 month ............................. 10 18 7 6

2 months ........................... 1 2 1 1

3 months ........................... 7 7 11 5

4-5 months ........................ 1 2 1 1 ( )

6 months ........................... 23 27 31 17

7-11 months ...................... 1 1 ( ) 1 ( ) 1

1 year ................................ 45 26 39 59

Over 1 year ....................... 1 ( ) 1 ( ) 1 1 ( )

Without service requirement 12 18 8 10

Service requirement not

determinable ................... 1 1 1 1

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals.

Where applicable, dash indicates no employees in this category.
Table 12. Paid vacations: Percent of full-time employees by

unused vacation policy, medium and large private

establishments, 1995

Type of plan

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid vacations ..................... 31,914 9,038 7,999 14,876

Percent

Total with paid vacations .......... 100 100 100 100

Carryover only ...................... 24 39 28 13

Cash-in only .......................... 11 6 6 18

Carryover and cash-in .......... 11 17 9 8

Unused benefit lost ............... 49 35 53 56

Data not available ................. 5 4 4 6

NOTE: Because of rounding, sums of individual items may not equal totals.

Where applicable, dash indicates no employees in this category.
Table 13. Paid vacations: Average number of days for full-time employees by carryover and cash-in

provisions, medium and large private establishments, 1995

Paid vacation by minimum

length of service requirement1 All plans

Carryover,

cash-in, or

both

Carryover

only

Cash-in

only

Carryover

and

cash-in

No

caryover or

cash-in

All employees

After 1 year2 ................. 9.6 11.2 11.4 7.2 15.0 8.2

After 3 years ................. 11.5 12.8 12.6 9.9 16.3 10.4

After 5 years ................. 13.9 15.5 15.4 12.4 19.1 12.5

After 10 years ............... 16.9 18.6 18.5 15.7 22.1 15.4

After 15 years ............... 18.9 20.8 20.7 17.9 23.9 17.3

After 20 years ............... 20.4 22.1 22.0 19.6 25.3 18.9

After 25 years ............... 21.7 23.3 23.3 20.6 26.1 20.4

After 30 years3 .............. 22.0 23.6 23.7 20.8 26.4 20.7

1 Employees either are granted a specific number of days after completion of the indicated length of service, or accrue

days during the next 12 month period. The total number of days are assumed available for use immediately upon

completion of the described length-of-service interval. 2 Employees receiving vacation days, but none at 1 year of service, were included only for the service periods for which

they receive vacations. 3 The average (mean) was essentially the same for longer lengths of service.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no

employees in this category.
Table 14. Paid personal leave: Percent of employees by

number of paid personal leave days available per year,

medium and large private establishments, 1995

Number of days

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid personal leave ............ 7,372 2,253 2,753 2,366

Percent

Total with paid personal leave .. 100 100 100 100

1 day ..................................... 16 16 12 21

2 days ................................... 34 22 45 33

3 days ................................... 17 18 15 17

4 days ................................... 11 13 10 9

5 days ................................... 10 14 6 10

More than 5 days .................. 8 11 7 7

No maximum specified1 ........ 3 4 2 3

Number of days not available 1 1 2 1

Average

 Average days per year ............ 3.3 3.9 3.0 3.2

1 Personal leave provided as needed.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 15. Paid funeral leave: Percent of employees by number

of paid funeral leave days available per occurrence, medium

and large private establishments, 1995

Number of days

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid funeral leave ............... 26,715 7,814 6,927 11,974

Percent

 100 100 100 100

Total with paid funeral leave

1 day ................................. 1 1 ( ) 1 ( ) 1

2 days ............................... 3 1 1 5

3 days ............................... 71 65 71 73

4 days ............................... 2 2 3 2

5 days ............................... 15 22 16 11

More than 5 days .............. 1 ( ) 1 ( ) 1 1 ( )

No maximum specified2 .... 5 6 6 4

Number of days not

available ..................... 3 3 2 3

Number of days varies by

relationship to

deceased3 .................. 31 33 35 29

Average

 Average days per occurrence .. 3.3 3.5 3.4 3.2

1 Less than 0.5 percent. 2 Funeral leave is provided as needed. 3 The maximum number of days for any occurrence was included in the

distribution of funeral leave days.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 16. Paid jury-duty leave: Percent of employees by

number of paid jury-duty leave days available per occurrence,

medium and large private establishments, 1995

Number of days

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid jury-duty leave ............ 28,354 8,566 7,250 12,537

Percent

Total .......................................... 100 100 100 100

Under 10 days ...................... 2 2 1 3

10 days ................................. 8 6 8 9

11 - 19 days .......................... 2 3 1 1

20 days ................................. 1 1 1 1

21 days ................................. 1 ( ) 1 ( ) 1 ( ) -

22 - 30 days .......................... 4 3 3 5

More than 30 days ................ 1 1 1 ( ) 2

No maximum specified2 ........ 81 82 85 79

Number of days not available 1 ( ) 1 1 ( ) 1 ( )

1 Less than 0.5 percent. 2 Jury-duty leave is provided as needed.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 17. Paid military leave: Percent of employees by

number of paid military leave days available per year, medium

and large private establishments, 1995

Number of days

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid military leave ............... 14,807 5,543 3,674 5,590

Percent

Total .......................................... 100 100 100 100

Under 10 days ...................... 2 2 2 1

10 days ................................. 51 50 52 51

11-14 days ............................ 5 6 5 3

15 days ................................. 9 6 6 14

16 - 19 days .......................... 2 2 5 1

20 days ................................. 2 2 2 3

21 - 29 days .......................... 2 3 1 2

30 days ................................. 2 3 2 2

More than 30 days ................ 3 6 2 1

No maximum specified1 ........ 21 20 23 21

Number of days not available 1 1 2 ( ) 1

Average

Average days per year ............. 14.7 17.3 14.1 12.6

1 Military leave is provided as needed. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 18. Unpaid family leave1: Percent of employees

by duration of benefits, medium and large private

establishments, 1995

Duration

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands)

with unpaid family

leave ........................... 28,033 8,315 6,955 12,763

Percent

Total with unpaid family

leave ........................... 100 100 100 100

Under 12 weeks .... 1111

12 weeks .............. 86 82 82 91

Over 12 weeks ...... 13 17 17 8

Average

Average weeks ............. 13.9 14.5 14.5 13.2

1 The maximum number of weeks available was included in the

distribution of unpaid family leave weeks.

NOTE: Because of rounding, sums of individual items may not

equal totals. Where applicable, dash indicates no employees in this

category.
This chapter discusses three types of disability benefits:

Sick leave, short-term disability coverage, and longterm disability insurance. Paid sick leave and shortterm disability plans protect workers against loss of income

during temporary absences from work due to illness or accident. Through long-term disability insurance plans, workers

may continue to receive their income during longer periods

of disability. (See tables at end of this chapter.) Among the

disability benefit provisions for which the EBS produces data

are:

• Waiting periods before benefits begin,

• Amount of benefits,

• Duration of benefits,

• Plan eligibility requirements.

There are two types of protection against loss of income

during short-term illness or injury. Sick leave usually provides 100 percent of the worker’s earnings, whereas shortterm disability plans (previously, sickness and accident insurance) usually replace 50 to 67 percent of pay. (Some sick

leave plans may provide days off at partial pay in addition to

those at full pay. All sick leave tables shown at the end of this

chapter exclude days paid at partial pay.)

Sick leave and short-term disability coverage are provided

to most full-time employees. Some workers have both sick

leave and short-term disability coverage, with the two benefits coordinated. Coordination can take two forms: starting

short-term disability benefits after sick leave pay has ended,

or paying both benefits concurrently. When payments are

made from both sources, sick leave pay is reduced by the

amount of short-term disability benefits, usually in the form

of sickness and accident insurance, so that the total benefit

does not exceed full salary.

Long-term disability insurance (LTD), which typically pays

60 percent of earnings, is also available to many full-time

employees in medium and large establishments. LTD insurance payments usually begin after 3 or 6 months of disability

and continue until retirement age or for a specified number of

months, depending on the worker’s age at the time of disability.

Paid sick leave and LTD insurance are more prevalent

among white-collar workers, and short-term disability benefits are more common among blue-collar workers.

Paid sick leave

Most employees are covered by paid sick leave plans for

a fixed number of days, such as 13 days, per year. Other

Chapter 3.

Disability Benefits

participants receive sick leave benefits on an “as needed”

basis, not specifying the maximum number of days.

Annual sick leave plans may provide either uniform benefits for all employees or benefits that increase with seniority, such as 12 days after 1 year of service, 18 days after 5

years, and 21 days after 10 years. Nearly all workers covered

by annual plans receive full pay while they are sick and their

benefits are not subject to a waiting period before benefits

begin.

Annual sick leave plans also allow many employees to carry

over and accumulate unused sick leave from year to year (cumulative plans). Most cumulative plans have limits on the

amount of sick leave, often 30 days, that can be carried over

to the next year. Other cumulative plans allow workers to accrue an unlimited amount of sick leave. Noncumulative plans

usually provide a greater number of days per year than cumulative plans (table 23).

Employees are often not eligible for sick leave benefits

when they first begin to work. Many workers have to meet

length of service requirements, frequently 1 to 6 months, before qualifying for sick leave benefits.

Although sick leave, often 30 days, is commonly thought

of as replacing lost income while an employee is ill or injured, a majority of workers can use their benefits for other

reasons. For example, using sick leave for a doctor’s appointment or to take care of a sick child were the most frequently

observed provisions.

Short-term disability coverage

Short-term disability plans cover many employees in medium and large private establishments. The majority of participants have their benefits paid by their employer through

funded plans, usually self-insured or insured by a commercial carrier (tables 26-35). Unfunded plans include per disability plans previously reported as sick leave.

The two most common ways to provide benefit payments

under funded short-term disability plans are either a percent

of employee earnings or a flat dollar amount. White-collar

participants are more likely to be covered by plans with earnings-based formulas than are blue-collar participants.

Under earnings-based formulas, the percent of earnings is

usually fixed__typically 50, 60, or 67 percent__although some

plans may vary the percent by length of service or length of

disability. Many participants in earnings-based plans have a

dollar limit on the amount of the weekly benefit.

Blue-collar workers frequently receive scheduled dollar

benefits, which provide either a fixed weekly amount, for example, $150 or $200, or varying weekly benefits (usually

based on earnings).

23
Funded plans that place a fixed maximum on the number

of weeks of coverage, normally 26 weeks, cover most participants.

Some of the employees with funded short-term disability

plans have to be on the job for a specified time before the

plan will cover them. This service requirement is typically 3

months or less.

Short-term disability benefits, unlike sick leave, usually require a waiting period before benefits begin, often 7 days.

Waiting periods may be shortened or eliminated entirely if an

employee is involved in an accident or hospitalized. The waiting period is effectively dropped when short-term disability

benefits are coordinated with sick leave, because short-term

disability payments typically start immediately after sick leave

pay has ended. Workers in New Jersey and New York are

covered by mandatory temporary disability insurance plans

that are at least partially employer financed. Both of these

State plans pay benefits based on a proportion of the worker’s

earnings for up to 26 weeks with a limit on the weekly

benefit.4 Hawaii requires that employers provide a minimum

level of temporary disability income protection for up to 26

weeks.

Long-term disability insurance

Long-term disability insurance provides a monthly benefit

to employees who, due to illness or injury, are unable to work

for an extended period of time. Generally, LTD benefit payments begin after 3 or 6 months of disability and continue

until retirement age, or for a specified number of months,

depending on the employee’s age at the time of disability. In

most instances, the LTD payments equal a fixed percent of

predisability earnings.

A large number of full-time employees have LTD coverage provided through their employers. The degree of participation varies widely among employee groups; white-collar

workers are more likely to have LTD insurance than bluecollar workers. However, some employees not covered under LTD insurance are eligible for an immediate disability

pension through their retirement plan (see chapter 6).

Participants often have to wait 6 months after the onset of

disability before beginning to receive LTD payments. For

some participants, LTD benefits begin after the expiration of

sick leave and short-term disability benefits (table 36).

The majority of LTD plan participants receive their LTD

benefit as a fixed percent of predisability earnings. The benefit commonly yields 60 percent of monthly pay. Most of these

plans set a limit on monthly payments, for example, between

$4,000 and $10,000 (tables 37-38).

Participants in long-term disability plans usually receive

their benefits until retirement or for a specified number of

months, depending on the employee’s age at the time of disability (table 39).

LTD plans usually have more restrictive service requirements than other insurance benefits studied (table 40).

Because of the long-term nature of the LTD benefits, employers often restrict eligibility to employees who demonstrate some attachment to the establishment. Most plans impose service requirements before LTD coverage begins, often

3 to 12 months.

4 Both States permit an employer to substitute a private plan for the State

plan if the benefits provided are at least equivalent. In New York, many

employers agree to pay the employee’s share of plan costs. California and

Disability Benefits

Rhode Island also have mandated temporary disability insurance plans, but

these plans require no employer contribution and, thus, are not included in

this survey.

 —ENDNOTES—

24
Table 19. Paid sick leave: Percent of full-time employees by

type of provision,1 medium and large private establishments,

1995

Provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid sick leave .................... 19,467 6,906 6,312 6,248

Percent

Total with paid sick leave .. 100 100 100 100

Sick leave provision:

Annual number of days2 ....... 92 90 95 93

As needed3 ........................... 5 7 3 3

Other basis4 .......................... 2 2 1 2

Policy not available ............... 1 1 5 ( ) 2

1 Per disability sick leave plans, previously reported under paid sick

leave, are now included under short-term disability coverage. 2 Employees earn or accrue a specified number of sick leave days per

year. This number may vary by length of service. 3 Plan does not specify maximum number of days. 4 Includes formal plans that change from a specified number of days per

year to a specified number of days per absence after a certain service period. 5 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 20. Paid annual sick leave: Percent of full-time employees by number

of days,1 medium and large private establishments, 1995

Sick leave policy2 All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Number (in thousands) with

paid annual sick leave ........ 17,962 6,196 5,975 5,791

Percent

Total with paid annual sick

leave3 ................................. 100 100 100 100

After 1 year of service:

Total .................................. 95 97 96 93

Under 5 days .................... 6 2 4 12

5 and under 10 days ......... 41 29 49 45

10 and under 15 days ....... 34 44 29 27

15 and under 30 days ....... 11 15 12 7

30 and under 60 days ....... 2 3 1 1

60 and under 120 days ..... 1 1 1 1

120 and under 180 days ... 1 1 4 ( ) 1

180 days or more .............. 4 ( ) 4 ( ) 4 ( ) 4 ( )

After 3 years of service:

Total .................................. 98 99 98 97

Under 5 days .................... 6 2 4 13

5 and under 10 days ......... 40 27 48 45

10 and under 15 days ....... 32 42 27 25

15 and under 30 days ....... 10 13 8 8

30 and under 60 days ....... 7 9 10 3

60 and under 120 days ..... 2 3 1 1

120 and under 180 days ... 1 3 4 ( ) 1

180 days or more .............. 4 ( ) 4 ( ) 4 ( ) 4 ( )

After 5 years of service:

Total .................................. 98 99 98 98

Under 5 days .................... 6 2 4 13

5 and under 10 days ......... 40 27 47 46

10 and under 15 days ....... 31 41 27 25

15 and under 30 days ....... 6 7 5 5

30 and under 60 days ....... 6 9 4 4

60 and under 120 days ..... 9 10 11 5

120 and under 180 days ... 1 3 4 ( ) 1

180 days or more .............. 4 ( ) 4 ( ) 4 ( ) 4 ( )

After 10 years of service:

Total .................................. 98 99 98 98

Under 5 days .................... 5 2 3 10

5 and under 10 days ......... 40 27 47 48

10 and under 15 days ....... 31 41 26 25

15 and under 30 days ....... 5 7 4 5

30 and under 60 days ....... 3 5 2 3

60 and under 120 days ..... 9 13 8 6

120 and under 180 days ... 4 5 6 1

180 days or more .............. 4 ( ) 4 ( ) 4 ( ) 4 ( )

After 15 years of service:

Total .................................. 99 100 98 98

Under 5 days .................... 5 2 3 10

5 and under 10 days ......... 40 27 47 48

10 and under 15 days ....... 31 41 26 25

15 and under 30 days ....... 5 7 4 5

30 and under 60 days ....... 3 4 2 2

See footnotes at end of table.
Table 20. Paid annual sick leave: Percent of full-time employees by number

of days,1 medium and large private establishments, 1995 — Continued

Sick leave policy2 All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Percent

After 15 years of service:

60 and under 120 days ..... 7 11 6 5

120 and under 180 days ... 7 8 9 3

180 days or more .............. 4 ( ) 4 ( ) 4 ( ) 4 ( )

After 20 years of service:

Total .................................. 99 100 98 98

Under 5 days .................... 5 2 3 10

5 and under 10 days ......... 40 27 47 48

10 and under 15 days ....... 31 41 26 25

15 and under 30 days ....... 5 7 4 5

30 and under 60 days ....... 3 4 2 2

60 and under 120 days ..... 6 8 5 4

120 and under 180 days ... 6 9 7 3

180 days or more .............. 2 2 3 2

After 25 years of service5

Total .................................. 99 100 98 98

Under 5 days .................... 5 2 3 9

5 and under 10 days ......... 41 27 47 49

10 and under 15 days ....... 31 41 26 25

15 and under 30 days ....... 5 7 4 5

30 and under 60 days ....... 3 4 2 2

60 and under 120 days ..... 4 6 4 3

120 and under 180 days ... 8 12 8 3

180 days or more .............. 2 3 3 2

1 Although some plans also provided sick leave at partial pay, this table presents data only

for days at full pay. 2 Employees receiving partial pay only or no sick leave in their early years of service are

included in the overall percentages of workers provided sick leave; however, they are

disregarded in computing the distributions by length of service up to the service period at

which they become eligible for full sick leave pay. 3 Employees are either granted a specific number of days after completion of the indicated

length of service, or accrue days during the next 12-month period. The total number of days

are assumed available for use immediately upon completion of the described length-of-service

interval. 4 Less than 0.5 percent. 5 Provisions were virtually the same after longer periods of service.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates that no data were reported.
Table 21: Paid annual sick leave: Average number of days at

full pay for full-time employees, medium and large private

establishments, 1995

Sick leave policy

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Paid annual sick leave days1 by

minimum length-of-service:

After 1 year ......................... 11.5 14.7 9.9 9.6

After 3 years ....................... 14.3 18.6 13.1 10.8

After 5 years ....................... 17.6 22.3 17.3 12.8

After 10 years ..................... 21.2 26.6 22.3 14.3

After 15 years ..................... 23.6 29.9 24.3 16.2

After 20 years ..................... 26.3 33.1 27.2 17.8

After 25 years2 .................... 27.7 34.9 28.6 19.0

1 Employees are either granted a specific number of days after

completion of the indicated length of service, or accrue days during the next

12-month period. The total number of days are assumed available for use

immediately upon completion of the described length-of-service interval. 2 The average (mean) was virtually the same after longer years of

service.

NOTE: Computation of average excluded days at partial pay and workers

with only partial pay days or zero days of sick leave.
Table 22: Paid annual sick leave:1 Percent of full-time

employees by unused sick leave policy and carryover

provisions, medium and large private establishments, 1995

Unused sick leave and

carryover provisions

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid annual sick leave ........ 17,962 6,196 5,975 5,791

Percent

Total with paid annual sick

leave ................... 100 100 100 100

Carryover only .......................... 42 47 41 37

Cash-in only .............................. 7 2 6 13

Carryover and cash-in .............. 9 10 7 11

Unused benefit lost ................... 39 37 44 37

Data not available ..................... 3 3 1 3

Total with carryover

provisions ............... 100 100 100 100

Unlimited accumulation ............ 19 27 16 14

Limit on total number of days

accumulated

Total ...................................... 80 73 83 85

Under 10 days ...................... 3 1 4 3

10 days ................................. 4 2 4 7

11-19 days ............................ 5 3 5 8

20 days ................................. 2 1 1 5

21-24 days ............................ 8 7 13 4

25 days ................................. 2 1 4 2

26-29 days ............................ 2 ( ) 2 ( ) 2 ( ) 1

30-39 days ............................ 14 11 14 17

40-49 days ............................ 4 4 3 4

50 days ................................. 2 ( ) 1 2 ( ) 2 ( )

51-64 days ............................ 7 7 6 8

65 days ................................. 2 3 2 3

66-79 days ............................ 5 4 6 4

80-89 days ............................ 1 1 1 1

90-99 days ............................ 6 6 5 6

100-109 days ........................ 1 2 ( ) 1 2

110-119 days ........................ 1 1 1 1

120-129 days ........................ 4 5 4 2

130 days ............................... 6 7 6 3

Over 130 days ...................... 5 7 4 4

Other3 ....................................... 1 1 1 1

1 Paid sick leave plans with a specified number of days available each

year. 2 Less than 0.5 percent. 3 Carryover provisions vary by length of service.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates that no data were reported.
Table 23: Paid annual sick leave1: Average number of days at

full pay for full-time employees by accumulation policy,

medium and large private establishments, 1995

Sick leave policy

All

employees

Professional,

technical,

and related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Sick leave days by minimum

length-of-service

requirement:2

After 1 year of service:

Cumulative plan ................ 9.1 10.4 8.4 8.2

Noncumulative plan .......... 14.2 21.3 11.4 10.9

After 3 years of service:

Cumulative plan ................ 9.6 11.1 8.8 8.3

Noncumulative plan .......... 19.6 29.8 17.4 13.0

After 5 years of service:

Cumulative plan ................ 10.0 11.8 9.1 8.5

Noncumulative plan .......... 26.3 38.4 25.4 16.9

After 10 years of service:

Cumulative plan ................ 10.7 12.9 9.8 8.8

Noncumulative plan .......... 33.5 47.7 35.0 19.6

After 15 years of service:

Cumulative plan ................ 10.9 13.1 9.9 8.9

Noncumulative plan .......... 38.4 55.4 38.8 23.3

After 20 years of service:

Cumulative plan ................ 11.7 14.3 10.8 9.2

Noncumulative plan .......... 43.2 62.0 43.7 26.4

After 25 years of service:3

Cumulative plan ................ 11.7 14.3 10.8 9.2

Noncumulative plan .......... 46.3 66.3 46.5 28.8

Data not available ..................... 4 ( ) 4 ( ) 4 ( ) 4 ( )

1 Paid sick leave plans with a specified number of days available each

year. 2 Employees are either granted a specific number of days after

completion of the indicated length of service, or accrue days during the next

12-month period. The total number of days are assumed available for use

immediately upon completion of the described length-of-service interval. 3 The average (mean) was virtually the same at longer years of service. 4 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates that no data were reported.

NOTE: Computation of average excluded days paid at partial pay and

workers with only partial pay days or zero days of sick leave.
Table 24: Paid annual sick leave: Percent of full-time

employees by length of service requirement for participation,

medium and large private establishments, 1995

Length of service requirement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid annual sick leave ........ 17,962 6,196 5,975 5,791

Percent

Total with paid annual sick

leave ............................. 100 100 100 100

With service requirement .......... 65 53 73 70

1 month ................................. 16 20 15 11

2 months ............................... 3 2 2 3

3 months ............................... 20 14 28 18

4-5 months ............................ 1 1 ( ) 1 1

6 months ............................... 15 13 18 13

7-11 months .......................... 2 - 1 ( ) 6

1 year .................................... 9 3 8 16

Over 1 year ........................... 1 1 ( ) 1 ( ) 2

Without service requirement ..... 35 47 27 30

Data not available ..................... 1 ( ) 1 ( ) 1 ( ) 1 ( )

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 25: Paid annual sick leave: Percent of full-time

employees in plans allowing use of sick leave for other

purposes, medium and large private establishments, 1995

Other purposes

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

paid annual sick leave ........ 17,962 6,196 5,975 5,791

Percent

Total with paid annual sick

leave ................... 100 100 100 100

Other purposes allowed1 .......... 68 74 73 57

Funeral ................................. 9 11 6 9

Doctors’ appointments .......... 57 61 62 48

Personal business ................ 13 12 12 14

Care of sick child .................. 45 46 53 36

Other ..................................... 12 14 11 11

Other purposes not allowed ...... 26 21 20 36

Data not available ..................... 6 5 6 8

1 This total is smaller than the sum of the components because some

employees could use sick leave for more than one other purpose.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 26. Short-term disability coverage: Method of funding,

full-time employees, medium and large private establishments,

1995

Type of funding

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

short-term disability

coverage ............................. 17,809 4,499 4,205 9,105

Percent

Total with short-term disability

coverage ............................. 100 100 100 100

Unfunded1 ............................ 14 23 21 7

Insured .................................. 20 15 16 25

Self-insured .......................... 44 44 40 45

Legally required .................... 13 14 15 11

Unknown ............................... 7 3 5 10

Other ..................................... 2 1 3 2

1 Includes per disability sick leave plans, formerly reported under sick

leave.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 27. Short-term disability coverage: Method of payment,

full-time employees, medium and large private establishments,

1995

Method of payment

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

funded short-term disability

coverage ............................. 15,308 3,483 3,312 8,512

Percent

Total with funded short-term

disability coverage .............. 100 100 100 100

Flat dollar amount ................. 27 10 12 41

Flat percent of earnings ........ 54 73 66 41

Percent varies1 ..................... 13 14 18 10

Dollar amount varies1 ........... 5 1 2 7

Other ..................................... 1 1 1 1

Not determinable .................. 2 ( ) 2 ( ) 1 2 ( )

1 Benefits may vary by earnings, length of service, or length of disability. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 28. Short-term disability coverage: Flat dollar amounts,

full-time employees, medium and large private establishments,

1995

Flat dollar amount per week

All

employees

Professional,

technical,

and

related 

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with flat

dollar amount ...................... 4,195 354 383 3,458

Percent

Total with flat dollar amount

benefit ................................. 100 100 100 100

Less than $100 ..................... 12 5 17 13

$100 - $149 .......................... 23 17 34 22

$150 - $199 .......................... 31 52 27 29

$200 - $249 .......................... 21 11 6 23

$250 - $299 .......................... 10 11 10 9

$300 or more ........................ 4 3 7 3

 Average1

Average flat dollar amount per

week ................................... $170 $171 $153 $171

1 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 29. Short-term disability coverage: Fixed percent of

earnings amounts, full-time employees, medium and large

private establishments, 1995

Fixed percent of earnings

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

fixed percent of earnings

benefit ................................. 8,247 2,552 2,200 3,495

Percent

Total with flat percent of

earnings benefit .................. 100 100 100 100

Less than 50 percent ........... 1 1 1 2

50 percent ............................. 27 19 28 31

51 - 59 percent ..................... 1 ( ) 1 ( ) 1 ( ) 1

60 percent ............................. 22 15 20 27

61 - 69 percent ..................... 34 39 35 29

70 percent ............................. 7 12 7 4

71 - 79 percent ..................... 3 1 ( ) 5 3

80 percent or more ............... 6 12 5 4

Average2

Average fixed percent of

earnings benefit .................. 63 66 62 61

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 30. Short-term disability coverage: Maximum benefits

placed on percent of earnings formulas, full-time employees,

medium and large private establishments, 1995

Maximum benefit per week

All

employees

Profes

sional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

percent of earnings benefit 10,244 3,049 2,809 4,386

Percent

Number with percent of

earnings benefit .................. 100 100 100 100

With maximum ...................... 55 53 53 57

Less than $200 ................. 16 13 17 17

$200 - $299 ...................... 8 4 5 14

$300 - $399 ...................... 15 12 17 15

$400 - $499 ...................... 3 7 1 ( ) 1

$500 - $599 ...................... 4 4 2 4

$600 or more .................... 9 13 12 6

No maximum ........................ 38 41 37 36

Not determinable .................. 7 6 9 7

Average2

Average maximum benefit per

week ................................... $470 $594 $531 $354

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 31. Short-term disability coverage: Minimum benefits

placed on percent of earnings formulas, full-time employees,

medium and large private establishments, 1995

Minimum benefit per week

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

percent of earnings benefit 10,244 3,049 2,809 4,386

Percent

Total with percent of earnings

benefit ................................. 100 100 100 100

With minimum ....................... 7 7 5 8

Less than $50 ................... 3 2 3 3

$50 - $99 .......................... 1 1 ( ) 1 ( ) 2

$100 - $149 ...................... 1 ( ) 1 ( ) 1 ( ) 1 ( )

$150 or more .................... 3 5 1 2

No minimum ......................... 84 87 82 84

Not determinable .................. 9 6 14 8

Average2

Average minimum benefit per

week ................................... $89 $109 $52 $91

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 32. Short-term disability coverage: Type of waiting

period, full-time employees, medium and large private

establishments, 1995

Waiting period

provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

funded short-term disability

coverage ............................. 15,308 3,483 3,312 8,512

Percent

Total with funded short-term

disability coverage .......... 100 100 100 100

Waiting period not

dependent on sick

leave ........................... 83 78 80 86

Waiting period begins after

sick leave .................... 7 11 10 5

Later of waiting period or

sick leave1 .................. 3 3 5 2

Earlier of waiting period or

sick leave2 .................. 2 5 1 3 ( )

Not determinable .............. 5 3 4 7

1 Benefits begin when sick leave is exhausted or the waiting period is

completed, whichever is later. 2 Benefits begin when sick leave is exhausted or the waiting period is

completed, whichever is earlier. 3 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 33. Short-term disability coverage: Length of waiting

period, full-time employees, medium and large private

establishments, 1995

Length of waiting period

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

funded short-term disability

coverage ............................. 15,308 3,483 3,312 8,512

Percent

Total with funded short-term

disability coverage .............. 100 100 100 100

Immediate ............................. 4 7 5 3

1 day ..................................... 6 6 4 7

2 days ................................... 1 1 1 1

3 days ................................... 4 2 3 5

4 days ................................... 1 1 1 2

5 days ................................... 4 5 7 3

6 days ................................... 2 3 3 2

7 days ................................... 51 49 47 54

Greater than 7 days .............. 20 24 26 17

Not determinable .................. 5 3 4 7

Average1

Average waiting period (in

days) ................................... 8.3 9.8 9.5 7.3

1 The average is presented for all covered workers; averages exclude

workers without plan provisions.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 34. Short-term disability coverage: Duration of benefits,

full-time employees, medium and large private establishments,

1995

Duration of benefits

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

funded short-term disability

coverage ............................. 15,308 3,483 3,312 8,512

Percent

Total with funded short-term

disability coverage .............. 100 100 100 100

Fixed duration ....................... 92 95 89 92

Less than 13 weeks .......... 3 4 5 1

13 weeks .......................... 12 9 9 14

14 - 25 weeks ................... 6 6 7 6

26 weeks .......................... 62 66 61 61

27 - 51 weeks ................... 3 3 4 3

52 weeks .......................... 5 4 2 6

Greater than 52 weeks ..... 2 3 1 1

Duration varies ..................... 7 5 10 8

Not determinable .................. 1 ( ) 1 ( ) 1 1 ( )

 Average2

Average benefit duration (in

weeks) ................................ 26 27 25 26

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 35. Short-term disability coverage: Eligibility

requirements, full-time employees, medium and large private

establishments, 1995

Eligibility requirement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

funded short-term disability

coverage ............................. 15,308 3,483 3,312 8,512

Percent

Total with funded short-term

disability coverage .............. 100 100 100 100

With a service requirement ... 57 45 58 61

1 month ............................. 14 14 14 14

2 months ........................... 5 2 3 8

3 months ........................... 21 13 22 23

4 -5 months ....................... 2 1 2 2

6 months ........................... 7 6 7 8

7 - 11 months .................... 1 2 - 1

12 months ......................... 6 6 10 4

Greater than 12 months .... 2 1 1 2

Without a service

requirement .................... 36 51 34 30

Not determinable .................. 7 4 8 9

Average1

Average service requirement (in

months) ............................... 4.6 5.1 5.1 4.2

1 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 36. Long-term disability insurance: Benefit waiting

period,1 full-time employees, medium and large private

establishments, 1995

Length of waiting period

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

long-term disability

insurance ............................ 14,144 5,664 4,307 4,173

Percent

Total with long-term disability

insurance ............................ 100 100 100 100

Fixed duration ....................... 75 78 79 68

Less than 3 months .......... 1 1 2 1

3 months ........................... 24 25 22 25

4 - 5 months ...................... 2 2 2 3

6 months ........................... 42 43 49 33

Greater than 6 months ...... 6 8 3 7

Expiration of short-term

disability benefits ............ 20 17 18 24

Other ..................................... 2 2 1 4

Not determinable .................. 2 3 2 3

Average2

Average fixed duration (in

months) ............................... 5.4 5.5 5.3 5.4

1 Length of time between onset of disability and beginning of long-term

disability insurance payments. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 37. Long-term disability insurance: Method of payment,

full-time employees, medium and large private establishments,

1995

Method of payment

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

long-term disability

insurance ............................ 14,144 5,664 4,307 4,173

Percent

Total with long-term disability

insurance ............................ 100 100 100 100

Fixed percent of earnings ..... 91 93 94 84

Less than 50 percent ........ 3 4 1 3

50 percent ......................... 18 14 22 20

51 - 59 percent ................. 1 ( ) 1 ( ) 1 ( ) 1

60 percent ......................... 50 52 51 45

61 - 66 percent ................. 2 2 3 2

67 percent ......................... 11 13 13 8

70 percent ......................... 4 6 2 2

Greater than 70 percent ... 2 3 1 3

Percent varies by earnings ... 4 4 3 5

Percent varies by service ..... 1 1 2 1

Flat dollar amount ................. 1 ( ) 1 ( ) 1 ( ) 1 ( )

Dollar amount varies ............. 1 ( ) - - 1 ( )

Other ..................................... 3 1 1 ( ) 8

Not determinable .................. 1 ( ) 1 ( ) 1 1 ( )

Average2

Average fixed percent of

earnings .............................. 59.1 59.7 58.8 58.4

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 38. Long-term disability insurance: Maximum benefits1

based on percent of earnings formulas, full-time employees,

medium and large private establishments, 1995

Maximum benefit

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

percent of earnings benefit 13,635 5,582 4,257 3,795

Percent

Total with percent of earnings

benefit ................................. 100 100 100 100

With maximum ...................... 69 72 70 64

Flat maximum per month .. 69 72 68 64

$2,000 or less ............... 6 5 6 9

$2,001 - $3,000 ............ 7 5 8 10

$3,001 - $4,000 ............ 3 3 4 3

$4,001 - $5,000 ............ 14 13 12 18

$5,001 - $7,500 ............ 11 14 9 9

$7,501 - $10,000 .......... 16 18 19 9

$10,001 or more ........... 11 14 10 7

Other maximum2 .............. 1 3 ( ) 1 3 ( )

No maximum ........................ 31 28 30 36

Average4

Average flat maximum benefit

(per month) ......................... $7,277 $7,823 $7,724 $5,841

1 Excludes limits on all disability income, which restrict long-term

disability insurance payments if income from all sources exceeds a specified

amount. 2 Includes maximums that vary by length of service. 3 Less than 0.5 percent. 4 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 39. Long-term disability insurance: Duration of

payments, full-time employees, medium and large private

establishments, 1995

Duration

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

long-term disability

insurance ............................ 14,144 5,664 4,307 4,173

Percent

Total with long-term disability

insurance ............................ 100 100 100 100

For life ................................... 3 3 3 3

Until a specified age ............. 21 17 17 30

Until retirement ..................... 18 15 20 20

Varies by age,1 one change 6 5 8 4

Varies by age,1 gradual

change ............................ 36 44 37 25

Varies by other than age ...... 2 1 1 6

Other ..................................... 2 2 2 1

Not determinable .................. 12 14 12 10

1 The duration of benefits may be reduced gradually according to a

schedule or once at a specified age.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 40. Long-term disability insurance: Eligibility

requirements, full-time employees, medium and large private

establishments, 1995

Length of service

requirement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

long-term disability

insurance ............................ 14,144 5,664 4,307 4,173

Percent

Total with long-term disability

insurance ............................ 100 100 100 100

With a service requirement ... 66 59 71 71

1 month ............................. 17 18 21 11

2 months ........................... 3 2 3 4

3 months ........................... 16 12 21 15

4 -5 months ....................... 1 1 ( ) 1 1

6 months ........................... 14 12 11 20

7 - 11 months .................... 3 1 ( ) 1 ( ) 9

12 months ......................... 10 12 9 9

Greater than 12 months .... 3 2 5 3

Without a service

requirement .................... 28 36 22 22

Average2

Average service requirement (in

months) ............................... 6.1 5.7 6.1 6.6

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Medical Care

Medical care benefits are provided to a majority of

full-time employees in medium and large private

establishments. EBS covers a number of medical

care benefit provisions, including:

• Types of plans,

• Coverage for hospitalization and surgery,

• Plan cost containment features,

• Prescription drug benefits,

• Mental health and substance abuse treatment benefits,

• Coverage for retired workers.

These topics are discussed throughout this chapter.

Types of medical care plans

Full-time workers with medical benefits are covered by

one of three types of plans__a traditional fee-for-service plan,

a Preferred Provider Organization (PPO), or a Health Maintenance Organization (HMO) (tables 41-49). These plans represent differences in fee arrangements, or in other words,

the method of selecting medical service providers and paying for care.

Fee-for-service plans allow patients to choose any provider

and pay for specific medical procedures as expenses are incurred. There are generally three ways of financing plan benefits: Through self-insured plans, commercially insured plans,

and Blue Cross/Blue Shield plans. Self-insured plans (in which

the plan sponsor__typically the employer__bears the financial risk of paying for covered medical services) cover the

largest number of participants in fee-for-service plans. Commercially insured plans and Blue Cross/Blue Shield plans

cover most of the other fee-for-service participants.

Establishments that self-insure their medical care benefits

may enter into an “administrative services only” (ASO) contract with a third party to pay claims and handle other administrative details (table 49). Under this contract, the employer

is responsible for financing all medical care claims. Another

arrangement available to self-insured plans is a minimum premium plan (MPP), which is insurance coverage to pay claims

above a specified amount. Such arrangements limit the

employer’s liability in the case of catastrophic expenses.

PPO’s, which have become widespread since first studied

in the EBS of medium and large private establishments in

1986, offer a higher level of reimbursement for services

performed by designated health care providers (such as hospitals and physicians), although participants are free to

choose any provider. Designated providers agree in advance

to a given fee schedule.

Financing arrangements for PPO’s are similar to fee-forservice plans. Most PPO’s are financed through a commercial insurer, a Blue Cross/Blue Shield organization, or are

self-insured.

PPO’s are a type of fee-for-service plan because care providers are not reimbursed until services are performed. In this

way, fee-for-service plans and PPO’s differ from HMO’s,

which pay providers a fixed amount for services before they

are performed over a given time period. Throughout this

chapter, HMO features are contrasted with features found in

non-HMO’s (both fee-for-service plans and PPO’s).

HMO’s, another arrangement that increased enrollment during the 1980’s, provide a prescribed set of benefits to enrollees for a fixed payment. The HMO thus bears the risk associated with delivering care.5 In this survey, HMO’s are classified as either group/staff, with services provided by central

facilities, or individual practice associations (IPA’s), with providers working from their own offices (table 50). HMO’s may

be financed through independent organizations, commercial

insurers, or Blue Cross/Blue Shield organizations. Independent organizations, such as Kaiser Permanente, are most common.

“Point-of-service” plans are HMO’s in which participants

can use care providers within or outside a given network, although reimbursement of expenses is less if participants do

not use network providers. “Point-of-service” plans include

those workers in HMO’s that have an open enrollment option. Such an option allows patients to receive services from

a non-HMO provider at a lower reimbursement than if care is

received from the designated HMO provider.

Fee-for-service plans

Fee-for-service plans allow patients to choose their own

providers and reimburse themselves or the provider they have

chosen after services are received. Benefits are typically subject to major medical limitations including deductibles, coinsurances, out-of-pocket expense limits, and plan maximums

(tables 51-56).

A majority of fee-for-service plans nearly always require a

participant to meet a specified deductible before he or she is

eligible for benefit payments. This discourages unnecessary

use of medical services. Deductibles are typically specified

Chapter 4.

Medical, Dental, and Vision Care

38
as an annual flat-dollar amount, such as $100 or $200 per

individual. In some plans, however, the deductible may not

apply to hospital room and board expenses. In other plans,

the deductible may be waived for certain benefits viewed to

be cost-effective, for example, alternatives to hospitalization

or outpatient surgery, to encourage their use in place of the

more costly benefits.

When medical care plans cover an employee and family, a

family deductible is often specified in addition to individual

deductibles. There are two types of family deductibles. In the

first type, the deductible is an annual flat-dollar amount. To

satisfy this deductible, one family member must meet an individual deductible, then another family member or a combination of family members must meet the remaining amount

of the family deductible. In the second type, the plan specifies the number of family members required to meet individual deductibles. After the required number of family members meet individual deductibles, no additional individual

deductibles are required during that year. Typically, family

deductibles are equal to two or three times the individual deductible.

Once the deductible has been met, the plan usually pays a

specified percentage of covered medical expenses, with the

employee paying the remainder (coinsurance). Most plans pay

80 percent of expenses; some plans may pay 90 percent. Alternatively, plans may have a different coinsurance rate for

certain services, such as hospital room and board and outpatient surgery. In those cases where coinsurance is different,

the plan usually pays a higher percent of expenses, often 100

percent.

Most full-time participants in fee-for-service plans have

their coinsurance increased to 100 percent after they have

paid out a specified dollar amount for covered expenses (outof-pocket expense limit), for example, $1,500 per individual.

Frequently, out-of-pocket expense limits are also specified

for family expenses. As used in this bulletin, the term “outof-pocket expense limit” refers to a ceiling on the eligible

medical expenses that must be paid by a plan participant.

However, a deductible, if required, is an additional expense

the participant must pay.

A plan’s out-of-pocket expense limit protects the participant from catastrophic medical expenses. For example, suppose a plan has a $250 annual deductible and then pays 80

percent of medical expenses up to an out-of-pocket expense

limit of $2,000. Once the out-of-pocket expense limit has been

reached, the plan’s reimbursement rate rises to 100 percent.

In this case, the employee would pay the first $250 of expenses and $2,000 (20 percent) of the next $10,000 of expenses. Covered expenses above that amount would be paid

in full by the plan.

Plans that require both an annual deductible and place a

limit on out-of-pocket expenses cover most participants. The

sum of these two items equals the total that the individual

must pay for covered medical expenses in a calendar year.

Fee-for-service plans often place a ceiling on the amount

payable by the plan, usually a lifetime maximum of $1 million.

Preferred provider organizations (PPO’S)

In a preferred provider organization, participants are covered for medical services at a higher rate of reimbursement if

they receive care from designated hospitals, physicians, laboratories, or dentists. Individuals may also choose their own

provider, although usually at a lower rate of reimbursement.

In PPO’s, like fee-for-service plans, benefits are typically

subject to limitations including deductibles, coinsurances, outof-pocket expense limits, and plan maximums that apply to

many or all services (tables 57-58). These limitations can differ

depending upon whether the care is received from a designated provider. For example, if an individual’s total covered

medical expenses are $3,600 in one year, and a PPO within

the network provides the care, the plan pays 90 percent of

expenses, or $3,240, and does not require a deductible. When

care is provided outside the PPO network, the plan imposes a

$100 a year deductible and reimburses 80 percent of the remaining expenses. Thus, outside the PPO network the plan

pays only $2,800 of the expenses.

PPO’s may also vary the way payments are made for outpatient physicians’ care. For example, services received from

physicians outside the network may be subject to a plan deductible and coinsurance. Services received from a network

physician, however, may only require a small copayment, such

as $10 per office visit. The plan covers the remaining cost of

such services.

Health maintenance organizations (HMO’s)

Health maintenance organizations provide a fixed set of

medical benefits for a prepaid fee. Most medical services are

either covered in full or require patients to pay a nominal

copayment. Typical copayments are $5 or $10 per physician’s

office visit or $3 or $5 per out-of-hospital prescription drug.

HMO’s encourage preventive care, including physical examinations, vision screening, hearing care, well-baby care,

and immunization and inoculation. Many HMO’s are federally qualified. In order to become federally qualified, these

HMO’s must provide a minimum set of benefits, such as home

health care, well-baby care, and hearing care.

Variation in coverage by type of medical care provider can

affect the enrollees’ out-of-pocket expenses. Non-HMO plan

participants generally pay a higher percentage of total health

care expenses than HMO participants.6

Cost containment

In addition to data on the extent of specific medical service coverage, the survey reports on availability of medical

plans with either benefit management programs, managed care

Medical, Dental, and Vision Care

39
plans, or review boards. These programs help make sure that

the services rendered are medically necessary and are provided in the most appropriate health care setting. These programs were created partly in response to the rapid rise in

medical care costs during the 1980’s.

Most medical care participants have some kind of “managed care” provision available to them (table 59). This includes all participants in HMO and PPO plans, in which the

plans manage care by directing patients to specific providers

or services. In addition, many fee-for-service participants are

in plans with at least one managed care feature. These could

include preadmission certification for hospitalization, preadmission testing, and utilization review (tables 60-61).

Some advanced managed care programs may consist of

four or more features. Frequently these include preadmission

review of all hospital admissions for nonemergency and

nonmaternity care, utilization review to monitor care while

hospitalized, discharge planning to coordinate a continued

course of treatment in more cost-effective health care settings, and mandatory second surgical opinions for selected

procedures. A higher level of reimbursement for outpatient

prehospitalization testing, a means of decreasing the length

of hospitalization, is also common.

Some managed care programs may consist of only one or

two cost containment provisions, such as mandatory second

surgical opinions and/or preadmission certification (except

in cases of emergency). Less prevalent cost containment features in fee-for-service plans include incentives for the employee to audit hospital bills and incentives for child deliveries in lower cost birthing centers, rather than in hospitals.

Increasingly, medical care plans require a separate deductible for hospital admission to discourage unnecessary hospitalization. These deductibles are often between $100 and $250

per hospital admission.

In fee-for-service plans, second surgical opinion provisions

generally apply to inpatient surgical benefits (table 62). Plan

enrollees usually receive lower levels of reimbursement if they

do not obtain second opinions.

By their very nature, HMO’s emphasize preventive, cost

efficient medical care. Built-in forms of utilization review,

including second surgical opinions, are automatically provided.

Hospital coverage

All medical plan enrollees covered by the survey have coverage for hospital room and board charges (tables 63-65).

(Coverage also extends to “miscellaneous” charges while hospitalized, such as routine nursing care, prescription drugs, and

surgical dressings.) Many plans cover hospital room and board

expenses at a percentage of the semiprivate room rate, frequently 80 percent. Coverage is typically subject to major

medical limits of the plan, such as a yearly deductible, before

the percent rate can go into effect. Other plans (called “first

dollar coverage” in this bulletin) either have hospital room

and board expenses covered at the full semiprivate room rate

for a specified period (usually 365 days per confinement),

followed by a percentage of the semiprivate room rate, or

reimburse expenses at the full semiprivate room rate for an

unlimited number of days without imposing either a deductible or dollar maximum.

Significant differences in hospital room and board coverage are seen by type of medical care plan. Although HMO

participants usually have hospital room and board fully covered without any limitations, total coverage is rare for hospitalization in non-HMO’s. When there is a limit on room and

board in HMO’s, it is usually a copayment per admission,

often between $100 and $250.

Alternatives to hospitalization

To help keep down medical care costs, a number of plans

provide coverage for less expensive alternatives to a hospital

stay. These alternatives include extended care facilities, home

health care, and hospices. Coverage patterns typically differ

between HMO and non-HMO participants (tables 66-69).

Extended care facilities provide skilled nursing care, rehabilitation, and convalescent services to patients who require

less intensive treatment than that provided in a hospital.

HMO’s usually provide coverage for stays in extended care

facilities, with some plans providing unlimited coverage. NonHMO’s also provide coverage for extended care benefits, but

few plans provide full coverage.

Home health care provides skilled nursing and related services to patients in their own homes. Home health care benefits are provided to most HMO participants; these benefits

are furnished less extensively to non-HMO participants (table

42). The higher incidence of coverage for home health care

benefits in HMO’s reflects the fact that federally qualified

HMO’s must provide this benefit. The majority of HMO participants in the survey belong to federally qualified plans.

When home health care benefits are provided in HMO’s, coverage is often unlimited. Unlimited coverage is quite rare in

non-HMO’s. Plans, especially non-HMO’s, often limit the

duration of stay in extended care facilities and the number of

visits from home health care service providers.

Another alternative to hospitalization is hospice care (table

42). A hospice offers nursing care and psychological support

to terminally ill patients__defined as individuals having 6

months or less to live__and to their families. Medical care

plans cover hospice care less often than other alternatives to

hospitalization.7

Surgical coverage

Medical plans base payments for in-hospital surgery on

the “usual, customary, and reasonable” (UCR) charges for

the specific procedure performed.8 In-hospital surgical benefits are likely to be covered under the plan’s major medical

Medical, Dental, and Vision Care

40
limits (table 70). In such cases, the plan coinsurance is applied to the UCR charges. Others are covered for the full UCR

charges or according to a schedule establishing a maximum

amount payable for each procedure. Charges exceeding the

scheduled maximums, however, are usually covered, subject

to the plan’s overall deductible and coinsurance.

Medical plans usually cover outpatient surgery the same

way as in-hospital surgery, whether in full, a percent of UCR

charges, or subject to a schedule of maximum payments. For

the majority of HMO enrollees, both inpatient and outpatient surgery are covered in full.

As the result of a steady rise in medical care costs, health

care providers are encouraging enrollees to substitute less

expensive outpatient services, such as outpatient surgery, for

inpatient hospital services. To encourage the use of outpatient surgery, non-HMO’s may provide higher reimbursement

rates over those provided for inpatient surgery.9

Outpatient physicians visits and diagnostic services

Virtually all health care participants have coverage for

 physicians’ visits and diagnostic x-ray and laboratory tests

(DXL) (tables 42, 43, and 46). Expenses for physicians’

office visits and DXL in non-HMO’s are generally covered

as a percentage of usual, customary and reasonable charges

and are subject to an annual deductible and a lifetime maximum benefit.

Most HMO’s require copayments for office visits (table

71). Although copayments are virtually non-existent in feefor-service plans, PPO’s often require copayments for office

visits. Copayments for office visits in HMO and PPO plans

are usually minimal, such as $5 and $10 per visit.

Prescription drug benefits

Almost all survey participants have medical plans that cover

outpatient prescription drugs (tables 72-74). Inpatient prescription drugs are always covered under hospital miscellaneous services, generally in the same way as room and board

charges. Outpatient prescription drugs are covered under separate provisions of the medical plan.

Coverage for outpatient prescription drugs differs by type

of medical plan. Often, in non-HMO plans, outpatient prescription drugs are covered under general plan limitations;

that is, before any benefits are provided, the participant has

to meet an annual deductible. Services are then covered at

the applicable coinsurance rate. However, in HMO’s, prescription medications are usually covered subject to a minimal copayment, commonly $5.

Perhaps due to the rapidly rising cost of prescription drugs,

medical care plans are turning to a variety of alternatives to

lower both plan and patient costs. These alternatives include:

• Encouraging patients to have pharmacies substitute less

expensive generic drugs for brand-name drugs;

• Setting up mail order programs for drugs needed on a

routine basis;

• Establishing relationships between plans and selected

pharmacies to provide drugs at a lower cost.

Pharmacies can often fill a prescription using either a brand

name drug or a generic drug. Because generic drugs cost less

than brand name drugs, participants usually receive higher

reimbursement for obtaining generic drugs.

Mail order drug programs are often available to participants in addition to regular prescription drug coverage. These

programs supply drugs for maintenance purposes, that is, drugs

required on a continuous basis. In such arrangements, participants often receive a higher reimbursement or pay less for

mail order drugs than for drugs purchased directly from a

pharmacy.

Some fee-for-service plan participants may receive higher

reimbursements if prescriptions are filled at certain pharmacies with discount policies. The plan providers negotiate the

price of prescriptions with the pharmacies, usually at cost

plus minimal dispensing fees. Group HMO plans normally

have an in-house pharmacy, where minimal copayments are

required for prescriptions. IPA HMO plans, on the other hand,

might be affiliated with “discount” pharmacies, that also provide prescriptions with minimal copayments.10

Mental health coverage and substance abuse treatment

Mental health coverage, though available to nearly all participants, is frequently subject to more restrictive limitations

than other illnesses (tables 75-78). Medical care plan participants with mental health benefits frequently have more restrictive hospital coverage for mental illness than for other

ailments. Plans usually limit the duration of hospital stays

and frequently impose a separate, lower dollar maximum on

covered hospital expenses (such as $50,000 on all mental

health benefits).

Even more restrictive is coverage for mental health care

outside the hospital (psychiatric office visits). Coverage is

nearly always subject to limits. Outpatient mental health care

is normally covered for fewer visits per year than other outpatient services, and it is subject to maximum dollar limits on

annual payments. Plans also frequently cover such care at a

coinsurance rate lower than the usual 80 percent paid by plans

for other illnesses.11 In addition, expenses for outpatient mental health and substance abuse care often can not be used to

meet the employee’s maximum out-of-pocket expense limit

(table 87). This restriction applies to inpatient care as well,

but in fewer cases than to outpatient care. Reimbursement for

these expenses does not increase to 100 percent even when

the out-of-pocket expense is met.

Alcohol and drug abuse treatment benefits cover nearly all

full-time medical participants (tables 79-86). Nearly all

Medical, Dental, and Vision Care

41
participants with alcohol abuse treatment benefits have the

same coverage for drug abuse treatment. Benefits provided

under substance abuse care include both detoxification and

rehabilitation. Detoxification involves supervised care by

medical personnel designed to reduce or eliminate the symptoms of chemical dependency. Rehabilitation provides a

variety of services intended to alter the behavior of substance

abusers. Such services are generally provided once a person

completes detoxification.

Detoxification is considered medically necessary, and thus

nearly all medical plans include it as a benefit. There is a

greater tendency to exclude inpatient rehabilitation, because

it requires less constant and immediate care. Outpatient alcohol abuse treatment, generally rehabilitative care, is available to most participants with alcoholism coverage. Coverage patterns are similar for drug abuse treatment benefits.

As is the case with mental health care, plans are more restrictive in covering substance abuse treatment than other illnesses.12 Participants are more likely to have inpatient detoxification treated the same as any other inpatient confinement

than to have inpatient rehabilitation or outpatient care covered the same as any other illness. Limitations for substance

abuse treatment most commonly include:

• Restrictions on the number of days of inpatient hospital

care per year;

• Restrictions on the number of outpatient visits per year;

• Reduced coinsurance levels for outpatient treatment;

• Employee’s share of the cost of outpatient care not included in out-of-pocket expense limit;

• Limits on maximum dollar amounts.13

Other medical benefits

The survey also measures the incidence of several other

services provided through medical care plans. For example,

some plans cover at least part of the costs for routine physical

examinations and well-baby care (table 42). HMO’s nearly

always include coverage for hearing care, physical examinations, well-baby care, and immunizations and inoculations.

HMO’s must include these benefits to qualify under the Health

Maintenance Organization Act of 1973, as amended.14

Participation requirements

Medical care plans typically require new employees to serve

only a short eligibility period, if any, before coverage begins

(table 88). Many medical care plan participants are allowed

to join a plan immediately upon being hired. For participants

who must complete a minimum length of service, the required

period is often 1 to 3 months.

Pre-existing condition limitation

Plans may impose restrictions on care provided to individuals who join a plan with a “pre-existing condition” (table

89). This is a medical condition that existed prior to coverage

by the plan. Among the possible restrictions imposed is a limit

on the amount the plan will pay for treatment of the condition

or a specified time period after joining the plan during which

no payment will be made for treatment of the condition.

Coverage for retired workers

Although the Consolidated Omnibus Budget Reconciliation Act of 1985 requires employers to continue health care

benefits for employees who are retired, laid off, or otherwise

separated from employment, workers may be charged all of

the premium costs at group rates. In addition, the continuation period stipulated by the law is limited.15 The survey of

medium and large private establishments focuses on coverage for retired employees that is financed by the employer,

the retiree, or both the employer and the retiree.

Many of the full-time medical care participants in the survey work for employers who finance, at least in part, medical

care protection after retirement (table 90). These workers are

commonly in plans that provide postretirement coverage regardless of their age. Retirees are usually covered by the same

plan as active employees, although benefits are coordinated

with Medicare once a retiree reaches age 65. It is more likely

for the coverage to be partly paid by the retiree than to be

wholly employer financed.

Dental Care

Dental care benefits are available to most full-time employees in medium and large private establishments. Dental

care may be offered as a part of a comprehensive medical

and dental plan, or as a separate plan in addition to medical

coverage. Often, employers offer a number of medical plans

as well as a separate dental plan that can accompany any medical plan, from which employees may choose.

Employers may impose a service requirement before employees are covered by a dental care plan. When imposed,

such requirements are often 1 or 3 months (table 91). Employers may set up a longer service requirement for dental

coverage than for medical coverage.

A large majority of participants covered by dental care plans

receive benefits through a fee-for-service plan, which reimburses patients or providers only after services are received

(table 92). Such plans are commonly self-insured or obtained

through a commercial insurer. The remaining participants have

their dental benefits provided through either a HMO or a PPO.

Dental plans nearly always cover preventive and restorative services (table 93). Preventive care typically includes

dental examinations, prophylaxis (cleaning), and x-rays. Restorative procedures include fillings, periodontal care, endodontic care, prosthetics, and crowns. Periodontal care is

the treatment of tissues and bones supporting the teeth.

Medical, Dental, and Vision Care

42
Endodontics involves the treatment of the tooth pulp, such as

root canal work. Prosthetics deals with the construction and

fitting of bridges and dentures.

Orthodontic care, including straightening teeth and maintaining proper spacing of teeth, is covered less often by dental plans than are other procedures. In addition, plans frequently limit orthodontic coverage to dependent children only.

Three methods are generally used by dental care plans to

cover services:

• Plan pays a percent of dental charges;

• Plan pays up to a specified dollar amount per procedure;

• Plan requires patient to pay an initial copayment, after

which the plan pays additional charges.

Dental payments are frequently based on a proportion of

the usual, customary, and reasonable charge for a procedure

(table 94). The proportion covered by a plan often depends

on the type of procedure performed. Less costly procedures

such as examinations and x-rays may be covered at 100 percent. Fillings, surgery, endodontics, and periodontics are more

likely to be covered at 80 percent. The most expensive

procedures__crowns, prosthetics, and orthodontia__are often covered at 50 percent of the usual, customary, and reasonable charge.

Some dental plan participants are offered reimbursement

based on a schedule of cash allowances. In this type of arrangement, each procedure is subject to a specified maximum

dollar amount that the plan will pay to the participant or the

dentist.

A few plans may require a copayment, after which benefits

are paid in full. Copayments, such as $5 or $10 per procedure, usually apply to preventive care, though higher copayments are often associated with other dental services.

Frequently, plans specify a deductible amount before any

dental benefits are paid by the plan. Deductibles for individual

coverage, such as $25 and $50 per year (tables 95- 97), often

apply; family deductibles are usually two or three times the

individual deductibles in the same plans. Some plans require

the participant to pay a one-time deductible (usually $50)

rather than a yearly deductible. When a deductible is specified, it frequently applies to restorative services. Deductibles

are less common for preventive services and ortho-dontia.

Most plans limit the amount of payment each year by specifying an annual maximum benefit, for example, $1,000 per

year (tables 98-99). Benefits for orthodontic services are often subject to a separate lifetime maximum, commonly ranging between $1,000 and $1,500.16

As a cost containment technique, dental plans often require

participants to obtain authorization from the plan before

undergoing expensive treatment (table 100). Usually, procedures costing $200 or more are subject to advance authorization.

Vision Care

Vision care coverage, when available, is typically provided through a fee-for-service plan. Vision benefits may also

be available through an HMO or a PPO, which restrict providers available to enrollees to those participating in the network.

Vision benefits cover eyeglasses, and, with few exceptions,

eye examinations and contact lenses (table 101). To be included in the survey, contact lenses must be available for cosmetic reasons. Coverage limited to medically necessary contact lenses is not included in the survey.

Participants with vision care coverage generally have limits placed on their benefits. Typically, vision care participants

have coverage for eyeglasses and contact lenses subject to a

scheduled dollar allowance per benefit. Eye examinations are

normally subject to either a dollar maximum per visit, or the

participant is required to pay a small copayment per visit. For

eyeware, other plans require an employee copayment or offer a discount on the purchase of eyeglasses and contact lenses

at specified locations.

Some vision care participants have eye examinations and

eyeglasses paid in full; a few have contact lenses covered in

full.17

5 For a more detailed discussion on HMO’s, see Thomas P. Burke and

Medical, Dental, and Vision Care

43
Medical, Dental, and Vision Care

—ENDNOTES—

Rita S. Jain, “Trends in Employer-Provided Health Care Benefits,” Monthly

Labor Review, February 1991, pp. 24-30. 6 For more information regarding out-of-pocket expenses for medical services, see Allan P. Blostin, Robert B. Grant, and William J. Wiatrowski,

“Employee Payments for Health Care Services,” Monthly Labor Review,

November 1992, pp. 17-32.

7 For a more detailed discussion on alternatives to hospitalization, see

Thomas P. Burke, “Alternatives to Hospital Care under Employee Benefit

Plans,” Monthly Labor Review, December 1991, pp. 9-15. 8 The “usual, customary, and reasonable” charge is defined as being not

more than the physician’s usual charge; within the customary range of fees

charged in the locality; and reasonable, based on the medical circumstances.

9 For more information on incentives for outpatient surgery, see Robert

B. Grant, “Outpatient Surgery: Helping to Contain Health Care Costs,”

Monthly Labor Review, November 1992, pp. 33-36. 10 For a more comprehensive discussion on prescription drug coverage, see

Cathy Baker and Natalie Kramer, “Employer-Sponsored Prescription Drug

Benefits,” Monthly Labor Review, February 1991, pp. 31-35. 11 A detailed examination of mental health care provisions in employerprovided health care plans is provided by Allan P. Blostin in “Mental Health

Benefits Financed By Employers,” Monthly Labor Review, July 1987, pp.

23-27.

12 The designation of substance abuse coverage as more restrictive than

that for other illnesses results from a comparison of types of coverage.

For instance, if a plan limits inpatient substance abuse care to 30 days per

year but the limit on inpatient care of any other illness exceeds 30 days per

year, that plan contains separate, more restrictive, limits.

13 For further information, see Substance Abuse Provisions in Employee

Benefit Plans, Bulletin No. 2412, U.S. Department of Labor, Bureau of

Labor Statistics, August, 1992.

14 Under this act, an HMO must provide certain coverage, such as home

health care, physical examinations, and children’s eye and ear examinaations. Under certain circumstances, employers may be required to offer

employees medical care coverage through Federally qualified HMO’s.

15 The act requires employers who maintain health insurance plans to continue coverage to terminated workers for up to 18 months. Workers may be

charged up to 102 percent of the premium cost. Based on a 1989 change to

this law, employees disabled at the time of termination can have benefits

continued for up to 29 months, and can be charged up to 150 percent of the

premium cost after 18 months.

16 For more details on dental care benefits, see Rita S. Jain, “EmployerSponsored Dental Insurance Eases The Pain,” Monthly Labor Review,

October 1988, pp. 18-23.

17 For more details on vision care benefits, see Rita S. Jain, “EmployerSponsored Vision Care Brought Into Focus,” Monthly Labor Review,

September 1988, pp. 19-23.

44
Table 41. Medical care benefits: Summary of selected

features, full-time employees, medium and large private

establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

medical care1 ...................... 25,546 7,467 6,158 11,921

Percent

Total with medical care ............. 100 100 100 100

Traditional fee-for-service2 ... 37 29 30 45

Preferred provider

organization3 .................. 34 36 36 33

Prepaid health maintenance

organization4 .................. 27 33 32 21

Retiree coverage available5 46 51 50 41

With a service requirement ... 64 51 67 71

1 Plans providing services or payments for services rendered in the

hospital or by a physician. Excludes plans that provided only dental, vision or

prescription drug coverage. 2 The plan pays for specific medical procedures as expenses are

incurred. 3 A preferred provider organization (PPO) is a group of hospitals and

physicians that contracts to provide comprehensive medical services. To

encourage use of organization members, the health care plan limits

reimbursement rates when participants use nonmembers’ services. 4 Includes federally qualified (those meeting standards of the Health

Maintenance Act of 1973, as amended) and other HMO’s delivering

comprehensive health care on a prepayment rather than fee-for-service

basis. 5 Tabulations cover plans in which insurance was continued for longer

than 1 month after retirement. It excludes plans that provide only the retiree’s

share of premiums for medical insurance under Medicare (Part B).

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 42. Medical care benefits: Coverage for selected services, by type of plan, full-time employees, medium and large private

establishments, 1995

Categories of care

All

employees

Professional, technical,

and related employees

Clerical and sales 

employees

Blue-collar

and 

service

employees

All

plans

NonHMO

plans

HMO

plans

All

plans

NonHMO

plans

HMO

plans

All

plans

NonHMO

plans

HMO

plans

All

plans

NonHMO

plans

HMO

plans

Number of employees (in

thousands) .......................... 25,546 18,558 6,988 7,467 4,968 2,499 6,158 4,170 1,988 11,921 9,419 2,502

Percent

Hospital room and board .......... 100 100 100 100 100 100 100 100 100 100 100 100

Inpatient surgery ....................... 100 100 100 100 100 100 100 100 100 100 100 100

Outpatient surgery1 .................. 100 100 100 100 100 100 100 100 100 100 100 100

Inpatient physician visits ........... 100 100 100 100 100 100 100 100 100 100 100 100

Office physician visits ............... 100 100 100 100 100 100 100 100 100 100 100 100

Diagnostic X-ray and laboratory 100 100 100 100 100 100 100 100 100 100 100 100

Extended care2 ......................... 73 71 80 77 75 80 71 70 74 72 69 83

Home health care2 .................... 78 73 91 81 76 92 79 73 91 75 71 91

Hospice care ............................. 56 61 44 60 65 49 54 61 37 56 59 44

Inpatient mental health ............. 97 98 94 97 99 94 97 98 94 97 98 92

Outpatient mental health .......... 91 90 95 92 90 96 94 93 96 90 89 94

Inpatient alcohol detoxification3 98 97 100 99 99 99 98 97 100 98 97 100

Inpatient alcohol rehabilitation4 77 81 66 77 81 69 76 83 61 77 80 66

Outpatient alcohol

rehabilitation4 ...................... 81 81 80 82 81 83 81 84 77 80 80 80

Inpatient drug detoxification ...... 97 97 98 98 98 99 96 96 96 97 96 100

Inpatient drug rehabitation ........ 76 80 65 77 81 69 75 83 60 76 79 65

Outpatient drug rehabilitation ... 80 81 80 81 80 83 81 83 77 79 79 80

Hearing care5 ........................... 33 12 87 39 14 89 35 10 88 28 13 85

Physical exam .......................... 56 40 98 63 45 99 57 38 96 50 37 99

Well-baby care .......................... 60 46 97 65 49 99 62 46 94 56 44 98

Immunization and inoculation ... 47 31 91 53 33 93 46 25 90 44 32 91

1 Charges incurred in the outpatient department of a hospital and

outside the hospital. 2 Some plans provide this care only to a patient who was previously

hospitalized and is recovering without need of the extensive care provided

by a general hospital. 3 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse.

4 Rehabilitation is designed to alter abusive behavior in patients once

they are free of acute physical and mental complications. 5 Plans provide, as a minimum, coverage for hearing examination

expenses.

NOTE: Because of rounding, sums of individual items may not equal totals.

 Where applicable, dash indicates no employees in this category.
Table 43. Non-health maintenance organizations: Coverage

for selected services, full-time employees, medium and large

private establishments, 1995

Category of care and extent of

coverage

All

 employees

Professional,

technical,

 and

related

employees

Clerical

and

sales

employees

Bluecollar

 and

service

employees

Percent

Hospital room and board

Total with coverage .................. 100 100 100 100

Covered in full ....................... 6 6 7 5

Subject to separate limits

only1 ............................... 3 1 3 4

Subject to separate limits

plus major medical .......... 22 27 21 20

Major medical only2 .............. 69 65 69 70

Inpatient surgery

Total with coverage .................. 100 100 100 100

Covered in full ....................... 11 13 10 11

Subject to separate limits

only1 ............................... 1 3 ( ) 1 2

Subject to separate limits

plus major medical .......... 6 5 6 6

Major medical only2 .............. 82 81 83 81

Outpatient surgery4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 12 13 12 12

Subject to separate limits

only1 ............................... 2 1 2 3

Subject to separate limits

plus major medical .......... 6 6 7 6

Major medical only2 .............. 80 80 80 79

Inpatient physician visits

Total with coverage .................. 100 100 100 100

Covered in full ....................... 10 10 9 9

Subject to separate limits

only1 ............................... 1 1 3 ( ) 2

Subject to separate limits

plus major medical .......... 8 10 8 7

Major medical only2 .............. 81 80 83 82

See footnotes at end of table.
Table 43. Non-health maintenance organizations: Coverage

for selected services, full-time employees, medium and large

private establishments, 1995 — Continued

Category of care and extent of

coverage

All

 employees

Professional,

technical,

 and

related

employees

Clerical

and

sales

employees

Bluecollar

 and

service

employees

Percent

Office physician visits

Total with coverage .................. 100 100 100 100

Covered in full ....................... 2 1 1 3

Subject to separate limits

only1 ............................... 16 17 18 13

Subject to separate limits

plus major medical .......... 16 21 18 13

Major medical only2 .............. 66 61 62 71

Diagnostic x-ray and

laboratory

Total with coverage .................. 100 100 100 100

Covered in full ....................... 13 14 13 12

Subject to separate limits

only1 ............................... 1 1 1 2

Subject to separate limits

plus major medical .......... 9 10 7 10

Major medical only2 .............. 77 76 79 76

1 Separate limits apply to individual categories of care; e.g., separate

limits on benefits for hospitalization. Limits may be set in terms of dollar or

day ceilings on benefits, a requirement that the participant pay a percentage

of costs (coinsurance), or a requirement that the participant pay a specific

amount (deductible or copayment) before reimbursement begins or services

are rendered. 2 Major medical limits are expressed only in terms of total benefits

payable under the plan, rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits. 3 Less than 0.5 percent. 4 Charges incurred in the outpatient department of a hospital and outside

of the hospital.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 44. Non-health maintenance organizations: Coverage

for alternatives to hospital care, full-time employees, medium

and large private establishments, 1995

Category of care and extent of

coverage

All 

employees

Professional,

technical,

and 

related 

employees

Clerical

and

sales

employees

Bluecollar 

and

service

employees

Percent

Extended care1

Total with coverage .................. 100 100 100 100

Covered in full ....................... 2 2 2 2

Subject to separate limits

only2 ............................... 9 10 9 9

Subject to separate limits

plus major medical .......... 70 65 70 72

Major medical only3 .............. 19 23 19 17

Home health care1

Total with coverage .................. 100 100 100 100

Covered in full ....................... 6 9 6 5

Subject to separate limits

only2 ............................... 9 9 7 8

Subject to separate limits

plus major medical .......... 54 52 57 53

Major medical only3 .............. 31 30 30 33

Hospice care

Total with coverage .................. 100 100 100 100

Covered in full ....................... 9 11 8 7

Subject to separate limits

only2 ............................... 7 9 5 8

Subject to separate limits

plus major medical .......... 42 37 51 40

Major medical only3 .............. 42 43 36 45

1 Some plans provide this care only to a patient who was previously

hospitalized and is recovering without need of the extensive care provided by

a general hospital. 2 Separate limits apply to individual categories of care; e.g., separate

limits or benefits for extended care. Limits may be set in terms of dollar or

day ceilings on benefits, a requirement that the participant pay a percentage

of costs (coinsurance), or a requirement that the participant pay a specific

amount (deductible or copayment) before reimbursement begins or services

are rendered. 3 Major medical limits are expressed in terms of total benefits payable

under the plan, rather than for individual categories of care. Limits are set as

deductibles, coinsurance percentages, and overall dollar limits on plan

benefits.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 45. Non-health maintenance organizations: Coverage for

mental health and substance abuse treatment, full-time

employees, medium and large private establishments, 1995

Category of care and extent of

coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Inpatient mental health

Total with coverage .................. 100 100 100 100

Covered in full ....................... 2 2 2 3

Subject to separate limits

only1 ............................... 16 13 13 19

Subject to separate limits

plus major medical .......... 66 66 73 63

Major medical only2 .............. 15 19 12 15

Outpatient mental health

Total with coverage .................. 100 100 100 100

Covered in full ....................... 1 1 1 1

Subject to separate limits

only1 ............................... 19 17 15 21

Subject to separate limits

plus major medical .......... 78 79 81 75

Major medical only2 .............. 3 3 3 3

Inpatient alcohol

detoxification3

Total with coverage .................. 100 100 100 100

Covered in full ....................... 3 3 3 3

Subject to separate limits

only1 ............................... 17 15 15 19

Subject to separate limits

plus major medical .......... 65 66 71 63

Major medical only2 .............. 15 16 12 15

Inpatient alcohol

rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 2 2 2 2

Subject to separate limits

only1 ............................... 21 21 18 22

Subject to separate limits

plus major medical .......... 73 72 77 71

Major medical only2 .............. 4 5 3 5

Outpatient alcohol

rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 1 2 1 1

Subject to separate limits

only1 ............................... 22 20 18 24

Subject to separate limits

plus major medical .......... 75 76 78 72

Major medical only2 .............. 3 2 3 3

See footnotes at end of table.
Table 45. Non-health maintenance organizations: Coverage for

mental health and substance abuse treatment, full-time

employees, medium and large private establishments, 1995 —

Continued

Category of care and extent of

coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Inpatient drug detoxification3

Total with coverage .................. 100 100 100 100

Covered in full ....................... 3 3 3 3

Subject to separate limits

only1 ............................... 17 15 14 19

Subject to separate limits

plus major medical .......... 66 66 71 63

Major medical only2 .............. 15 16 12 15

Inpatient drug rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 2 2 2 2

Subject to separate limits

only1 ............................... 20 19 17 22

Subject to separate limits

plus major medical .......... 73 73 77 71

Major medical only2 .............. 5 5 4 4

Outpatient drug

rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 1 1 1 1

Subject to separate limits

only1 ............................... 21 20 18 24

Subject to separate limits

plus major medical .......... 75 77 79 73

Major medical only2 .............. 2 2 2 3

1 Separate limits apply to individual categories of care; e.g., separate

limits or benefits for inpatient mental health. Limits may be set in terms of

dollar or day ceilings on benefits, a requirement that the participant pay a

percentage of costs (coinsurance), or a requirement that the participant pay a

specific amount (deductible or copayment) before reimbursement begins or

services are rendered. 2 Major medical limits are expressed only in terms of total benefits

payable under the plan, rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits. 3 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 4 Rehabilitation is designed to alter abusive behavior in patients once

they are free of acute physical and mental complications

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 46. Health maintenance organizations: Coverage for

selected services, full-time employees, medium and large

private establishments, 1995

Category of care and extent of

coverage

All 

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar 

and

service

employees

Percent

Hospital room and board

Total with coverage .................. 100 100 100 100

Covered in full ....................... 77 81 78 73

Subject to limits1 ................... 23 19 22 27

Inpatient surgery

Total with coverage .................. 100 100 100 100

Covered in full ....................... 92 92 94 91

Subject to limits1 ................... 8 8 6 9

Outpatient surgery2

Total with coverage .................. 100 100 100 100

Covered in full ....................... 80 84 77 79

Subject to limits1 ................... 20 16 23 21

Inpatient physician visits

Total with coverage .................. 100 100 100 100

Covered in full ....................... 94 94 96 94

Subject to limits1 ................... 6 6 4 6

Office physician visits

Total with coverage .................. 100 100 100 100

Covered in full ....................... 13 13 14 11

Subject to limits1 ................... 87 87 86 89

Diagnostic x-ray and

laboratory services

Total with coverage .................. 100 100 100 100

Covered in full ....................... 94 95 95 93

Subject to limits1 ................... 6 5 5 7

1 Limits may be set in terms of dollar or day ceilings on benefits, a

requirement that the participant pay a percentage of costs (coinsurance), or a

requirement that the participant pay a specific amount (deductible or

copayment) before reimbursement begins or services are rendered. 2 Charges incurred in the outpatient department of a hospital and outside

of the hospital

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 47. Health maintenance organizations: Coverage for

alternatives to hospital care, full-time employees, medium and

large private establishments, 1995

Category of care and extent of

coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales 

employees

Bluecollar

and 

service

employees

Percent

Extended care1

Total with coverage .................. 100 100 100 100

Covered in full ....................... 14 16 13 13

Subject to limits2 ................... 86 84 87 87

Home health care1

Total with coverage .................. 100 100 100 100

Covered in full ....................... 76 78 78 73

Subject to limits2 ................... 24 22 22 27

Hospice care

Total with coverage .................. 100 100 100 100

Covered in full ....................... 61 68 55 57

Subject to limits2 ................... 39 32 45 43

1 Some plans provide this care only to a patient who was previously

hospitalized and is recovering without need of the extensive care provided by

a general hospital. 2 Limits may be set in terms of dollar or day ceilings on benefits, a

requirement that the participant pay a percentage of cost (coinsurance), or a

requirement that the participant pay a specific amount (deductible or

copayment) before reimbursement begins or services are rendered.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 48. Health maintenance organizations: Coverage for

mental health and substance abuse treatment, full-time

employees, medium and large private establishments, 1995

Category of care and extent of

coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and 

service

employees

Percent

Inpatient mental health

Total with coverage .................. 100 100 100 100

Covered in full ....................... 8 11 6 5

Subject to limits1 ................... 92 89 94 95

Outpatient mental health

Total with coverage .................. 100 100 100 100

Covered in full ....................... 1 1 3 2 ( )

Subject to limits1 ................... 99 99 97 100

Inpatient alcohol

detoxification3

Total with coverage .................. 100 100 100 100

Covered in full ....................... 35 38 39 29

Subject to limits1 ................... 65 62 61 71

Inpatient alcohol

rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 10 11 10 8

Subject to limits1 ................... 90 89 90 92

Outpatient alcohol

rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 5 5 7 2

Subject to limits1 ................... 95 95 93 98

See footnotes at end of table.
Table 48. Health maintenance organizations: Coverage for

mental health and substance abuse treatment, full-time

employees, medium and large private establishments, 1995 —

Continued

Category of care and extent of

coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and 

service

employees

Percent

Inpatient drug detoxification3

Total with coverage .................. 100 100 100 100

Covered in full ....................... 36 38 40 29

Subject to limits1 ................... 64 62 60 71

Inpatient drug rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 9 11 9 7

Subject to limits1 ................... 91 89 91 93

Outpatient drug

rehabilitation4

Total with coverage .................. 100 100 100 100

Covered in full ....................... 4 4 7 2

Subject to limits1 ................... 96 96 93 98

1 Limits may be set in terms of dollar or day ceilings on benefits, a

requirement that the participant pay a percentage of cost (coinsurance), or a

requirement that the participant pay a specific amount (deductible or

copayment) before reimbursement begins or services are rendered. 2 Less than 0.5 percent. 3 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 4 Rehabilitation is designed to alter abusive behavior in patients once

they are free of acute physical and mental complications.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 49. Medical care benefits:1 Fee arrangement and

financial intermediary, full-time employees, medium and large

private establishments, 1995

Fee arrangement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

medical care ....................... 25,546 7,467 6,158 11,921

Percent

Total with medical care ............. 100 100 100 100

Traditional fee-for-service2 ... 37 29 30 45

Self insured3 ..................... 26 20 20 33

With administrative

services only

contract4 ................. 15 13 11 19

Without administrative

services only

contract ................... 11 7 9 14

Commercial insurance

company ..................... 6 5 6 6

Blue Cross/Blue Shield ..... 5 5 5 6

Combined financed5 ......... 6 ( ) 6 ( ) 6 ( ) 6 ( )

Preferred provider

organization7 .................. 34 36 36 33

Self insured3 ..................... 21 24 25 18

With administrative

services only

contract4 ................. 14 15 19 11

Without administrative

services only

contract ................... 7 9 6 7

Commercial insurance

company ..................... 9 7 6 11

Blue Cross/Blue Shield ..... 4 4 4 4

Combined financed5 ......... 6 ( ) 6 ( ) 6 ( ) 6 ( )

See footnotes at end of table.
Table 49. Medical care benefits:1 Fee arrangement and

financial intermediary, full-time employees, medium and large

private establishments, 1995 — Continued

Fee arrangement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Total with medical care

Health maintenance

organization8 .................. 27 33 32 21

Commercial insurance

company ..................... 6 6 7 4

Blue Cross/Blue Shield ..... 3 4 3 3

Independent organization9 18 24 23 13

Combined financed5 ......... 6 ( ) - 6 ( ) 6 ( )

Other10 .................................. 1 1 2 1

1 Plans providing services or payments for services rendered in the

hospital or by a physician. Excludes plans that provided only dental, vision,

or prescription drug coverage. 2 These plans pay for specific medical procedures as expenses are

incurred. 3 Includes plans that are financed on a pay-as-you-go basis, plans

financed through contributions to a trust fund established to pay benefits, and

plans operating their own facilities if at least partially financed by employer

contributions. Includes plans that are administered by a commercial carrier

through Administrative Services Only (ASO) contracts. 4 An arrangement where an establishment pays the cost of benefits, but

hires another establishment to handle administrative services. 5 These are plans where the financing comes from two different kinds of

financial intermediaries. For example, an establishment contracts with Blue

Cross/Blue Shield to pay part of the benefits and a commercial company to

pay the other benefits. 6 Less than 0.5 percent. 7 A preferred provider organization (PPO) is a group of hospitals and

physicians that contracts to provide comprehensive medical services. To

encourage use of organization members, the health care plan limits

reimbursement rates when participants use nonmember services. 8 Includes federally qualified (those meeting standards of the Health

Maintenance Organization Act of 1973, as amended) and other HMO’s

delivering comprehensive health care on a prepayment rather than

fee-for-service basis. 9 These organizations provide and finance all benefits, but are not

affiliated with an insurance company or Blue Cross/Blue Shield. 10 Includes exclusive provider organizations, which are groups of hospitals

and physicians that contract to provide comprehensive medical services. 

Participants are required to obtain services from members of the organization

in order to receive plan benefits.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 50. Health maintenance organizations: Summary of

selected features, full-time employees, medium and large

private establishments, 1995

Feature

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in HMO

plans ................................... 6,988 2,499 1,988 2,502

Percent

Total in HMO plans ................... 100 100 100 100

Model type:

Group/staff1 ...................... 31 32 26 34

Individual practice

association2 ................ 43 45 44 42

Mixed model3 .................... 23 21 28 20

Not determinable .............. 3 2 2 4

Point of service feature4 ....... 15 16 13 15

Federally qualified ................ 65 66 69 61

Limit on copayments5 ........... 29 27 24 33

Preventive dental care6 ........ 11 13 8 10

Vision screening or

examinations .................. 87 87 87 88

1 Care is provided at centralized locations. 2 Care is provided by doctors working out of their offices. 3 When an HMO uses a combination of models--group, staff, and

individual association--it is referred to as a mixed model. 4 Enrollees may obtain care from non-HMO providers, with limited

reimbursement. 5 In these plans, HMO’s limit the dollar amount the individual pays after

which coverage is in full. For example, there is a copayment limit of $1,000

after which the HMO covers all services at 100 percent. 6 Includes dental examinations and/or x-rays only.

NOTE: Where applicable, dash indicates no employees in this category.
Table 51. Non-health maintenance organizations: Amount of individual deductible,1 full-time employees, medium and large

private establishments, 1995

Deductible2

All employees Professional, technical,

and related employees

Clerical and sales

employees

Blue-collar and service

employees

All

nonHMO

plans3

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans3

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans3

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans3

Feeforservice

plans

Preferred

provider

organizations

Number (in thousands) in

non-HMO plans .................. 18,558 9,430 8,770 4,968 2,187 2,676 4,170 1,858 2,218 9,419 5,385 3,876

Percent

Total in non-HMO plans ............ 100 100 100 100 100 100 100 100 100 100 100 100

Deductible specified ............. 77 91 63 74 92 61 73 91 60 80 91 67

Deductible on an annual

basis4 .......................... 76 91 63 73 92 60 73 91 60 80 91 67

Based on earnings5 ...... 8 10 6 8 12 6 7 10 4 9 10 9

Flat dollar amount ......... 68 81 57 65 80 55 66 81 56 70 80 59

Less than $100 ......... 212213111222

$100 .......................... 17 20 14 12 15 10 14 18 11 20 23 18

$101 - $149 .............. 6 ( ) 6 ( ) 6 ( ) 6 ( ) 1 - 6 ( ) - 6 ( ) 6 ( ) 6 ( ) -

$150 .......................... 9 11 7 9 11 7 7 6 7 10 12 6

$151 - $199 .............. 6 ( ) 6 ( ) 1 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 1 1 6 ( ) 1

$200 .......................... 18 19 17 17 19 16 18 20 16 18 19 17

$201 - $249 .............. 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) - 6 ( ) 6 ( ) 1 6 ( ) 6 ( ) 6 ( )

$250 .......................... 8 11 5 9 14 4 10 157694

$251 - $299 .............. 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) -

$300 .......................... 556666564547

Over $300 ................. 9 12 6 10 13 7 11 15 8 7 10 4

Other ................................. 6 ( ) 6 ( ) 6 ( ) 6 ( ) 6 ( ) 1 6 ( ) 6 ( ) - 6 ( ) 1 -

No deductible ........................ 23 8 36 26 7 39 26 7 40 20 9 33

Not determinable .................. 6 ( ) 1 6 ( ) 6 ( ) 6 ( ) 6 ( ) 1 1 1 6 ( ) 6 ( ) 6 ( )

Average7

Average annual deductible ....... $247 $264 $222 $264 $285 $239 $273 $295 $247 $229 $245 $199

1 The deductible is the amount of covered expenses that an individual

must pay before any charges are paid by the medical care plan. 

Deductibles that apply separately to a specific category of expense, such as

a deductible for each hospital admission, were excluded from this

tabulation. 2 Amount of deductible described is for each insured person. However,

many plans contain a maximum family deductible. In some plans, the

individual and the family deductibles are identical. If the deductible applied

only to dependents’ coverage, it was not tabulated. 3 These plans include fee-for-service, preferred provider organizations,

and exclusive provider organizations.

4 Deductibles are calculated on an annual basis, with the enrollee

responsible for satisfying a new deductible requirement each plan year. 5 These plans have deductibles that vary by the amount of the

participant’s earnings. A typical provision is 1 percent of annual earnings

with a maximum deductible of $150. 6 Less than 0.5 percent. 7 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals.

 Where applicable, dash indicates no employees in this category.
Table 52. Non-health maintenance organizations: Relationship of individual and family deductibles,1 full-time employees,

medium and large private establishments, 1995

Relationship of individual and

family deductibles

All employees Professional, technical,

and related employees

Clerical and sales

employees

Blue-collar and service

employees

All

nonHMO

plans2

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans2

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans2

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans2

Feeforservice

plans

Preferred

provider

organizations

Number (in thousands) in

non-HMO plans .................. 18,558 9,430 8,770 4,968 2,187 2,676 4,170 1,858 2,218 9,419 5,385 3,876

Percent

Total with non-HMO plans ........ 100 100 100 100 100 100 100 100 100 100 100 100

Individual and family

deductibles specified ...... 61 70 53 60 72 53 60 72 51 62 68 55

Family deductible is

multiple of individual

deductible3 .................. 52 62 43 53 63 46 50 64 39 53 61 43

1 times .......................... 4 ( ) 1 4 ( ) 4 ( ) 4 ( ) 4 ( ) 4 ( ) 4 ( ) 4 ( ) 1 1 4 ( )

1.1 to 1.9 times ............. 4 ( ) 4 ( ) 4 ( ) 1 1 1 4 ( ) 1 4 ( ) 4 ( ) 4 ( ) 4 ( )

2 times .......................... 22 27 18 24 29 21 21 28 16 22 26 17

2.1 to 2.4 times ............. 1 2 - 1 2 - 2 3 - 1 1 -

2.5 times ....................... 223332232324

2.6 to 2.9 times ............. 111111 4 ( ) 4 ( ) 1 1 2 4 ( )

3 times .......................... 24 27 21 23 26 21 24 28 20 24 27 22

Greater than 3 times ..... 1 1 - 4 ( ) 4 ( ) - 4 ( ) 1 - 1 2 -

Specified number of

individual deductibles

must be met to satisfy

family deductible5 ....... 9 8 10 8 9 6 10 8 12 9 7 12

Less than 3 individual

deductibles ............. 444342445435

3 individual deductibles 546564648537

More than 3 individual

deductibles ............. 4 ( ) 4 ( ) 4 ( ) 4 ( ) 4 ( ) 4 ( ) 4 ( ) - 4 ( ) 4 ( ) 4 ( ) 4 ( )

No individual and/or family

deductible ....................... 39 30 46 39 28 47 39 26 48 38 32 45

Not determinable .................. 4 ( ) 1 4 ( ) 4 ( ) 4 ( ) 4 ( ) 1 1 1 4 ( ) 4 ( ) 4 ( )

1 Deductibles are calculated on an annual basis with the enrollee

responsible for satisfying a new deductible requirement each plan year. 2 These plans include fee-for-service, preferred provider organizations,

and exclusive provider organizations. 3 For example, the individual deductible requirement is $100 while the

family deductible requirement is $300.

4 Less than 0.5 percent. 5 For example, the individual requirement is $100 and three individual

deductibles must be met to satisfy the family requirement.

NOTE: Because of rounding, sums of individual items may not equal totals.

 Where applicable, dash indicates no employees in this category.
Table 53. Non-health maintenance organizations: Coinsurance rates, full-time employees, medium and large private

establishments, 1995

Coinsurance

All employees Professional, technical,

and related employees

Clerical and sales

employees

Blue-collar and service

employees

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

Number (in thousands) in

non-HMO plans .................. 18,558 9,430 8,770 4,968 2,187 2,676 4,170 1,858 2,218 9,419 5,385 3,876

Percent

Total with non-HMO plans ........ 100 100 100 100 100 100 100 100 100 100 100 100

With coinsurance2 ................ 84 95 75 80 95 69 85 96 79 85 94 76

Coinsurance rate3

80 percent ..................... 60 82 38 54 81 35 55 81 35 65 83 43

85 percent ..................... 444342556445

90 percent ..................... 16 4 30 19 6 31 21 5 36 13 3 27

Other percent ................ 352352452341

Varies4 .......................... 5 ( ) 5 ( ) - - - - 5 ( ) 1 - 5 ( ) 5 ( ) -

Without coinsurance6 ........... 16 5 25 20 5 31 15 4 21 15 6 24

1 These plans include fee-for-service, preferred provider organizations,

and exclusive provider organizations. 2 Represents the initial coinsurance in plans that have 100 percent

coverage after the individual pays a specified dollar amount toward

expenses. For example, the plan pays 80 percent until the individual’s

out-of-pocket expenses reach $1,000, and then coverage is at 100 percent. 3 A few plans have more than one coinsurance rate. In those cases,

the coinsurance rate shown is that which applies to the majority of benefits

under the plan.

4 The overall coinsurance rate varies by specified dollar amount of

expenses. For example, 80 percent coverage up to $5,000 and 90 percent

thereafter. 5 Less than 0.5 percent. 6 Includes plans with overall benefit limitations, such as maximum dollar

amounts and deductibles, where the coinsurance rate is 100 percent.

NOTE: Because of rounding, sums of individual items may not equal totals.

 Where applicable, dash indicates no employees in this category.
Table 54. Non-health maintenance organizations: Maximum out-of-pocket expense provisions, full-time employees, medium

and large private establishments, 1995

Item

All employees Professional, technical,

and related employees

Clerical and sales

employees

Blue-collar and service

employees

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

Number (in thousands) with

non-HMO plans .................. 18,558 9,430 8,770 4,968 2,187 2,676 4,170 1,858 2,218 9,419 5,385 3,876

Percent

Total with non-HMO plans ........ 100 100 100 100 100 100 100 100 100 100 100 100

With limit on out-of-pocket

expense .......................... 83 88 79 81 90 74 85 90 81 83 86 80

With an annual dollar

maximum on

out-of-pocket

expense2 .................... 71 77 66 71 80 64 71 79 65 72 75 69

Per individual:

$1 - $299 .................. 111223111111

$300 .......................... 1 3 ( ) 1 3 ( ) 1 3 ( ) 1 1 1 1 3 ( ) 2

$301 - $399 .............. 3 ( ) - 3 ( ) 3 ( ) - 3 ( ) 3 ( ) - 3 ( ) 3 ( ) - 3 ( )

$400 .......................... 443342343444

$401 - $499 .............. 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) - 3 ( ) 3 ( ) 3 ( ) 3 ( )

$500 .......................... 657656658666

$501 - $749 .............. 352232471462

$750 - $999 .............. 657898648445

$1,000 ....................... 18 15 21 16 16 16 16 16 17 19 13 27

$1,001 - $1,499 ........ 7 9 6 7 9 6 9 12 7 6 7 5

$1,500 - $1,999 ........ 11 15 8 11 14 8 9 10 8 13 17 7

$2,000 ....................... 887758897896

$2,000 or greater ...... 7 9 5 8 13 5 8 11 5 6 7 5

Per family:

$1 - $499 .................. 1 1 - 3 ( ) 1 - 3 ( ) 1 - 1 1 -

$500 - $749 .............. 222324241111

$750 - $999 .............. 12112123 3 ( ) 1 1 1

$1,000 ....................... 434324435435

$1,001 - $1,249 ........ 111111111222

$1,250 - $1,499 ........ 3 ( ) 1 3 ( ) 3 ( ) 1 3 ( ) 1 1 3 ( ) 3 ( ) 3 ( ) 3 ( )

$1,500 ....................... 231342121231

$1,501 - $1,999 ........ 223324324212

$2,000 ....................... 657878656647

$2,001 - $2,999 ........ 7 8 6 9 8 11 7 11 3 6 7 4

$3,000 ....................... 11 11 10 8 9 7 7 6 7 14 14 14

$3,001 or greater ...... 12 13 10 13 16 10 13 16 10 11 12 9

No family maximum .. 15 17 13 13 19 9 15 16 15 16 17 15

Family maximum

cannot be

computed4 .......... 8 8 8 6 6 5 10 8 12 8 8 8

Annual maximum on

out-of-pocket expense

based on earnings ...... 9 8 10 8 8 8 11 8 15879

Annual maximum on

out-of-pocket expense

varies by coinsurance

rate5 ............................ 342231241342

Other ................................. 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) -

See footnotes at end of table.
Table 54. Non-health maintenance organizations: Maximum out-of-pocket expense provisions, full-time employees, medium

and large private establishments, 1995 — Continued

Item

All employees Professional, technical,

and related employees

Clerical and sales

employees

Blue-collar and service

employees

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

All

nonHMO

plans1

Feeforservice

plans

Preferred

provider

organizations

Percent

Total with non-HMO plans

No out-of-pocket expense

required6 ......................... 6 3 9 5 2 8 5 2 8 7 5 11

No limit on out-of-pocket

expense .......................... 11 9 11 14 8 17 9 8 9 10 9 9

Not determinable .................. 3 ( ) 3 ( ) 1 3 ( ) 3 ( ) 1 1 3 ( ) 2 3 ( ) 3 ( ) 3 ( )

Average7

Average annual dollar

maximum on individual

out-of-pocket expense ........ $1,358 $1,450 $1,229 $1,419 $1,542 $1,293 $1,354 $1,439 $1,247 $1,328 $1,414 $1,179

Average annual dollar

maximum on family

out-of-pocket expense ........ 2,858 2,923 2,738 2,894 3,135 2,654 2,948 2,980 2,878 2,801 2,807 2,736

1 These plans include fee-for-service, preferred provider organizations,

and exclusive provider organizations. 2 Deductible amounts were excluded from computation of the

out-of-pocket dollar limits. With rare exceptions, an out-of-pocket limit was

specified on an annual basis. Few workers were in plans where the

expense limit applied to a disability or a period other than a year. Charges

for certain services, such as mental health care, may not be counted toward

the out-of-pocket maximum. 3 Less than 0.5 percent. 4 These are plans where a family maximum is stated in such a way that

it cannot be computed. For example, the individual out-of-pocket expense

is limited to $1,000 per year and the family out-of-pocket expense is limited

to three individuals. The family out-of-pocket expense cannot be computed

because each of the three individuals must separately reach an

out-of-pocket limit of $1,000. Thus, if two individuals each reach $1,000 in

their out-of-pocket expenses, and two other family members reach $900

and $800 respectively in out-of-pocket expenses, the family out-of-pocket

limit would not have been met. A family dollar maximum cannot be

computed in this example. 5 Some plans reimburse medical expenses at more than one

coinsurance rate. They impose a limit on out-of-pocket expenses by

specifying a maximum on covered medical expenses beyond which all

expenses are paid at 100 percent. 6 All covered expenses are paid at 100 percent. 7 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals.

 Where applicable, dash indicates no employees in this category.
Table 55. Non-health maintenance organizations: Maximum benefit

provisions, full-time employees, medium and large private establishments,

1995

Maximum1 All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

non-HMO plans .................. 18,558 4,968 4,170 9,419

Percent

Total with non-HMO plans ........ 100 100 100 100

With maximum limits ............. 72 68 68 76

Lifetime maximum only ..... 70 68 67 72

Less than $250,000 ...... 2 2 ( ) 1 3

$250,000 ....................... 4 1 3 6

$250,001 - $499,999 .... 1 1 2 ( ) 1

$500,000 ....................... 6 5 5 7

$500,001 - $999,999 .... 1 2 ( ) 1 2

$1,000,000 .................... 47 48 50 45

More than $1,000,000 .. 9 13 7 8

Annual or disability

maximum only ............ 2 ( ) 2 ( ) 1 2 ( )

Both lifetime and annual or

disability maximums ... 1 1 2 ( ) 2

Other maximum ................ 2 ( ) - - 2 ( )

Without maximum limits ........ 27 31 31 24

Not determinable .................. 1 1 1 2 ( )

Average3

Average lifetime maximum ....... $1,026,396 $1,174,864 $1,040,008 $949,870

1 Maximum described is for each insured person. Where the maximum differed for

employees and dependents, the employee maximum was tabulated. 2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude workers without the

plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category.
Table 56. Medical care benefits: Average major medical provisions,

full-time employees, medium and large private establishments, 1995

Average1 All

employees

Professional,

technical,

and

related

employees

Clerical

and sales

employees

Bluecollar and

service

employees

Annual deductible2

Individual .............................. $247 $264 $273 $229

Family ................................... 618 635 709 572

Annual out-of-pocket expense

maximum3

Individual .............................. 1,358 1,419 1,354 1,328

Family ................................... 2,858 2,894 2,948 2,801

Lifetime maximum4 ................... 1,026,396 1,174,864 1,040,008 949,870

1 The average is presented for all covered workers; averages exclude workers without the

plan provision. 2 The deductible is the amount of covered expenses that an individual or family must pay

before any charges are paid by the medical care plan. Deductibles that apply separately to a

specific category of expense, such as a deductible for each hospital admission, were excluded

from this tabulation. 3 The out-of-pocket expense maximum is the amount an individual or family must pay

before the plan will pay 100 percent of additional charges. Deductible amounts were excluded

from computation of the out-of-pocket dollar limits. Usually, out-of-pocket limits were specified

on an annual basis. Charges for certain services, such as mental health care, may not be

counted toward the out-of-pocket maximum. 4 The maximum is the total amount of expenses that the plan will pay. Maximum

described is for each insured person. Where the maximum differed for employees and

dependents, the employee maximum was tabulated.
Table 57. Preferred provider organizations:1 Summary of

selected features, full-time employees, medium and large

private establishments, 1995

Item

All employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in PPO

plans ................................... 8,770 2,676 2,218 3,876

Percent

Total with PPO plans ................ 100 100 100 100

Services subject to PPO

incentive:

Hospital room and board .. 94 96 97 91

Surgery ............................. 92 90 94 92

Physician’s in-hospital

visits ............................ 92 90 93 92

Office visits ....................... 83 83 87 80

Outpatient prescription

drugs ........................... 39 38 41 39

Type of PPO incentives:2

Coinsurance rate differs ... 92 94 88 93

Lower annual deductible ... 49 46 51 49

Higher lifetime maximum

benefit limit ................. 8 8 9 9

Lower catastrophic

maximum limit ............. 54 54 52 55

Lower hospital deductible 18 21 16 17

Office visits copayment ..... 40 45 44 35

Outpatient prescription

drugs copayment ........ 20 22 22 19

Discounted for PPO3 ............ 7 5 11 6

Not determinable .................. 1 1 1 2

1 A preferred provider organization (PPO) is a group of hospitals and

physicians that contract to provide comprehensive medical services. To

encourage use of organization members, the health care plan limits

reimbursement rates when participants use nonmember services. 2 Sum of individual items is greater than the total because many plan

participants were in plans with more than one incentive. 3 The amount of total expenses incurred by the individual is discounted

under the PPO. For example, under the non-PPO, total expenses are

$10,000; under the PPO, total expenses are discounted by 10 percent.

NOTE: Where applicable, dash indicates no employees in this category.
Table 58. Preferred provider organizations:1 Coinsurance rate

comparison with traditional fee-for-service plans, full-time

employees, medium and large private establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in PPO

plans ................................... 8,770 2,676 2,218 3,876

Percent

Total with PPO plans ................ 100 100 100 100

Overall coinsurance rate

differs based on PPO2 .... 92 94 88 93

100 vs 80 .......................... 17 15 13 22

90 vs 80 ............................ 9 8 13 8

100 vs 70 .......................... 8 12 7 6

90 vs 70 ............................ 22 18 22 25

80 vs 70 ............................ 8 8 6 8

80 vs 60 ............................ 8 10 8 6

Other coinsurance rate ..... 20 23 19 17

Overall coinsurance rate

does not differ based on

PPO ................................ 7 5 12 5

Not determinable .................. 1 1 1 2

1 A preferred provider organization (PPO) is a group of hospitals and

physicians that contract to provide comprehensive medical services. To

encourage use of organization members, the health care plan limits

reimbursement rates when participants use nonmember services. 2 The first figure is the percentage of covered expenses paid by the plan

when a preferred provider is used; the second figure is the percentage of

expenses paid by the plan when a non-preferred provider is used.

NOTE: Because of rounding sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 59. Medical care benefits: Availability of managed care

benefits, full-time employees, medium and large private

establishments, 1995

Managed care plan

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

medical care ....................... 25,546 7,467 6,158 11,921

Percent

Total with medical care ............. 100 100 100 100

With managed care benefits 91 92 92 90

Traditional fee-for-service

with managed care

features1 ..................... 28 21 22 35

Preferred provider

organization2 .............. 34 36 36 33

Exclusive provider

organization3 .............. 1 1 2 1

Prepaid health

maintenance

organization4 .............. 27 33 32 21

Without managed care ......... 9 8 8 10

1 Fee-for-service plans with preadmission certification or mandatory

second surgical opinion features. 2 A preferred provider organization (PPO) is a group of hospitals and

physicians that contract to provide comprehensive medical services. To

encourage use of organization members, the health care plan limits

reimbursement rates when participants use nonmember services. 3 An exclusive provider organization is a group of hospitals and

physicians that contract to provide comprehensive medical services. 

Participants are required to obtain services from members of the organization

to receive plan benefits. 4 A health maintenance organization provides a prescribed set of benefits

to enrollees for a fixed payment.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 60. Non-health maintenance organizations: Availability

of selected cost containment features, full-time employees,

medium and large private establishments, 1995

Cost containment feature

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans .................. 18,558 4,968 4,170 9,419

Percent

Total with non-HMO plans ........ 100 100 100 100

With cost containment

features ........................... 77 74 75 79

Preadmission certification

requirement ................ 65 64 64 67

Utilization or concurrent

review ......................... 38 35 39 39

Preadmission testing ........ 42 40 37 45

Nonemergency weekend

admission restriction ... 10 10 9 10

Hospital audit program ..... 7 7 8 6

Other feature .................... 1 ( ) 1 ( ) - 1 ( )

1 Less than 0.5 percent.

NOTE: Sum of individual items may be greater than the total because many

participants were in plans with more than one type of cost containment

feature.
Table 61. Non-health maintenance organizations: 

Prehospitalization certification requirements, full-time

employees, medium and large private establishments, 1995

Managed care plan

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

preadmission certification ... 12,119 3,165 2,690 6,264

Percent

Total with preadmission

certification ......................... 100 100 100 100

Plan does not impose

penalty ............................ 4 6 5 2

Plan does impose penalty .... 96 94 95 98

No benefit ......................... 4 4 4 5

Deductible on hospital

admission ................... 34 32 39 33

Less than $100 ............. 1 - 1 ( ) 1

$100 - $199 .................. 5 5 6 4

$200 - $299 .................. 12 7 15 13

$300 - $399 .................. 6 10 5 4

$400 - $499 .................. 2 3 1 2

$500 or greater ............. 9 7 12 9

Reduced coinsurance paid

by plan ........................ 19 18 14 21

40 percent ..................... 1 ( ) - 1 ( ) 1 ( )

50 percent ..................... 11 13 6 12

60 percent ..................... 2 2 2 1

80 percent ..................... 1 1 2 1

Other percent ................ 5 3 5 6

Reduced coinsurance by .. 11 13 9 11

20 percent ..................... 4 6 4 3

25 percent ..................... 1 1 1 1

50 percent ..................... 5 6 4 5

Other percent ................ 1 1 1 2

Reduced coinsurance paid

by plan up to

maximum deductible

on hospital admission 7 6 5 8

Reduced coinsurance and

separate deductible

per admission ............. 2 2 1 2

Other ................................. 4 3 4 5

Penalty not determinable .. 14 15 18 12

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 62. Non-health maintenance organizations: Second

surgical opinion provisions, full-time employees, medium and

large establishments, 1995

Second surgical opinion

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans .................. 18,558 4,968 4,170 9,419

Percent

Total with non-HMO plans ........ 100 100 100 100

With second surgical opinion

program .......................... 53 55 51 54

With no penalties for

non-compliance .......... 31 33 31 30

With penalties for

non-compliance .......... 22 21 20 23

Coinsurance reduced

to:

60 percent ................. 1 1 2 1

50 percent ................. 9 10 8 9

40 percent ................. 1 2 1 1

Other ......................... 4 3 4 4

Lower schedule of

payments ............ 1 ( ) 1 ( ) 1 ( ) 1 ( )

No coverage ................. 1 ( ) 1 ( ) 1 ( ) 1 ( )

Deductible imposed ...... 3 3 2 4

Other penalties ............. 1 ( ) 1 ( ) 1 ( ) 1

Penalty not

determinable ........... 2 1 2 3

No second surgical opinion

program2 ......................... 47 45 49 46

1 Less than 0.5 percent. 2 Includes plans in which documentation does not detail a second

surgical opinion program. By definition, managed care plans, such as

preferred provider organizations integrate second surgical opinion programs

as part of their structure. These managed care plans are quite often

responsible for initiating the second surgical opinion program. When this

occurs, that program was not tabulated.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 63. Non-health maintenance organizations: Extent of

coverage for hospital room and board, full-time employees,

medium and large private establishments, 1995

Extent of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

 and

service

employees

Number (in thousands) in

non-HMO plans with

hospital room and board

coverage ............................. 18,558 4,968 4,170 9,419

Percent

Total in non-HMO plans with

hospital room and board

coverage ............................. 100 100 100 100

First dollar coverage only1 ........ 9 8 10 9

First dollar coverage then major

medical ............................... 22 27 21 20

Major medical only2 .................. 69 65 69 70

1 Includes plans in which all expenses were reimbursed for the full

semiprivate room rate, for a specified dollar amount, or for a limited or

unlimited number of days. 2 Major medical limits are expressed only in terms of total benefits

payable under the plan rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 64. Non-health maintenance organizations: Types of

limitations on hospital room and board coverage, full-time

employees, medium and large private establishments, 1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans with

hospital room and board

coverage ............................. 18,558 4,968 4,170 9,419

Percent

Total in non-HMO plans with

hospital room and board

coverage ............................. 100 100 100 100

Covered in full ....................... 6 6 7 5

Subject to limits other than

major medical ................. 26 29 24 25

Separate copayment ........ 10 14 12 8

Separate coinsurance ....... 3 5 2 3

Limits on days ................... 13 13 11 15

Per confinement ........... 13 13 10 13

Per year ........................ 1 1 ( ) 1 1

Limit on dollars ................. 3 1 1 4

Other ................................. 1 ( ) 1 1 ( ) 1 ( )

Major medical limits only2 ..... 69 65 69 70

1 Less than 0.5 percent. 2 Major medical limits are expressed only in terms of total benefits

payable under the plan rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits.

NOTE: Sum of individual items may be greater than the total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category.
Table 65. Hospital room and board coverage: Copayment provisions,1 by type of plan, full-time employees, medium and large

private establishments, 1995

Type of copayment provision

All employees Professional, technical,

and related employees

Clerical and sales

employees

Blue-collar and service

employees

HMO

plans2

Non-HMO plans

HMO

plans2

Non-HMO plans

HMO

plans2

Non-HMO plans

HMO

plans2

Non-HMO plans

Feeforservice

plans3

Preferred

provider

organization4

Feeforservice

plans3

Preferred

provider

organization4

Feeforservice

plans3

Preferred

provider

organization4

Feeforservice

plans3

Preferred

provider

organization4

Number (in thousands) with

separate copayment ........... 1,200 534 1,220 318 174 466 365 128 336 518 232 417

Percent

Total with separate copayment 100 100 100 100 100 100 100 100 100 100 100 100

Per confinement ................... 83 84 79 85 85 71 90 83 87 76 83 80

$100 .................................. 18 30 28 22 19 28 10 19 38 21 43 21

$200 .................................. 24 18 17 18 13 18 42 17 17 15 23 15

$250 .................................. 13 2 4 13 3 5 ( ) 11 2 7 14 5 ( ) 6

$300 .................................. 1 25 11 1 37 10 1 36 4 2 10 18

$400 .................................. 1 3 - 5 ( ) 2 - 1 - - 1 5 -

$500 .................................. 8 - - 3 - - 9 - - 9 - -

Greater than $500 ............ 2 2 - 2 5 ( ) - 4 7 - 1 5 ( ) -

Other ................................. 16 4 18 26 10 15 10 2 21 13 1 20

Limited to maximum amount

per year6 ......................... 10 2 8 9 3 11 6 1 2 13 1 10

Copayment per year ............. 2 6 4 1 5 2 2 10 4 2 5 6

Copayment per day .............. 17 9 21 16 14 31 10 6 17 24 6 14

Copayment limited to a

specified number of days - 6 5 ( ) - 5 5 ( ) - 3 5 ( ) - 10 -

1 A copayment is the amount of covered expenses that an individual

must pay before any charges are paid by the medical care plan. 2 Includes federally qualified (those meeting standards of the Health

Maintenance Organization Act of 1973, as amended) and other HMO’s

delivering comprehensive health care on a prepayment rather than

fee-for-service basis. 3 These plans pay for specific medical procedures as expenses are

incurred. 4 A preferred provider organization (PPO) is a group of hospitals and

physicians that contracts to provide comprehensive medical services. To

encourage use of organization members, the health care plan limits

reimbursement rates when participants use nonmember services. 5 Less than 0.5 percent. 6 These are plans where a limit is placed on the maximum copayment

an individual is responsible for during the year. For example, an individual

is subject to a copayment of $100 per confinement with a limit of $300 per

year.

NOTE: Because of rounding, sums of individual items may not equal totals.

 Where applicable, dash indicates no employees in this category.
Table 66. Non-health maintenance organizations: Extent of

coverage for extended care facilities, full-time employees,

medium and large private establishments, 1995

Extent of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans with

extended care benefits ....... 13,116 3,716 2,917 6,483

Percent

Total in non-HMO plans with

extended care benefits ....... 100 100 100 100

First dollar coverage only1 .... 11 12 11 11

First dollar coverage then

major medical ................. 70 65 70 72

Major medical only2 .............. 19 23 19 17

1 Includes plans in which all expenses were reimbursed for the full

semiprivate room rate, for a specified dollar amount, or for a limited or

unlimited number of days. 2 Major medical limits are expressed only in terms of total benefits

payable under the plan, rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 67. Non-health maintenance organizations: Types of

limitations on extended care facilities, full-time employees,

medium and large private establishments, 1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans with

extended care benefits ....... 13,116 3,716 2,917 6,483

Percent

Total in non-HMO plans with

extended care benefits ....... 100 100 100 100

Covered in full ....................... 2 2 2 2

Subject to limits other than

major medical ................. 79 75 79 81

Limit on days .................... 71 66 72 74

Limit on dollars ................. 3 4 3 2

Separate coinsurance ....... 6 8 6 5

Limited to maximum

percentage rate of

prior hospital

confinement ................ 15 11 17 15

Other limits ....................... 4 6 4 2

Limits not determinable .... 1 1 1 ( ) 1

Major medical limits only2 ..... 19 23 19 17

1 Less than 0.5 percent. 2 Major medical limits are expressed only in terms of total benefits

payable under the plan, rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits.

NOTE: Sum of individual items may be greater than the total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category.
Table 68. Non-health maintenance organizations: Limitations

on days of extended care facility coverage, full-time

employees, medium and large private establishments, 1995

Day limits

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans with day

limits on extended care ....... 8,822 2,270 2,012 4,540

Percent

Total in non-HMO plans with

day limits on extended care 100 100 100 100

First dollar coverage1 for a

limited number of days

per confinement .............. 11 9 7 14

30 days ............................. 2 ( ) 1 2 ( ) 2 ( )

60 days ............................. 3 1 2 4

90 days ............................. 2 ( ) 2 ( ) 2 ( ) 2 ( )

120 days ........................... 1 2 2 1

180 days ........................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Other ................................. 6 4 3 9

Major medical coverage3 for

a limited number of days

per confinement .............. 41 45 41 38

30 days ............................. 1 1 2 ( ) 1

60 days ............................. 13 14 14 12

90 days ............................. 3 7 2 2

100 days ........................... 5 7 6 3

120 days ........................... 10 10 13 9

180 days ........................... 2 5 1 2

Other ................................. 6 2 5 10

First dollar coverage1 for a

limited number of days

per year .......................... 5 6 6 5

60 days ............................. 1 2 1 1

100 days ........................... 3 2 4 3

120 days ........................... 1 1 1 1

180 days ........................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Other ................................. 2 ( ) 2 ( ) 2 ( ) 2 ( )

See footnotes at end of table.
Table 68. Non-health maintenance organizations: Limitations

on days of extended care facility coverage, full-time

employees, medium and large private establishments, 1995 —

Continued

Day limits

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Total in non-HMO plans with

day limits on extended care

Major medical coverage3 for

a limited number of days

per year .......................... 43 40 46 43

60 days ............................. 17 12 13 21

90 days ............................. 2 2 4 2

100 days ........................... 7 8 6 8

120 days ........................... 11 12 17 9

180 days ........................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Other ................................. 5 7 6 4

First dollar coverage1 for a

limited number of days

per lifetime ...................... 2 ( ) 1 2 ( ) 2 ( )

Major medical coverage3 for

a limited number of days

per lifetime ...................... 2 3 3 2

Days not determinable .......... 2 ( ) 1 2 ( ) 2 ( )

1 Includes plans in which all expenses were reimbursed for the full

semiprivate room rate, for a specified dollar amount, or for a limited or

unlimited number of days. 2 Less than 0.5 percent. 3 Major medical limits are expressed only in terms of total benefits

payable under the plan, rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits.

NOTE: Sum of individual items may be greater than the total because some

participants were in plans with more than one type of day limit. Where

applicable, dash indicates no employees in this category.
Table 69. Health maintenance organizations: Extent of

coverage for extended care facilities, full-time employees,

medium and large private establishments, 1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in HMO

plans with extended care

benefits ............................... 5,563 2,002 1,481 2,080

Percent

Total in HMO plans with

extended care benefits ....... 100 100 100 100

Covered in full ....................... 14 16 13 13

Day limit ................................ 81 81 77 84

Per year ............................ 60 60 58 60

30 days ......................... 4 3 3 5

60 days ......................... 7 6 7 8

90 days ......................... 2 2 2 3

100 days ....................... 35 41 39 26

Other ............................. 12 8 8 19

Per confinement ............... 20 20 19 21

30 days ......................... 1 1 1 ( ) 1 ( )

60 days ......................... 4 5 3 3

90 days ......................... 1 ( ) 1 ( ) 1 ( ) 1

100 days ....................... 10 12 10 9

Other ............................. 6 3 5 9

Per lifetime ........................ 1 1 1 1

Not determinable .............. 1 1 ( ) 1 2

Other limits (only) ................. 5 2 10 3

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 70. Non-health maintenance organizations: Extent of

coverage for surgical services, full-time employees, medium

and large private establishments, 1995

Type of surgery and extent of

coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans with

inpatient surgery ................. 18,558 4,968 4,170 9,419

Number (in thousands) in

non-HMO plans with

outpatient surgery ............... 18,558 4,968 4,170 9,419

Percent

Inpatient surgery

Total in non-HMO plans with

inpatient surgery ............. 100 100 100 100

Covered in full ................... 11 13 10 11

Subject to limits other than

major medical ............. 7 6 7 8

Dollar limit ..................... 3 1 2 4

Separate coinsurance ... 3 4 3 3

Separate deductible ...... 1 1 2 1

Other limit ..................... 1 ( ) 1 ( ) 1 ( ) 1 ( )

Major medical limits only2 82 81 83 81

Outpatient surgery3

Total in non-HMO plans with

outpatient surgery ........... 100 100 100 100

Covered in full ................... 12 13 12 12

Subject to limits other than

major medical ............. 8 6 8 9

Dollar limit ..................... 3 1 2 4

Separate coinsurance ... 2 2 2 2

Separate deductible ...... 1 1 1 1

Other limit ..................... 2 3 3 2

Major medical limits only2 80 80 80 79

1 Less than 0.5 percent. 2 Major medical limits are expressed only in terms of total benefits

payable under the plan, rather than for individual categories of care. Limits

are set as deductibles, coinsurance percentages, and overall dollar limits on

plan benefits. 3 Charges incurred in the outpatient department of a hospital and outside

of the hospital.

NOTE: Sum of individual items may be greater than the total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category.
Table 71. Health maintenance organizations: Extent of

coverage for physicians’ office visits, full-time employees,

medium and large private establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in HMO

plans with physicians’ office

visits coverage .................... 6,988 2,499 1,988 2,502

Percent

Total in HMO plans with

physicians’ office visits

coverage ............................. 100 100 100 100

Covered in full ....................... 13 13 14 11

Subject to a copayment ........ 86 86 85 87

$1 per visit ........................ 1 ( ) - 1 ( ) -

$2 per visit ........................ 1 1 2 1

$3 per visit ........................ 1 1 2 1

$4 per visit ........................ 1 ( ) 1 ( ) 1 -

$5 per visit ........................ 34 33 34 35

$6 - 9 per visit .................. 1 ( ) 1 ( ) 1 1 ( )

$10 per visit ...................... 42 43 39 43

More than $10 per visit ..... 6 6 7 6

Unspecified copayment .... 1 1 1 2

Subject to other limits only .... 1 1 1 1

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 72. Outpatient prescription drug benefits: Summary of

coverage, full-time employees, medium and large private

establishments, 1995

Provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales 

employees

Bluecollar

 and 

service

employees

Number of employees (in

thousands) with outpatient

prescription drug coverage 24,770 7,199 6,020 11,551

Percent

Total with outpatient

prescription drug

coverage ....................... 100 100 100 100

Coverage for brand name drugs 99 99 99 99

Higher reimbursement for

generic drugs ...................... 41 43 43 38

Coverage for mail order drugs1 32 33 33 32

Higher reimbursement for

prescriptions filled at

selected pharmacies ........... 27 30 26 26

1 Programs that provide drugs for maintenance purposes, that is, drugs

required on a continuous basis.

NOTE: Sum of individual items may be greater than the total because some

participants were in plans with more than one type of coverage. Where

applicable, dash indicates no employees in this category.
Table 73. Outpatient prescription drug benefits: Brand name

drug provisions in non-health maintenance organization plans,

full-time employees, medium and large private establishments,

1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number of employees (in

thousands) in non-HMO

plans with outpatient brand

name drug coverage ........... 17,495 4,699 3,925 8,871

Percent

Total in non-HMO plans

with outpatient brand

name drug coverage ..... 100 100 100 100

Covered in full ........................... 1 ( ) 1 ( ) 1 1

Subject to the major medical

limits of plan ........................ 58 58 53 61

Subject to copayment per

prescription ......................... 45 46 48 44

Less than $5.00 .................... 5 5 4 5

$5.00 ..................................... 11 10 11 12

$5.01-$6.99 .......................... 2 3 1 1

$7.00 ..................................... 2 1 3 2

$7.01-$9.99 .......................... 7 5 10 6

$10.00 ................................... 12 13 15 11

Greater than $10.00 ............. 4 6 4 4

Unspecified copayment ........ 2 2 1 2

Subject to a separate yearly

deductible ........................... 6 4 8 6

Subject to a separate

coinsurance rate ................. 8 11 8 7

Subject to a separate yearly

maximum ............................ 1 1 ( ) 1 2

Difference in cost between

generic and brand name

drugs2 ................................. 4 6 5 3

Other ......................................... 1 2 3 1

1 Less than 0.5 percent. 2 These are plans where the individual participant is required to use a

generic equivalent when available; if a generic equivalent is not chosen, the

individual must pay the difference in total cost between the brand name and

generic drug plus the cost to the individual. For example, if an individual is

subject to a $5 copayment for generic drugs and the brand name equivalent

is purchased, the individual must pay the difference in total cost between the

brand name and generic drug, plus the $5 copayment.

NOTE: Sum of individual items may be greater than the total because some

participants were in plans with more than one type of coverage. Where

applicable, dash indicates no employees in this category.
Table 74. Outpatient prescription drug benefits: Brand name

drug provisions in health maintenance organization plans,

full-time employees, medium and large private establishments,

1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number of employees (in

thousands) in HMO plans

with outpatient brand name

drug coverage ..................... 6,508 2,319 1,884 2,304

Percent

Total in HMO plans with

outpatient brand name

drug coverage ............... 100 100 100 100

Covered in full ........................... 3 3 2 4

Subject to copayment per

prescription ......................... 89 90 88 89

Less than $5.00 .................... 9 12 10 7

$5.00 ..................................... 40 38 42 41

$5.01-$6.99 .......................... 2 2 2 2

$7.00 ..................................... 5 5 2 7

$7.01-$9.99 .......................... 6 5 6 6

$10.00 ................................... 17 19 18 15

Greater than $10.00 ............. 6 9 3 5

Unspecified copayment ........ 4 3 3 6

Subject to a separate yearly

deductible ........................... 2 1 2 4

Subject to a separate yearly

maximum ............................ 3 3 2 3

Difference in cost between

generic and brand name

drugs1 ................................. 5 4 7 3

Other ......................................... 4 5 4 4

1 These are plans where the individual participant is required to use a

generic equivalent when available; if a generic equivalent is not chosen, the

individual must pay the difference in total cost between the brand name and

generic drug plus the cost to the individual. For example, if an individual is

subject to a $5 copayment for generic drugs and the brand name equivalent

is purchased, the individual must pay the difference in total cost between the

brand name and generic drug, plus the $5 copayment.

NOTE: Sum of individual items may be greater than the total because some

participants were in plans with more than one type of coverage. Where

applicable, dash indicates no employees in this category.
Table 75. Mental health care benefits: Relationship to other

coverage,1 full-time employees, medium and large private

establishments, 1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Inpatient2

Total covered ...................... 100 100 100 100

Covered the same .................... 18 22 12 17

Covered differently ................... 82 78 88 83

Outpatient3

Total covered ...................... 100 100 100 100

Covered the same .................... 2 3 3 2

Covered differently ................... 98 97 97 98

1 Relationship to other coverage is a comparison to similar non-mental

health treatment. For example, if inpatient mental health care is limited to 30

days per year, but inpatient care for any other type of illness is not limited in

terms of days, the plan contains mental health provisions that are covered

differently. 2 Excludes doctor’s charges in the hospital. 3 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 76. Mental health care benefits: Limits on coverage

full-time employees, medium and large private establishments,

1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

mental health care benefits 24,764 7,251 5,968 11,545

Number (in thousands) with

outpatient mental health

care benefits ....................... 23,368 6,866 5,799 10,703

Percent

Inpatient1

Total with mental health care

benefits ........................... 100 100 100 100

No separate limits2 ........... 19 23 14 20

Subject to separate limits3 81 77 86 80

Days ............................. 57 56 61 55

Dollars .......................... 42 37 42 44

Coinsurance ................. 14 14 15 14

Copayment ................... 7 7 10 5

Other ............................. 2 2 1 2

Outpatient4

Total with mental health care

benefits ........................... 100 100 100 100

No separate limits2 ........... 4 3 4 3

Subject to separate limits3 96 97 96 97

Days ............................. 51 57 54 46

Dollars .......................... 59 55 57 62

Coinsurance ................. 40 37 39 43

Copayment ................... 28 30 34 24

Other ............................. 2 3 2 2

1 Excludes doctor’s charges in the hospital. 2 These include plans covered without any limits; they also include plans

subject to only the major medical limits of the plan. 3 Separate limitations indicate that mental health care benefits are more

restrictive than benefits for other treatments. For example, if a plan limits

inpatient mental health care to 30 days per year, that plan contains separate

limits. The total is less than the sum of the individual items because many

plans had more than one type of limitation. 4 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, doctor’s office care was tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 77. Mental health care benefits: Limits on coverage in

health maintenance organizations, full-time employees,

medium and large private establishments, 1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

mental health care benefits 6,543 2,356 1,873 2,313

Number (in thousands) with

outpatient mental health

care benefits ....................... 6,667 2,407 1,912 2,348

Percent

Inpatient1

Total with mental health care

benefits ........................... 100 100 100 100

No separate limits2 ........... 11 16 8 8

Subject to separate limits3 89 84 92 92

Days ............................. 84 80 87 86

Dollars .......................... 10 10 12 10

Coinsurance ................. 13 8 9 21

Copayment ................... 15 15 18 13

Other ............................. 1 4 ( ) 1 1

Outpatient5

Total with mental health care

benefits ........................... 100 100 100 100

No separate limits2 ........... 2 1 4 2

Subject to separate limits3 98 99 96 98

Days ............................. 88 88 86 89

Dollars .......................... 16 17 16 14

Coinsurance ................. 20 19 14 26

Copayment ................... 56 57 63 49

Other ............................. 3 3 1 4

1 Excludes doctor’s charges in the hospital. 2 These include plans covered without any limits; they also include plans

subject to overall plan limits such as plan maximums. 3 Separate limitations indicate that mental health care benefits are more

restrictive than benefits for other treatments. For example, if a plan limits

inpatient mental health care to 30 days per year, that plan contains separate

limits. The total is less than the sum of the individual items because many

plans had more than one type of limitation. 4 Less than 0.5 percent. 5 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, doctor’s office care was tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 78. Mental health care benefits: Limits on coverage in

non-health maintenance organizations, full-time employees,

medium and large private establishments, 1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

mental health care benefits 18,221 4,895 4,094 9,232

Number (in thousands) with

outpatient mental health

care benefits ....................... 16,701 4,460 3,887 8,355

Percent

Inpatient1

Total with mental health care

benefits ........................... 100 100 100 100

No separate limits2 ........... 22 26 17 22

Subject to separate limits3 78 74 83 78

Days ............................. 47 45 50 47

Dollars .......................... 53 50 56 53

Coinsurance ................. 15 16 18 13

Copayment ................... 4 3 6 3

Other ............................. 2 2 2 2

Outpatient4

Total with mental health care

benefits ........................... 100 100 100 100

No separate limits2 ........... 4 4 4 4

Subject to separate limits3 96 96 96 96

Days ............................. 36 40 38 34

Dollars .......................... 76 75 76 76

Coinsurance ................. 48 47 51 47

Copayment ................... 17 16 20 16

Other ............................. 2 3 2 2

1 Excludes doctor’s charges in the hospital. 2 These include plans covered without any limits; they also include plans

subject to only the major medical limits of the plan. 3 Separate limitations indicate that mental health care benefits are more

restrictive than benefits for other treatments. For example, if a plan limits

inpatient mental health care to 30 days per year, that plan contains separate

limits. The total is less than the sum of the individual items because many

plans had more than one type of limitation. 4 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, doctor’s office care was tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 79. Alcohol and drug abuse: Relationship between

provisions, full-time employees, medium and large private

establishments, 1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

medical care ....................... 25,546 7,467 6,158 11,921

Percent

Total .......................................... 100 100 100 100

Covered together1 ................ 76 77 76 76

Covered separately but with

the same limits2 .............. 2 2 2 2

Other3 ................................... 22 22 22 23

1 These are plans where all limits that apply to alcohol abuse treatment

also apply to drug abuse treatment. When care is received for one of these

types of treatment, it reduces the availability of care from the other. For

example, if alcohol and drug abuse are limited to 30 days per year and 20

days are used for alcohol abuse, then there are 10 days left for drug abuse. 2 These are plans where alcohol and drug abuse are subject to separate

and identical limits. For example, alcohol abuse treatment is limited to 30

days per year and drug abuse treatment is limited to a separate 30 days per

year. 3 Includes plans where alcoholism coverage differs from drug coverage;

and where some limits for alcohol and drug abuse treatment are separate

and identical and different limits reduce the availability of care from the other;

and where there is no coverage for alcohol and drug abuse treatment.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in the category.
Table 80. Substance abuse treatment benefits: Relationship

to other coverage,1 full-time employees, medium and large

private establishments, 1995

Type of coverage

All

employees

Professional,

 technical,

and

 related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Alcohol abuse

Total with inpatient

detoxification2 ................. 100 100 100 100

Covered the same .................... 28 31 28 26

Covered differently ................... 72 69 72 74

Total with inpatient

rehabilitation3 ................ 100 100 100 100

Covered the same .................... 6 8 6 6

Covered differently ................... 94 92 94 94

Total with outpatient

rehabilitation4 ................ 100 100 100 100

Covered the same .................... 6 8 6 4

Covered differently ................... 94 92 94 96

Drug abuse

Total with inpatient

detoxification2 ................. 100 100 100 100

Covered the same .................... 28 31 29 26

Covered differently ................... 72 69 71 74

Total with inpatient

rehabilitation3 ................ 100 100 100 100

Covered the same .................... 6 8 6 5

Covered differently ................... 94 92 94 95

Total with outpatient

rehabilitation4 ................ 100 100 100 100

Covered the same .................... 6 8 6 4

Covered differently ................... 94 92 94 96

1 Relationship to other coverage is a comparison to similar

non-substance abuse treatment. For example, if alcohol rehabilitation is

limited to 30 days per year, but inpatient care for any other type of illness is

not limited in terms of days, the plan contains inpatient alcohol rehabilitation

provisions that are covered differently. 2 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 3 Rehabilitation is designed to alter the abusive behavior in patients once

they are free of acute physical and mental complications. 4 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 81. Alcohol abuse treatment benefits: Limits on

coverage, full-time employees, medium and large private

establishments, 1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

inpatient detoxification

benefits ............................... 25,039 7,384 6,024 11,631

Number (in thousands) with

inpatient rehabilitation

benefits ............................... 19,579 5,760 4,659 9,160

Number (in thousands) with

outpatient rehabilitation

benefits ............................... 20,642 6,108 5,017 9,516

Percent

Inpatient detoxification1

Total with inpatient

detoxification benefits ..... 100 100 100 100

No separate limits2 ........... 29 31 30 28

Subject to separate limits3 71 69 70 72

Days ............................. 50 48 49 52

Dollars .......................... 36 33 36 39

Coinsurance ................. 13 13 14 12

Copayment ................... 5 6 6 4

Other ............................. 3 4 2 2

Inpatient rehabilitation4

Total with inpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 8 9 7 8

Subject to separate limits3 92 91 93 92

Days ............................. 67 66 69 67

Dollars .......................... 45 42 46 46

Coinsurance ................. 17 17 19 16

Copayment ................... 6 7 8 5

Other ............................. 3 5 2 2

See footnotes at end of table.
Table 81. Alcohol abuse treatment benefits: Limits on

coverage, full-time employees, medium and large private

establishments, 1995 — Continued

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Outpatient rehabilitation5

Total with outpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 7 10 8 5

Subject to separate limits3 93 90 92 95

Days ............................. 49 49 51 47

Dollars .......................... 53 50 54 55

Coinsurance ................. 28 25 29 30

Copayment ................... 22 23 25 20

Other ............................. 3 4 2 3

1 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 2 These include plans covered without any limits; they also include plans

subject to only the major medical limits of the plan. 3 Separate limitations indicate that alcohol abuse treatment benefits are

more restrictive than benefits for other treatments. For example, if a plan

limits inpatient rehabilitation care to 30 days per year, but the limit on

inpatient care for any other type of illness is greater than 30 days per year,

the plan contains separate limits. The total is less than the sum of the

individual items because many plans had more than one type of limitation. 4 Rehabilitation is designed to alter the abusive behavior in patients once

they are free of acute physical and mental complications. 5 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 82. Drug abuse treatment benefits: Limits on coverage,

full-time employees, medium and large private establishments,

1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

inpatient detoxification

benefits ............................... 24,856 7,343 5,931 11,582

Number (in thousands) with

inpatient rehabilitation

benefits ............................... 19,433 5,718 4,649 9,066

Number (in thousands) with

outpatient rehabilitation

benefits ............................... 20,529 6,058 4,999 9,471

Percent

Inpatient detoxification1

Total with inpatient

detoxification benefits ..... 100 100 100 100

No separate limits2 ........... 30 32 30 28

Subject to separate limits3 70 68 70 72

Days ............................. 50 47 48 52

Dollars .......................... 36 33 36 38

Coinsurance ................. 13 13 15 12

Copayment ................... 5 6 6 4

Other ............................. 3 4 2 2

Inpatient rehabilitation4

Total with inpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 8 9 8 7

Subject to separate limits3 92 91 92 93

Days ............................. 67 65 69 67

Dollars .......................... 45 42 46 46

Coinsurance ................. 17 17 19 16

Copayment ................... 6 7 8 5

Other ............................. 3 5 2 2

See footnotes at end of table.
Table 82. Drug abuse treatment benefits: Limits on coverage,

full-time employees, medium and large private establishments,

1995 — Continued

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Outpatient rehabilitation5

Total with outpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 7 10 8 5

Subject to separate limits3 93 90 92 95

Days ............................. 49 49 51 47

Dollars .......................... 53 50 54 55

Coinsurance ................. 29 26 29 30

Copayment ................... 22 23 25 20

Other ............................. 3 4 2 3

1 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 2 These include plans covered without any limits; they also include plans

subject to only the major medical limits of the plan. 3 Separate limitations indicate that drug abuse treatment benefits are

more restrictive than benefits for other treatments. For example, if a plan

limits inpatient rehabilitation care to 30 days per year, but the limit on

inpatient care for any other type of illness is greater than 30 days per year,

the plan contains separate limits. The total is less than the sum of the

individual items because many plans had more than one type of limitation. 4 Rehabilitation is designed to alter the abusive behavior in patients once

they are free of acute physical and mental complications. 5 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 83. Alcohol abuse treatment benefits: Limits on

coverage in health maintenance organizations, full-time

employees, medium and large private establishments, 1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

inpatient detoxification

benefits ............................... 6,961 2,483 1,982 2,496

Number (in thousands) with

inpatient rehabilitation

benefits ............................... 4,595 1,734 1,208 1,653

Number (in thousands) with

outpatient rehabilitation

benefits ............................... 5,623 2,078 1,533 2,012

Percent

Inpatient detoxification1

Total with inpatient

detoxification benefits ..... 100 100 100 100

No separate limits2 ........... 44 43 48 41

Subject to separate limits3 56 57 52 59

Days ............................. 44 44 42 45

Dollars .......................... 12 12 12 12

Coinsurance ................. 10 5 9 16

Copayment ................... 9 10 9 8

Other ............................. 2 3 1 3

Inpatient rehabilitation4

Total with inpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 11 12 12 9

Subject to separate limits3 89 88 88 91

Days ............................. 76 73 79 77

Dollars .......................... 18 18 18 18

Coinsurance ................. 17 10 15 26

Copayment ................... 14 13 18 14

Other ............................. 4 4 2 4

See footnotes at end of table.
Table 83. Alcohol abuse treatment benefits: Limits on

coverage in health maintenance organizations, full-time

employees, medium and large private establishments, 1995 —

Continued

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Outpatient rehabilitation5

Total with outpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 14 18 16 9

Subject to separate limits3 86 82 84 91

Days ............................. 67 64 70 66

Dollars .......................... 19 21 18 18

Coinsurance ................. 13 8 12 19

Copayment ................... 36 35 40 35

Other ............................. 4 4 2 6

1 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 2 These include plans covered without any limits; they also include plans

subject to overall plan limits such as plan maximums. 3 Separate limitations indicate that alcohol abuse treatment benefits are

more restrictive than benefits for other treatments. For example, if a plan

limits inpatient rehabilitation care to 30 days per year, but the limit on

inpatient care for any other type of illness is greater than 30 days per year,

the plan contains separate limits. The total is less than the sum of the

individual items because many plans had more than one type of limitation. 4 Rehabilitation is designed to alter the abusive behavior in patients once

they are free of acute physical and mental complications. 5 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 84. Drug abuse treatment benefits: Limits on coverage

in health maintenance organizations, full-time employees,

medium and large private establishments, 1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

inpatient detoxification

benefits ............................... 6,866 2,464 1,908 2,494

Number (in thousands) with

inpatient rehabilitation

benefits ............................... 4,530 1,717 1,185 1,629

Number (in thousands) with

outpatient rehabilitation

benefits ............................... 5,588 2,070 1,523 1,994

Percent

Inpatient detoxification1

Total with inpatient

detoxification benefits ..... 100 100 100 100

No separate limits2 ........... 45 44 51 41

Subject to separate limits3 55 56 49 59

Days ............................. 43 44 40 45

Dollars .......................... 12 12 12 12

Coinsurance ................. 10 5 9 16

Copayment ................... 9 10 8 8

Other ............................. 2 3 1 3

Inpatient rehabilitation4

Total with inpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 11 12 12 8

Subject to separate limits3 89 88 88 92

Days ............................. 77 73 81 78

Dollars .......................... 18 18 17 18

Coinsurance ................. 17 10 15 26

Copayment ................... 14 13 17 14

Other ............................. 4 4 2 4

See footnotes at end of table.
Table 84. Drug abuse treatment benefits: Limits on coverage

in health maintenance organizations, full-time employees,

medium and large private establishments, 1995 — Continued

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Outpatient rehabilitation5

Total with outpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 14 18 16 9

Subject to separate limits3 86 82 84 91

Days ............................. 67 65 71 66

Dollars .......................... 19 21 18 18

Coinsurance ................. 13 8 12 19

Copayment ................... 36 35 40 35

Other ............................. 4 4 2 6

1 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 2 These include plans covered without any limits; they also include plans

subject to overall plan limits such as plan maximums. 3 Separate limitations indicate that drug abuse treatment benefits are

more restrictive than benefits for other treatments. For example, if a plan

limits inpatient rehabilitation care to 30 days per year, but the limit on

inpatient care for any other type of illness is greater than 30 days per year,

the plan contains separate limits. The total is less than the sum of the

individual items because many plans had more than one type of limitation. 4 Rehabilitation is designed to alter the abusive behavior in patients once

they are free of acute physical and mental complications. 5 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 85. Alcohol abuse treatment benefits: Limits on

coverage in non-health maintenance organizations, full-time

employees, medium and large private establishments, 1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Blue--

collar

and

service

employees

Number (in thousands) with

inpatient detoxification

benefits ............................... 18,078 4,900 4,042 9,135

Number (in thousands) with

inpatient rehabilitation

benefits ............................... 14,984 4,026 3,451 7,507

Number (in thousands) with

outpatient rehabilitation

benefits ............................... 15,018 4,030 3,484 7,504

Percent

Inpatient detoxification1

Total with inpatient

detoxification benefits ..... 100 100 100 100

No separate limits2 ........... 24 26 20 24

Subject to separate limits3 76 74 80 76

Days ............................. 52 49 53 54

Dollars .......................... 45 43 47 46

Coinsurance ................. 14 17 17 11

Copayment ................... 4 4 5 3

Other ............................. 3 5 2 2

Inpatient rehabilitation4

Total with inpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 7 8 6 7

Subject to separate limits3 93 92 94 93

Days ............................. 64 63 65 64

Dollars .......................... 53 52 55 53

Coinsurance ................. 17 20 20 14

Copayment ................... 4 5 5 3

Other ............................. 3 5 2 2

See footnotes at end of table.
Table 85. Alcohol abuse treatment benefits: Limits on

coverage in non-health maintenance organizations, full-time

employees, medium and large private establishments, 1995 —

Continued

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Blue--

collar

and

service

employees

Outpatient rehabilitation5

Total with outpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 5 6 5 4

Subject to separate limits3 95 94 95 96

Days ............................. 42 41 43 42

Dollars .......................... 66 65 70 65

Coinsurance ................. 34 34 36 33

Copayment ................... 17 16 19 16

Other ............................. 2 3 2 2

1 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 2 These include plans covered without any limits; they also include plans

subject to only the major medical limits of the plan. 3 Separate limitations indicate that alcohol abuse treatment benefits are

more restrictive than benefits for other treatments. For example, if a plan

limits inpatient rehabilitation care to 30 days per year, but the limit on

inpatient care for any other type of illness is greater than 30 days per year,

the plan contains separate limits. The total is less than the sum of the

individual items because many plans had more than one type of limitation. 4 Rehabilitation is designed to alter the abusive behavior in patients once

they are free of acute physical and mental complications. 5 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 86. Drug abuse treatment benefits: Limits on coverage

in non-health maintenance organizations, full-time employees,

medium and large private establishments, 1995

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

inpatient detoxification

benefits ............................... 17,990 4,879 4,022 9,088

Number (in thousands) with

inpatient rehabilitation

benefits ............................... 14,902 4,002 3,464 7,437

Number (in thousands) with

outpatient rehabilitation

benefits ............................... 14,941 3,988 3,476 7,477

Percent

Inpatient detoxification1

Total with inpatient

detoxification benefits ..... 100 100 100 100

No separate limits2 ........... 24 26 21 24

Subject to separate limits3 76 74 79 76

Days ............................. 52 49 52 54

Dollars .......................... 46 44 48 46

Coinsurance ................. 14 18 17 11

Copayment ................... 4 4 5 3

Other ............................. 3 5 2 2

Inpatient rehabilitation4

Total with inpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 7 8 6 7

Subject to separate limits3 93 92 94 93

Days ............................. 64 62 64 64

Dollars .......................... 53 53 55 53

Coinsurance ................. 17 20 20 14

Copayment ................... 4 5 5 3

Other ............................. 3 5 2 2

See footnotes at end of table.
Table 86. Drug abuse treatment benefits: Limits on coverage

in non-health maintenance organizations, full-time employees,

medium and large private establishments, 1995 — Continued

Coverage limitation

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Outpatient rehabilitation5

Total with outpatient

rehabilitation benefits ...... 100 100 100 100

No separate limits2 ........... 4 5 5 4

Subject to separate limits3 96 95 95 96

Days ............................. 42 41 42 42

Dollars .......................... 66 65 70 64

Coinsurance ................. 34 35 36 33

Copayment ................... 17 16 19 16

Other ............................. 2 3 2 2

1 Detoxification is the systematic use of medication and other methods

under medical supervision to reduce or eliminate the effects of substance

abuse. 2 These include plans covered without any limits; they also include plans

subject to overall plan limits such as plan maximums. 3 Separate limitations indicate that drug abuse treatment benefits are

more restrictive than benefits for other treatments. For example, if a plan

limits inpatient rehabilitation care to 30 days per year, but the limit on

inpatient care for any other type of illness is greater than 30 days per year,

the plan contains separate limits. The total is less than the sum of the

individual items because many plans had more than one type of limitation. 4 Rehabilitation is designed to alter the abusive behavior in patients once

they are free of acute physical and mental complications. 5 Includes treatment in one or more of the following: outpatient

department of a hospital, residential treatment center, organized outpatient

clinic, day-night treatment center, or doctor’s office. If benefits differed by

location of treatment, the location offering the most beneficial coverage was

tabulated.

NOTE: Sum of individual items is greater than total because some

participants were in plans with more than one type of limit. Where applicable,

dash indicates no employees in this category. 
Table 87. Mental health care and substance abuse treatment

benefits: Application to out-of-pocket expense provisions1 in

non-health maintenance organizations, full-time employees,

medium and large private establishments, 1995

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Inpatient mental health care

Total .......................................... 100 100 100 100

Subject to out-of-pocket

limits ............................... 65 72 59 64

Not subject to out-of-pocket

limits ............................... 35 28 41 36

Outpatient mental health care

Total .......................................... 100 100 100 100

Subject to out-of-pocket

limits ............................... 40 43 35 41

Not subject to out-of-pocket

limits ............................... 60 57 65 59

Inpatient alcohol

detoxification

Total .......................................... 100 100 100 100

Subject to out-of-pocket

limits ............................... 68 73 64 67

Not subject to out-of-pocket

limits ............................... 32 27 36 33

Inpatient alcohol

rehabilitation

Total .......................................... 100 100 100 100

Subject to out-of-pocket limit 60 63 57 59

Not subject to out-of-pocket

limits ............................... 40 37 43 41

Outpatient alcohol

rehabilitation 

Total .......................................... 100 100 100 100

Subject to out-of-pocket

limits ............................... 46 44 44 49

Not subject to out-of-pocket

limits ............................... 54 56 56 51

See footnotes at end of table.
Table 87. Mental health care and substance abuse treatment

benefits: Application to out-of-pocket expense provisions1 in

non-health maintenance organizations, full-time employees,

medium and large private establishments, 1995 — Continued

Type of coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Inpatient drug detoxification

Total .......................................... 100 100 100 100

Subject to out-of-pocket

limits ............................... 68 73 63 68

Not subject to out-of-pocket

limits ............................... 32 27 37 32

Inpatient drug rehabilitation 

Total .......................................... 100 100 100 100

Subject to out-of-pocket

limits ............................... 60 63 57 60

Not subject to out-of-pocket

limits ............................... 40 37 43 40

Outpatient drug rehabilitation

Total .......................................... 100 100 100 100

Subject to out-of-pocket

limits ............................... 47 44 44 49

Not subject to out-of-pocket

limits ............................... 53 56 56 51

1 Each total relates to a plan’s overall out-of-pocket limits. In addition,

the specified inpatient benefit and hospital room and board must be subject

to the plan’s overall limits while the specified outpatient benefit and office

physician’s care must be subject to the plan’s overall benefits. For example,

the total for inpatient mental health care includes the following: there is a plan

out-of-pocket limit, and both inpatient mental health care and hospital room

and board are subject to the plan’s overall limits.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 88. Medical care plans: Eligibility requirements,

full-time employees, medium and large private establishments,

1995

Eligibility requirement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

medical care ....................... 25,546 7,467 6,158 11,921

Percent

Total .......................................... 100 100 100 100

With a service requirement ... 64 51 67 71

1 month ............................. 21 24 22 19

2 months ........................... 6 4 5 8

3 months ........................... 26 17 31 28

4 -5 months ....................... 1 1 1 2

6 months ........................... 6 4 6 6

7 - 11 months .................... 3 1 1 ( ) 6

12 months ......................... 1 1 1 ( ) 1

Greater than 12 months .... 1 ( ) - 1 ( ) 1 ( )

Without a service

requirement .................... 31 46 29 23

Not determinable2 ................. 5 3 5 6

1 Less than 0.5 percent. 2 Plans providing services or payments for services rendered in the

hospital or by a physician. Excludes plans that provided only dental, vision,

or prescription drug coverage.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 89. Non-health maintenance organizations: Pre-existing

condition provisions,1 full-time employees, medium and large

private establishments, 1995

Funding and administration

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) in

non-HMO plans .................. 18,558 4,968 4,170 9,419

Percent

Total with non-HMO plans ........ 100 100 100 100

Pre-existing condition clause 54 50 57 55

No pre-existing condition

clause ............................. 46 50 43 45

1 A pre-existing condition is any ailment present at the time the

participant enrolls in the plan. Plans will typically deny or limit coverage of

such conditions for a specific time period following enrollment.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 90. Medical care benefits: Effect of retirement on

coverage,1 full-time employees, medium and large private

establishments, 1995

Retiree coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

medical care ....................... 25,546 7,467 6,158 11,921

Percent

Total with medical care ............. 100 100 100 100

Under Age 65

With retiree coverage ........... 46 50 50 41

Employer paid ................... 9 9 8 10

Retiree paid ...................... 7 9 7 6

Both retiree and employer

paid ............................. 25 28 29 22

Payment available, but

unknown ..................... 4 5 6 3

Without retiree coverage ...... 45 41 42 50

Not determinable .................. 9 9 8 10

Age 65 and over

With retiree coverage ........... 41 44 45 37

Employer paid ................... 9 9 8 9

Retiree paid ...................... 6 6 6 6

Both retiree and employer

paid ............................. 22 24 26 19

Payment available, but

unknown ..................... 4 5 5 3

Without retiree coverage ...... 50 47 46 53

Not determinable .................. 9 9 8 10

1 Plans providing services or payments for services rendered in the 

hospital or by a physician. Excludes plans that provided only dental, vision,

or prescription drug coverage.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 91. Dental care benefits: Eligibility requirements,

full-time employees, medium and large private

esatablishments, 1994

Eligibility requirement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

dental care .......................... 18,866 6,217 4,603 8,046

Percent

Total with dental care ............... 100 100 100 100

With a service requirement ... 64 52 67 71

1 month ............................. 19 20 19 18

2 months ........................... 5 3 4 8

3 months ........................... 24 16 32 24

4 -5 months ....................... 2 1 1 3

6 months ........................... 6 6 7 6

7 - 11 months .................... 5 2 1 9

12 months ......................... 3 3 3 2

Greater than 12 months .... 1 ( ) - 1 ( ) 1 ( )

Without a service

requirement .................... 32 46 29 23

Not determinable2 ................. 4 2 3 5

1 Less than 0.5 percent. 2 Plans where service requirements were unknown, usually because plan

documents (typically prepared by dental care provider) did not specify the

employer’s eligibility provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 92. Dental care benefits: Fee arrangement and financial

intermediary, full-time employees, medium and large private

establishments, 1995

Fee arrangement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

dental care .......................... 18,866 6,217 4,603 8,046

Percent

Total with dental care ............... 100 100 100 100

Traditional fee-for-service1 ... 85 82 84 87

Self insured2 ..................... 52 47 56 53

Commercial insurance

company ..................... 15 11 14 18

Blue Cross/Blue Shield ..... 5 6 4 5

Independent organization3 4425

Combined financed4 ......... 5 ( ) 5 ( ) 5 ( ) 5 ( )

Dental society6 ................. 9 13 8 5

Preferred provider

organization7 .................. 6 10 6 4

Self insured2 ..................... 2 2 4 2

Commercial insurance

company ..................... 1 1 1 5 ( )

Blue Cross/Blue Shield ..... 1 2 5 ( ) 1

Independent organization3 1 1 5 ( ) 5 ( )

Dental society6 ................. 1 2 1 5 ( )

See footnotes at end of table.
Table 92. Dental care benefits: Fee arrangement and financial

intermediary, full-time employees, medium and large private

establishments, 1995 — Continued

Fee arrangement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Total with dental care

Health maintenance

organization8 .................. 8 8 10 7

Self insured2 ..................... 5 ( ) 1 5 ( ) 5 ( )

Commercial insurance

company ..................... 2 2 3 2

Blue Cross/Blue Shield ..... 1 1 1 1

Independent organization3 4344

Dental society6 ................. 1 1 2 1

Other9 ................................... 1 1 5 ( ) 2

1 These plans pay for specific dental procedures as expenses are

incurred. 2 Includes plans that are financed on a pay-as-you-go basis, plans

financed through contributions to a trust fund established to pay benefits, and

plans operating their own facilities if at least partially financed by employer

contributions. Includes plans that are administered by a commercial carrier

through Administrative Services Only (ASO) contracts. 3 These organizations provide and finance all benefits, but are not

affiliated with an insurance company or Blue Cross/Blue Shield. 4 These are plans where the financing comes from two different kinds of

financial intermediaries. For example, an establishment contracts with Blue

Cross/Blue Shield to pay part of the benefits and a commercial company to

pay the other benefits. 5 Less than 0.5 percent. 6 Organizations of providers other than Blue Cross/Blue Shield. 7 A preferred provider organization (PPO) is a group of hospitals and

dentists that contracts to provide comprehensive dental services. To

encourage use of organization members, the dental care plan limits

reimbursement rates when participants use nonmember services. 8 Includes federally qualified (those meeting standards of the Health

Maintenance Organization Act of 1973, as amended) and other HMO’s

delivering comprehensive health care on a prepayment rather than

fee-for-service basis. 9 Includes exclusive provider organizations, which are groups of hospitals

and dentists that contract to provide comprehensive dental services. 

Participants are required to obtain services from members of the organization

in order to receive plan benefits.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 93. Dental care benefits: Coverage for selected procedures, full-time employees, medium and large private

establishments, 1995

Extent of coverage

Type of dental procedure

Exams X-rays Surgery1 Fillings Periodontal care

Endodontics Crowns ProstheticsOrthodontia2

Number (in thousands) with

dental care .............................. 18,866 18,866 18,866 18,866 18,866 18,866 18,866 18,866 18,866

Professional, technical, and

related employees .......... 6,217 6,217 6,217 6,217 6,217 6,217 6,217 6,217 6,217

Clerical and sales employees 4,603 4,603 4,603 4,603 4,603 4,603 4,603 4,603 4,603

Blue-collar and service

employees ...................... 8,046 8,046 8,046 8,046 8,046 8,046 8,046 8,046 8,046

Percent

All employees

Total ................................ 100 100 100 100 100 100 100 100 100

Covered3 .............................. 100 100 99 100 97 99 96 96 71

In full4 ............................... 14 14 5844321

Scheduled cash allowance 668877884

Subject to copayment5 ..... 215356668

Percent of usual,

customary and

reasonable charge ...... 77 78 80 80 79 80 80 80 60

Other6 ............................... 233333221

Not covered .......................... 7 ( ) 7 ( ) 1 7 ( ) 2 1 4 4 27

Not determinable .................. – – 7 ( ) 7 ( ) 1 7 ( ) 7 ( ) 1 2

Professional, technical, and

related

Total ................................ 100 100 100 100 100 100 100 100 100

Covered3 .............................. 100 100 99 100 97 98 96 95 73

In full4 ............................... 13 13 574422 7 ( )

Scheduled cash allowance 447666664

Subject to copayment5 ..... 1 7 ( ) 4 2 4 4 6 5 11

Percent of usual,

customary and

reasonable charge ...... 78 78 79 80 78 79 81 81 63

Other6 ............................... 445555222

Not covered .......................... 7 ( ) 7 ( ) 1 7 ( ) 2 1 4 4 25

Not determinable .................. – – 7 ( ) 0 1 7 ( ) 7 ( ) 7 ( ) 2

See footnotes at end of table.
Table 93. Dental care benefits: Coverage for selected procedures, full-time employees, medium and large private

establishments, 1995 — Continued

Extent of coverage

Type of dental procedure

Exams X-rays Surgery1 Fillings Periodontal care

Endodontics Crowns ProstheticsOrthodontia2

Percent

Clerical and sales

Total ................................ 100 100 100 100 100 100 100 100 100

Covered3 .............................. 100 100 99 100 97 99 97 95 67

In full4 ............................... 12 13 574411 7 ( )

Scheduled cash allowance 769998884

Subject to copayment5 ..... 1 7 ( ) 5 3 6 7 7 6 8

Percent of usual,

customary and

reasonable charge ...... 78 79 80 79 78 79 80 79 56

Other6 ............................... 223333221

Not covered .......................... 7 ( ) 7 ( ) 7 ( ) 7 ( ) 1 7 ( ) 3 3 31

Not determinable .................. – – 7 ( ) 7 ( ) 1 7 ( ) 7 ( ) 1 2

Blue-collar and service

Total ................................ 100 100 100 100 100 100 100 100 100

Covered3 .............................. 100 100 99 99 97 98 96 96 72

In full4 ............................... 15 15 6954442

Scheduled cash allowance 778877884

Subject to copayment5 ..... 215366667

Percent of usual,

customary and

reasonable charge ...... 75 78 81 81 81 82 79 79 61

Other6 ............................... 111111111

Not covered .......................... 7 ( ) 7 ( ) 7 ( ) 7 ( ) 2 1 4 4 27

Not determinable .................. – – 7 ( ) 7 ( ) 1 7 ( ) 7 ( ) 7 ( ) 2

1 Excludes plans that limited coverage to accidental injuries, removal

of impacted wisdom teeth, or repair of jaw. 2 Participants were included as having coverage for orthodontia in

cases where benefits were limited to children. 3 Sum of individual items is greater than total because some

participants were in plans with more than one limit. 4 Includes plans that paid the full cost with no deductible or maximum

dollar amount. 5 Participant pays a specific amount per procedure and plan pays all

remaining expenses. In the case of orthodontia, the copayment is

generally applied once per lifetime. 6 Includes plans that provide care based on an incentive schedule or

discounted benefit. An incentive schedule is a reimbursement

arrangement in which the percentage of dental expenses paid by the plan

increases if regular dental appointments are scheduled. Discounted

benefits are available if obtained from an approved provider. 7 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this category.
Table 94. Dental care benefits: Percent of charges paid by plan for selected procedures, full-time employees, medium and

large private establishments, 1995

Percent of usual, customary,

and reasonable charge

Type of dental procedure

Exams X-rays Surgery1 Fillings Periodontal care

Endodontics Crowns ProstheticsOrthodontia

Number of employees (in

thousands) in dental plans

with coverage based on a

percentage of charges ............ 14,470 14,804 15,027 15,020 14,879 15,062 15,016 14,966 11,248

Professional, technical, and

related employees .......... 4,847 4,877 4,913 4,955 4,854 4,892 5,025 5,021 3,892

Clerical and sales employees 3,599 3,653 3,643 3,631 3,570 3,632 3,657 3,618 2,586

Blue-collar and service

employees ...................... 6,024 6,274 6,472 6,434 6,455 6,538 6,333 6,327 4,770

Percent

All employees

Total with dental care based

on a percentage of

charges ........................... 100 100 100 100 100 100 100 100 100

Less than 50 ..................... - 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 1 1 2 ( )

50 ...................................... 2 ( ) 1 6 7 11 8 69 75 80

51-59 ................................ ------- 2 ( ) -

60 ...................................... 1 1 3 2 3 2 10 10 6

61-74 ................................ 2 ( ) 2 ( ) 3 3 3 3 2 2 1

75 ...................................... 116666331

80 ...................................... 21 23 65 67 65 67 9 6 8

85 ...................................... 2 ( ) 1 3 3 3 3 2 ( ) 2 ( ) -

90 ...................................... 57766641 2 ( )

91-99 ................................ - - 2 ( ) 2 ( ) 2 ( ) 2 ( ) - - 2 ( )

1003 .................................. 71 64 8846213

Not determinable .............. 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( )

Professional, technical, and

related

Total with dental care based

on a percentage of

charges ........................... 100 100 100 100 100 100 100 100 100

Less than 50 ..................... - 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 1 1 1

50 ...................................... 2 ( ) 2 ( ) 6 8 11 8 69 75 82

51-59 ................................ - - - - - - - 1-

60 ...................................... 1 1 2 2 3 3 10 10 6

61-74 ................................ 2 ( ) 2 ( ) 2 2 2 2 2 2 -

75 ...................................... 115455431

80 ...................................... 18 19 66 70 70 71 11 7 8

85 ...................................... 2 ( ) 2 ( ) 2 2 2 2 2 ( ) 2 ( ) -

90 ...................................... 6764442 2 ( ) -

91-99 ................................ - - 2 ( ) 2 ( ) 2 ( ) 2 ( ) - - 2 ( )

1003 .................................. 73 70 9835112

Not determinable .............. 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( )

See footnotes at end of table.
Table 94. Dental care benefits: Percent of charges paid by plan for selected procedures, full-time employees, medium and

large private establishments, 1995 — Continued

Percent of usual, customary,

and reasonable charge

Type of dental procedure

Exams X-rays Surgery1 Fillings Periodontal care

Endodontics Crowns ProstheticsOrthodontia

Percent

Clerical and sales

Total with dental care based

on a percentage of

charges ........................... 100 100 100 100 100 100 100 100 100

Less than 50 ..................... - - 2 ( ) 2 ( ) 2 ( ) 2 ( ) 1 1 2 ( )

50 ...................................... 2 ( ) 1 6 6 10 8 66 69 78

51-59 ................................ ------- 2 ( ) -

60 ...................................... 1 1 2 1 2 2 12 13 6

61-74 ................................ 114444332

75 ...................................... 115555432

80 ...................................... 19 21 70 73 69 71 10 8 6

85 ...................................... 2 ( ) 1 2 2 2 2 2 ( ) 1 -

90 ...................................... 4544442 2 ( ) 1

91-99 ................................ - - 2 ( ) 2 ( ) 2 ( ) 2 ( ) - - -

1003 .................................. 73 70 7635114

Not determinable .............. 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( )

Blue-collar and service

Total with dental care based

on a percentage of

charges ........................... 100 100 100 100 100 100 100 100 100

Less than 50 ..................... - 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 1 1 2 ( )

50 ...................................... 2 ( ) 1 6 7 10 8 70 79 80

51-59 ................................ ------- 2 ( ) -

60 ...................................... 113242896

61-74 ................................ 2 ( ) 2 ( ) 3 3 3 2 1 1 -

75 ...................................... 217777321

80 ...................................... 24 27 61 62 60 61 8 5 10

85 ...................................... 2 ( ) 3 4 4 4 4 2 ( ) 2 ( ) -

90 ...................................... 498888621

91-99 ................................ -------- 2 ( )

1003 .................................. 68 57 9847222

Not determinable .............. 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( )

1 Excludes plans that limited coverage to accidental injuries, removal

of impacted wisdom teeth, or repair of jaw. 2 Less than 0.5 percent. 3 Includes plans that paid 100 percent of charges, but imposed a

deductible and limited payment to a maximum dollar amount.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this category.
Table 95. Dental care benefits: Amount of individual

deductible,1 full-time employees, medium and large private

establishments, 1995

Type of deductible

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

dental care

Total with dental care ..... 18,866 6,217 4,603 8,046

Percent

Total with dental care ......... 100 100 100 100

Subject to separate dental

deductible2 ...................... 66 67 71 62

Yearly deductible only .. 61 61 67 58

Under $25 ............. 1 1 3 ( ) 1

$25 ........................ 15 15 12 16

$26-$49 ................ 1 1 1 1

$50 ........................ 40 41 46 36

$51-$99 ................ 3 2 5 3

$100 ...................... 2 1 3 1

Over $100 ............. 3 ( ) 3 ( ) 3 ( ) 3 ( )

Lifetime deductible only 1 2 2 1

Less than $50 ....... 3 ( ) 3 ( ) 3 ( ) 3 ( )

$50 ........................ 1 2 1 1

Over $50 ............... 3 ( ) 3 ( ) 3 ( ) –

Both yearly and lifetime

deductibles ............. 3 4 2 3

No deductible ........................ 33 32 28 37

Not determinable .................. 1 1 1 2

Average4

Average employee yearly

deductible ........................... $46 $45 $49 $45

Average employee lifetime

deductible ........................... 46 38 57 48

1 Amount of deductible described is for each insured person. In some

plans, the individual and family deductibles are identical. Excludes separate

deductibles for orthodontic procedures. 2 Deductibles may not apply to all covered dental procedures. If

separate deductibles applied to different procedures, the sum of the

deductible amounts was tabulated. 3 Less than 0.5 percent. 4 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 96. Dental care benefits: Relationship of yearly family

deductibles to yearly individual deductibles, full-time

employees, medium and large private establishments, 1995

Relationship

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

dental care .......................... 18,866 6,217 4,603 8,046

Percent

Total with dental care ......... 100 100 100 100

With individual and family

deductible ........................... 43 48 50 36

Family deductible relates to

individual deductible:

Equal to individual

deductible ................... 1 ( ) 1 ( ) 1 1 ( )

2 times individual

deductible ................... 13 16 12 11

3 times individual

deductible ................... 29 31 36 24

Other2 ............................... 1 ( ) 1 ( ) 1 1 ( )

Without individual and family

deductible ........................... 57 52 50 64

1 Less than 0.5 percent. 2 Includes plans where family deductible is not an even multiple of

individual coverage.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 97. Dental care benefits: Services covered by

deductible1 provisions, full-time employees, medium and large

private establishments, 1995

Categories of care

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number of employees (in

thousands) with a dental

deductible ........................... 12,138 4,047 3,195 4,896

Percent

Total with a dental

deductible ..................... 100 100 100 100

All categories2 ...................... 20 18 21 20

All except exams and x-rays 46 48 47 42

All except exams, x-rays, and

orthodontia ...................... 24 24 25 25

All except orthodontia ........... 3 4 3 4

All except exams and

orthodontia ...................... 1 1 3 ( ) 2

Other4 ................................... 6 5 5 7

1 Includes plans with both a yearly deductible only, and a yearly and

lifetime deductible. 2 This applies to all categories of care covered by the plan. The

categories of dental care are exams, x-rays, surgery, fillings, periodontal

care, endodontics, crowns, prosthetics, and orthodontia. 3 Less than 0.5 percent. 4 Includes other category combinations.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 98. Dental care benefits: Maximum benefit provisions,1

full-time employees, medium and large private establishments,

1995

Dollar amount2

All

 employees

Professional,

technical,

 and

related

employees

Clerical

 and

sales

employees

Bluecollar

 and

service

 employees

Number (in thousands) with

dental care .......................... 18,866 6,217 4,603 8,046

Percent

Total with dental care ......... 100 100 100 100

Yearly maximum specified3 ...... 82 83 82 81

Less than $500 ..................... 1 1 4 ( ) 1

$500 ...................................... 2 2 3 3

$501-$749 ............................ 1 4 ( ) 4 ( ) 1

$750 ...................................... 7 6 9 6

$751-$999 ............................ 1 4 ( ) 1 1

$1,000 ................................... 40 38 39 42

$1,001-$1,499 ...................... 10 8 9 12

$1,500 ................................... 12 14 14 10

$1,501-$1999 ....................... 3 4 1 2

$2,000 ................................... 4 7 4 3

Greater than $2,000 ............. 1 2 1 2

No yearly maximum .................. 17 16 17 17

Maximum provision not

determinable ....................... 1 1 1 2

Average5

Average yearly maximum ......... $1,166 $1,218 $1,141 $1,139

1 Includes all covered dental procedures except orthodontia. Amount of

maximum specified is for each insured person. 2 Coverage for dental procedures may also be subject to scheduled

allowance, deductible, or coinsurance provisions in addition to maximum

dollar limitations. 3 If separate yearly maximums applied to different procedures, the sum

of the maximums was tabulated. Maximums applied to dental expenses only. 4 Less than 0.5 percent. 5 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 99. Orthodontic care benefits: Maximum benefit

provisions, full-time employees, medium and large private

establishments, 1995

Dollar amount1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

orthodontic care .................. 13,749 4,692 3,163 5,894

Percent

Total with orthodontic care 100 100 100 100

Lifetime maximum specified .... 83 82 83 83

Less than $500 ..................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

$500 ...................................... 7 9 5 7

$501-$749 ............................ 1 2 2 1

$750 ...................................... 8 8 16 5

$751-$999 ............................ 1 1 2 ( ) 1

$1,000 ................................... 31 27 32 35

$1,001-$1,499 ...................... 11 10 7 15

$1,500 ................................... 16 20 13 14

Greater than $1,500 ............. 6 6 8 5

Dollar amount unspecified .... 2 ( ) 2 ( ) 1 2 ( )

No lifetime maximum ................ 15 15 14 14

Provision not determinable ....... 3 3 3 2

Average3

Average lifetime maximum ....... $1,138 $1,144 $1,128 $1,139

1 Coverage for orthodontia procedure may also be subject to scheduled

allowance, deductible, or coinsurance provisions in addition to maximum

dollar limitations. 2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 100. Dental care benefits: Pretreatment authorization

provisions full-time employees, medium and large private

establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

dental care .......................... 18,866 6,217 4,603 8,046

Percent

Total with dental care ......... 100 100 100 100

Preauthorization required ......... 49 45 52 50

Minimum expense requiring

preauthorization:

$100 .................................. 8 6 6 10

$101-$199 ........................ 5 4 6 5

$200 .................................. 13 14 11 12

Greater than $200 ............ 18 15 23 19

Dollar amount not

determinable ............... 5 6 6 4

Preauthorization not required ... 47 51 45 45

Data not determinable .............. 4 4 3 5

Average1

Average minimum expense

requiring preauthorization ... $225 $219 $235 $224

1 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 101. Vision care benefits: Coverage for selected services, full-time employees, medium and large private

establishments, 1995

Type of vision benefit Total Covered1 Covered

in full

Scheduled

allowance

Copayment Other2 Not

covered

Not

determinable

Percent

All employees

Eye exam .............................. 100 95 18 38 34 15 4 1

Contact lenses3 .................... 100 94 5 67 19 17 5 1

Eyeglasses ........................... 100 100 10 53 25 17 – 4 ( )

Professional, technical,

and related participants

Eye exam .............................. 100 95 20 35 35 12 5 4 ( )

Contact lenses3 .................... 100 95 5 65 16 18 4 1

Eyeglasses ........................... 100 100 12 51 24 19 – 4 ( )

Clerical and sales

participants

Eye exam .............................. 100 95 17 37 34 16 4 1

Contact lenses3 .................... 100 96 4 70 16 22 3 1

Eyeglasses ........................... 100 100 11 54 22 22 – 4 ( )

Blue-collar and service

participants

Eye exam .............................. 100 96 16 41 34 17 3 1

Contact lenses3 .................... 100 93 5 67 22 13 6 1

Eyeglasses ........................... 100 99 9 54 28 14 – 1

1 The total is less than the sum of individual items because

many participants are in plans with more than one type of

limitation. 2 Includes plans subject to coinsurance and retail discount. 3 Includes plans where coverage is for elected contact lenses;

medically necessary contact lenses, i.e., cataract surgery, is

normally provided under the surgical portion of the medical plan

and is not described in this table. 4 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not

equal totals. Where applicable, dash indicates no employees in

this category.
Life insurance is provided to a large majority of fulltime employees in medium and large private establishments (tables 102-112). More than half of all full-time

employees with life insurance are covered by formulas based

on earnings, such as multiple-of-earnings formulas, which usually provide basic insurance of one or two times annual

salary. Flat dollar amounts, often $5,000 to $25,000, cover

many of the remaining life insurance plan participants.

Employers, in most cases, pay the entire cost of basic life

insurance. When employee contributions are required, it is

frequently because life insurance benefits are being offered

as part of a cafeteria plan or reimbursement account. (For

definitions, see chapter 8.) These plans allow workers to

choose from various benefit options depending on their needs.

In such cases, employees may have to contribute, often in the

form of pretax dollars, to obtain the benefit package they desire. Another form of employee contribution is a specified

monthly flat dollar amount per $1,000 of coverage, such as

20 cents per $1,000.

Types and amounts of benefit formulas

Basic coverage for full-time life insurance participants is

often linked to their earnings. This link enables the level of

protection to increase automatically with a rise in pay. The

most common method of tying life insurance protection to

earnings is to multiply the employee’s annual earnings by a

factor of one or two and round the product to the next higher

$1,000. For example, an employee earning $22,700 would

receive $46,000 of coverage under a plan providing two times

earnings ($22,700 x 2 = $45,400, which rounds up to $46,000).

Participants covered by these plans may have a limit placed

on the amount of coverage available. Such maximums usually range between $50,000 and $500,000.

A flat dollar amount of insurance, regardless of earnings,

is the other prevalent means of providing life insurance protection. Insurance amounts ranging from $5,000 to $25,000

are quite common in such plans. Blue-collar and service workers are much more likely to receive this type of benefit than

professional, technical, and related workers or clerical and

sales workers. However, when provided, the average flat-dollar amount of life insurance coverage participation is usually

highest for professional, technical, and related workers.

Although it usually provides smaller amounts of insurance

than earnings-based formulas, flat-amount coverage has improved considerably over the years. For example, participation in flat-dollar plans providing life insurance of $20,000

or more has increased tenfold since the survey was first conducted in 1979.

Chapter 5. Life Insurance

Other methods of providing life insurance protection cover

a small percent of participants. These include: flat dollar

amounts that increase as service increases; flat dollar amounts

that increase as wages increase; and multiple-of-earnings formulas that increase the multiple at higher salary levels.

Coverage for retirees

Basic life insurance coverage continues after retirement for

many full-time participants in medium and large private establishments. This coverage almost always continues for the

rest of the retiree’s life, but the amount of the benefit is usually reduced at least once during retirement.18

Related protection

Additional life insurance, supplementing basic coverage,

is often available. The typical supplemental plan provides term

life insurance in multiples of the employees’ annual pay. Life

insurance coverage for dependents is also widely available to

participants. Dependent coverage is often a flat dollar benefit; for example, $5,000 for a spouse and $2,000 for a child.

Workers with this coverage often must pay the entire premium,

but usually at group rates.

Service requirements

Life insurance participants often must work a minimum period to qualify for the plan. The most prevalent service requirements for such workers are 1 to 3 months. Most of the

other participants do not have to meet any service requirement to qualify for benefits.

Accidental death and dismemberment

Accidental death and dismemberment (AD&D) insurance

is available to the majority of full-time employees in medium

and large private establishments. This insurance provides additional benefits if a worker dies or loses an eye or a limb in

an accident. The AD&D benefit commonly equals the

basic life insurance benefit for accidental death, and a portion of that benefit for dismemberment.19

Survivor income benefits

A small percent of full-time employees in medium and large

private establishments are covered by plans that provide a

monthly income to surviving members of a deceased

employee’s family. These survivor income benefits are in addition to other benefits, such as basic life insurance and survivor pension benefits. Survivor income payments are generally a percentage of the employee’s pay or a flat dollar amount.

Benefits usually continue for 24 months, although some

92
continue until a specific event occurs, such as the surviving spouse remarries or reaches age 65, or surviving

Life Insurance

18 For more information on retiree life insurance, see Margaret Simons

and Cynthia Thompson, “Life Insurance Benefits for Retired Workers,”

Monthly Labor Review, September 1990, pp. 17-21.

children reach a given age.

19 For more information on accidental death and dismemberment benefits,

see Cynthia Thompson, “Compensation for Death and Dismemberment,”

Monthly Labor Review, September 1989, pp. 13-17.

—ENDNOTES—

93
Table 102. Life insurance: Summary of provisions, full-time

employees, medium and large private establishments, 1995

Item

All

employees

Professional,

technical,

and 

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

basic life insurance ............. 29,078 8,721 7,227 13,130

Percent

Total with basic life insurance ... 100 100 100 100

Multiple of earnings benefit ... 57 74 72 36

Dollar amount benefit ........... 43 25 27 63

Retiree coverage available ... 37 39 40 34

Supplemental coverage

available ......................... 59 71 67 47

Dependent coverage available ................................. 52 57 61 44

Required employee contribution .................................. 13 13 16 11

NOTE: Where applicable, dash indicates no employees in this category.
Table 103. Life insurance: Method of determining basic

coverage, full-time employees, medium and large private

establishments, 1995

Type

All

employees

Professional,

technical,

and 

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

basic life insurance ............. 29,078 8,721 7,227 13,130

Percent

Total with basic life insurance ... 100 100 100 100

Multiple of earnings benefit 57 74 72 36

Fixed multiple of

earnings2 .................. 56 74 72 36

Multiple varies by

earnings .................... 1 ( ) 1 ( ) 1 ( ) 1 ( )

Multiple varies by service 1 ( ) 1 ( ) 1 ( ) 1 ( )

Dollar amount benefit ......... 43 25 27 63

Flat dollar amount ........... 38 23 24 55

Dollar amount varies by

earnings .................... 4 2 2 6

Dollar amount varies by

service ...................... 1 1 ( ) 1 2

Other ................................... 1 1 1 ( ) 1

1 Less than 0.5 percent. 2 Includes participants in plans in which insurance equaled a multiple of

earnings, plus or minus a specified amount.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 104. Life insurance: Flat dollar benefit amounts,

full-time employees, medium and large private establishments,

1995

Amount of insurance

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

dollar amount of basic life

insurance ............................ 12,375 2,200 1,958 8,217

Percent

Total with dollar amount of

basic life insurance ............. 100 100 100 100

Flat dollar amount ............. 89 90 90 88

Less than $5,000 .......... 4 1 2 5

$5,000 - $9,999 ............ 17 10 19 19

$10,000 - $14,999 ........ 27 34 32 23

$15,000 - $19,999 ........ 13 7 10 15

$20,000 - $24,999 ........ 14 8 12 17

$25,000 - $29,999 ........ 5 11 4 3

$30,000 - $49,999 ........ 4 2 6 4

$50,000 - $99,999 ........ 5 13 5 2

$100,000 and over ........ 1 5 1 1

Dollar amount varies by

earnings ...................... 9 10 7 9

Dollar amount varies by

service ........................ 2 1 ( ) 3 2

Average2

Average flat dollar amount of

basic life insurance ............. 22281 42766 22792 16560

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 105. Life insurance: Multiple of earnings benefit

amounts, full-time employees, medium and large private

establishments, 1995

Formula

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

multiple of earnings basic

life insurance ...................... 16,430 6,474 5,237 4,719

Percent

Total with multiple of earnings

formula ................................ 100 100 100 100

Flat multiple-of-earnings1 99 100 99 99

Less than 1.0 ................ 4 3 5 3

1.0 ................................. 55 49 58 61

1.1 - 1.9 ........................ 13 14 11 13

2.0 ................................. 20 22 20 16

2.1 - 2.9 ........................ 4 6 3 2

3.0 ................................. 3 3 2 3

Greater than 3.0 ........... 1 1 1 1

Multiple varies by earnings 2 ( ) 2 ( ) 2 ( ) 2 ( )

Multiple varies by service 2 ( ) 2 ( ) 2 ( ) 2 ( )

Average3

Average flat multiple of

earnings formula ................. 1.4 1.5 1.4 1.4

1 Includes participants in plans in which insurance equaled a multiple of

earnings, plus or minus a specified amount. 2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 106. Life insurance: Maximum benefits placed on multiple of

earnings formulas, full-time employees, medium and large private

establishments, 1995

Maximum

All

employees

Professional,

technical,

and

related

employees

Clerical

and sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

multiple of earnings formula 16,430 6,474 5,237 4,719

Percent

Total with multiple of earnings

formula ................................ 100 100 100 100

With maximum benefit

amount ............................ 57 58 55 57

Less than $50,000 ............ 1221

$50,000 - $99,999 ............ 16 16 16 19

$100,000 ........................... 6558

$100,001 - $249,999 ........ 7877

$250,000 - $499,999 ........ 12 16 11 10

$500,000 ........................... 7669

$500,001 - $999,999 ........ 2132

$1,000,000 or more .......... 4462

No maximum specified ......... 39 38 41 38

Not determinable .................. 4444

Average1

Average maximum .................... $317,829 $317,074 $372,990 $259,684

1 The average is presented for all covered workers; averages exclude workers

without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category.
Table 107. Life insurance: Minimum benefits placed on multiple of

earnings formulas, full-time employees, medium and large private

establishments, 1994

Minimum

All

employees

Professional,

techni-

 cal,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

multiple of earnings formula 16,430 6,474 5,237 4,719

Percent

Total with multiple of earnings

formula ................................ 100 100 100 100

With minimum benefit

amount ............................ 8 8 8 10

Less than $5,000 .............. 1 ( ) 1 ( ) 1 ( ) 1 ( )

$5,000 - $9,999 ................ 1 2 1 1 ( )

$10,000 - $14,999 ............ 5 3 5 9

$15,000 and over .............. 2 3 2 1

No minimum specified .......... 92 92 92 90

Not determinable .................. 1 ( ) 1 ( ) – –

Average2

Average minimum ..................... $14,127 $16,295 $14,210 $11,744

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude workers

without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 108. Life insurance: Retiree coverage, full-time

employees, medium and large private establishments, 1995

Coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

basic life insurance ............. 29,078 8,721 7,227 13,130

Percent

Total with basic life insurance ... 100 100 100 100

With retiree coverage ......... 37 39 40 34

Employer paid ................. 28 27 28 28

Jointly paid ...................... 2 2 2 2

Retiree paid .................... 7 10 9 4

No retiree coverage ............ 53 51 52 56

Not determinable ................ 10 10 8 11

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 109. Life insurance: Reductions in benefits for retirees,

full-time employees, medium and large private establishments,

1995

Reduction policy

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

basic life insurance ............. 29,078 8,721 7,227 13,130

Percent

Total with basic life insurance ... 100 100 100 100

With retiree coverage ......... 37 39 40 34

No reductions ................. 5 6 5 4

With reductions

Reduced once .......... 19 20 17 20

Reduced more than

once .................... 10 10 15 7

Not determinable ................ 3 2 2 3

No retiree coverage ............ 53 51 52 56

Not determinable ................ 3 2 2 3

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 110. Life insurance: Supplemental coverage, full-time

employees, medium and large private establishments, 1995

Coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

basic life insurance ............. 29,078 8,721 7,227 13,130

Percent

Total with basic life insurance ... 100 100 100 100

With supplemental coverage .... 59 71 67 47

Employee paid ...................... 47 53 52 40

Jointly paid ............................ 2222

Flexible benefits .................... 10 16 13 4

No supplemental coverage ....... 33 25 28 42

Not determinable ...................... 8 4 5 12

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 111. Life insurance: Dependent coverage, full-time

employees, medium and large private establishments, 1995

Coverage

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

basic life insurance ............. 29,078 8,721 7,227 13,130

Percent

Total with basic life insurance ... 100 100 100 100

With dependent coverage ......... 52 57 61 44

Employer paid ....................... 6567

Employee paid ...................... 34 37 41 29

Jointly paid ............................ 2123

Flexible benefits .................... 10 14 13 5

No dependent coverage ........... 40 36 34 45

Not determinable ...................... 8 6 5 11

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 112. Life insurance: Eligibility requirement, full-time

employees, medium and large private establishments, 1995

Length-of-service requirement

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

basic life insurance ............. 29,078 8,721 7,227 13,130

Percent

Total with basic life insurance ... 100 100 100 100

With service requirement .......... 60 48 61 68

1 month ................................. 20 23 18 19

2 months ............................... 5247

3 months ............................... 25 16 31 28

4 - 5 months .......................... 1 1 1 ( ) 2

6 months ............................... 5455

7 - 11 months ........................ 2 1 ( ) 1 ( ) 4

12 months ............................. 2212

Greater than 12 months ........ 1 ( ) 1 ( ) 1 ( ) 1

No service requirement ............ 35 48 35 26

Not determinable ...................... 5447

Average2

Average service requirement (in

months) ............................... 3.2 2.8 2.9 3.5

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Adefined benefit pension plan requires an employer

to provide retirement benefits calculated by a formula

specified in the plan. Benefits are normally based on

salary, years of service, or both. An employer, however, usually has considerable freedom in financing these benefits. Most

full-time employees in medium and large private establishments participate in defined benefit pension plans. However,

participation in defined benefit plans has declined in recent

years while defined contribution plans, such as 401(k) plans,

have become more common. Defined contribution plans,

which specify employer and__if applicable__employee contributions, but do not guarantee a specific benefit, are discussed in the next chapter.

The Employee Benefits Survey includes a variety of defined benefit pension plans provisions (table 113), such as:

• Formulas for calculating benefits;

• How benefits are coordinated with Social Security payments;

• Ceilings on benefit payments;

• Survivor annuities;

• Age and service requirements for retirement;

• Availability of supplements to normal and early retirement pension benefits;

• Disability retirement benefits;

• Vesting schedules;

• Postretirement pension increases;

• Employee contributions; and

• Plan participation requirements.

Each of these topics is discussed in the following sections of

this chapter.

Benefit formulas

Earnings-based formulas are the most common method

used to determine retirement payments for employees covered by defined benefit pension plans (tables 114-117). Such

formulas provide a flat percent of the employee’s annual earnings per year of service (for example, 1.5 percent of earnings

times 30 years of service, or 45 percent of annual earnings),

or a percent that varies by service, earnings, or age.20

Approaches to calculating annual earnings and the rate paid

per year of service vary. For most participants with earningsbased formulas, pensions are based on earnings in the final

Chapter 6.

Defined Benefit Plans

years of employment (terminal-earnings formula); for the remainder, an average of career earnings is used (career-earnings formula).

Terminal earnings often are defined as average earnings

over a 5-year period. These formulas usually designate the 5

consecutive years with the highest earnings out of the last 10

years before retirement.

Participants in plans with terminal-earnings formulas frequently have benefit formulas that vary according to service,

earnings, or a combination of the two. For example, a terminal-earnings formula might credit an employee with 1 percent of earnings up to the first $12,000 in each year of service

plus 1.5 percent of the earnings exceeding that amount. If

earnings were $40,000 and service was 30 years, the annual

pension payment would be computed as follows:

1 percent times $12,000 ................................... $120

1.5 percent times $28,000 ................................ $420

Total credits per year of service ....................... $540

Credits ($540) times 30 years .......................$16,200

Similarly, formulas based on career earnings often provide

participants with percentages that vary, usually by earnings.

The earnings used to compute pension benefits for earnings-based formulas normally include only “basic” earnings,

that is, straight-time earnings. When additional earnings are

part of the benefit calculation, such earnings may include overtime pay, shift differentials, bonuses, and commissions.

Most plans that do not use a percent-of-earnings benefit

formula specify a dollar amount to be paid for each year of

service; for example, a plan might pay $20 monthly for each

of an employee’s 30 years of service, thus yielding a pension

of $600 a month. Although the dollar amount in these formulas sometimes varies with an employee’s earnings or service,

the predominant method is to multiply a uniform (single) dollar

amount by years of service (table 118).

The basis of pension payments differs sharply by employee

group. A large majority of white-collar participants are provided with earnings-based pensions; in contrast, many plans

covering blue-collar participants use dollar-amount formulas. In addition, two other types of defined benefit pension

formulas are used, although they cover only a small percent

of participants. Percent-of-contribution formulas specify a

periodic contribution by an employer, and occasionally by an

employee, to a plan. The benefits equal a percent of total

100
Defined Benefit Plans 101

contributions, for example, 1 percent of total contributions

per month; if career contributions totaled $40,000, then

monthly pension benefits would equal $400.

Very few employees were covered by cash account pension formulas, which specify an employer contribution and a

rate of interest on that contribution. Benefits are computed as

a percent of each employee’s account balance. Although both

percent-of-contribution and cash account pension formulas

resemble the formulas in defined contribution plans, the Internal Revenue Service classifies these plans as defined benefit plans because the employer guarantees a certain level of

benefits.

Participants in some pension plans, particularly those based

on percent of terminal earnings formulas, are eligible to receive benefits from either primary or alternative formulas,

whichever yields a greater benefit. Alternative formulas often are included to provide a minimum level of benefits for

persons with short service or low earnings. For example, a

plan may offer a choice of one of the following formulas: A

primary formula of 1.25 percent of average career earnings

times years of service and an alternative formula of $15 a

month (or $180 a year) for each year of service. In this case,

the alternative formula provides a higher benefit for persons

with average career earnings of less than $14,400 a year.

Private benefits and Social Security payments

Regardless of whether they provide private retirement plans,

all employers (except certain exempted ones) share the cost

of Social Security coverage equally with their employees.

Because many plan sponsors feel that private pension and

Social Security benefits should not be duplicative, pension

plans may contain Social Security integration provisions. Such

integration may take the form of an offset provision, under

which part of the Social Security benefit is subtracted from

the annuity, or a provision to calculate the pension at a lower

rate for earnings below the Social Security taxable wage base21

than for earnings above the base (table 119).

Social Security offsets are usually applied immediately upon

retirement, whether or not the retiree is eligible for Social

Security benefits. The offset typically is specified as a small

percentage of the Social Security payment, (for example, 1

percent) times years of service. Frequently, the maximum offset is limited to 50 percent of the total Social Security payment.

Plans that apply lower pension benefit rates to an

employee’s earnings below a specified level and higher rates

above that level are known as “step-rate excess” plans. For

example, a plan may provide a benefit equal to 1 percent of

earnings up through the Social Security taxable wage base

and 1.5 percent of earnings above the base for each year of

service.

Benefit formulas are often coordinated with Social

Security for pension plan participants. In 1989 and earlier

surveys, the offset approach to coordinating private pension

plans and Social Security was more prevalent than the steprate excess approach, especially among terminal-earningsbased plans. Since 1991, step-rate excess plans have been the

most frequently observed method of coordinating benefits for

all earnings-based plans. This change resulted from the Tax

Reform Act of 1986, which imposed new rules for pension

plans that coordinate with Social Security benefits.22

Maximum and minimum benefit provisions

The Employee Retirement Income Security Act of 1974

(ERISA) and subsequent amendments place ceilings on the

size of annual pensions from defined benefit plans. These

restrictions mostly affect only highly compensated employees. Many plans, however, have provisions that restrict benefit levels for all participants. For example, some participants

are in plans that limit the number of years of service included

in benefit computations; maximums of 30 to 40 years are

typical (table 120). For other participants, annual pensions

can not exceed either a specified percent of average annual

earnings, or a specified dollar amount.

In some pension plans, participants are covered by a provision for a minimum retirement benefit, regardless of age or

service. Such minimum benefits provide a level of protection, such as a flat amount of $100 a month, below which

retirement benefits can not fall.

Methods of payment

The benefit formulas just described are used to compute a

straight-life annuity, that is, a periodic payment for the life of

the retiree, with no additional payments to survivors. Defined

benefit pension plans offer a variety of additional payment

methods, although each is based on the straight-life annuity.

For married employees, the standard benefit prescribed by

law is the joint-and-survivor annuity, which provides payments to a surviving spouse after a retiree dies. Such employees may choose a straight-life annuity or some other form of

benefit, but only with written approval of their spouse.

Another optional method of payment is for the employee

to receive the pension benefit in a lump-sum payment (table

121). This lump sum provides the employee with the actuarial equivalent of the annuity. In most of these plans, only a

full lump-sum option is available. If a participant chooses a

full lump-sum distribution, he or she receives no further benefits from the pension plan. Where a partial distribution is

available, the participant generally receives a reduced annuity for the remainder of his or her life.

Survivor annuities

ERISA also requires defined benefit pension plans to provide a spouse with at least 50 percent of the retiree’s payments after the retiree’s death (table 122). When this type of

pension is paid, the employee will usually receive a smaller

101
benefit payment during retirement to make up for the plan’s

length of time. When the retiree dies, the surviving spouse

will receive a lifetime pension benefit. All defined benefit

pension plan participants have survivor annuity options available to them.23

The most prevalent type of survivor benefits__joint-andsurvivor annuities__provides a reduced benefit to the retiree

and a percentage of that reduced benefit to the spouse upon

the retiree’s death. The reduction may be a percent of the

benefit__for example, 10 percent__or may be actuarially determined based on the life expectancy of the retiree and spouse.

Although some participants have plans that offer only one

joint-and-survivor option that pays a surviving spouse 50

percent of the retiree’s adjusted pension, a majority of participants have a choice of two alternative percentages or more

(for example, 50, 67, or 100 percent) to be continued to the

spouse, with corresponding reductions in the employees’ annuities. Should the spouse die before the retiree, the retiree’s

unreduced benefit may be restored, although such provisions

are not common.

Unlike joint-and-survivor annuities, survivor annuities

based on the retiree’s accrued benefit do not reduce the

employee’s pension to adjust for survivor benefits. The retiree receives the straight-life annuity; following the retiree’s

death, the spouse receives a percent of that annuity__often

50 percent. Such plans cover few participants.

A few pension plans provide a lump sum or installment

death benefit to the survivor of a deceased retiree. Payments

are in the form of a flat amount, such as $5,000, in addition to

the survivor annuity or a certain number of monthly payments,

such as 60 or 180, less payments already received by the retiree. The latter usually occurs when the retiree and the spouse

do not elect to take the joint and survivor annuity option.

Preretirement survivor benefits

Nearly all defined benefit pension plans offer survivor benefits in case the employee dies before retirement (table 123).

Participants usually have to be vested, that is, have a permanent right to accrued pension benefits before plans would make

such benefits available. For most participants, a surviving

spouse would receive an annuity equivalent to the amount

payable if the employee had retired on the day prior to death

with a joint-and-survivor form of payment in effect. Most survivor pensions like these are based on an early retirement

benefit and, aside from the joint-and-survivor reduction, are

provided at no cost to the employee. For a few participants,

however, preretirement joint-and-survivor protection may

involve an extra cost to the employee and is available only if

chosen. The employee normally pays this cost through a small

deduction in the pension, ultimately payable to either the

employee or the surviving spouse.

A few participants have a preretirement survivor annuity

calculated as a portion of their accrued benefit (the benefit

earned as of the date they died, without a joint-and-survivor

reduction). If an active employee dies after completion of the

vesting requirement, a typical survivor would receive an annuity equal to 50 percent of the deceased accrued benefit to

date. Payments may be reduced by the early retirement adjustment and begin when the employee would have reached

early retirement age.

Some plans also provide lump-sum death benefits (in addition to regular annuities) to the survivors of employees who

die before retirement. Payments are in the form of a fixed

amount, such as $3,000, or the equivalent of a specified number of monthly retirement payments, such as 60.

Normal retirement

A majority of defined benefit pension plan participants can

retire before age 65 and still receive normal (unreduced) retirement benefits (table 124). Participants who are required

to be age 65 to receive unreduced benefits usually do not

have to satisfy a length-of-service requirement; however, some

plans may require workers hired after age 60 to complete at

least 5 years of service.

When plans permit normal retirement prior to age 65, they

generally impose a minimum service requirement. For example, normal retirement at age 60 and 62 is available to a

large number of participants, but the majority of these workers also have a service requirement, commonly 5 or 10 years.

Participants, who can retire with unreduced benefits prior to

age 60, including those who can retire at any age, usually

have to work 30 years.

Plans that require combining a worker’s age and service to

reach a specified sum, such as 80 or 85, for retirement with

full benefits cover only a few participants. This type of arrangement usually specifies a minimum age. Minimum lengths

of service are less common. When a plan specifies alternative age-and-service requirements for normal retirement, such

as age 62 with 10 years of service or age 55 with 20 years of

service, the earliest age and associated service is tabulated.

A few pension plans provide monthly payments to supplement normal retirement pension benefits. These supplements

are usually found in plans where participants can retire before age 62 and normally last until retirees are eligible for

Social Security benefits.

Early retirement

Virtually all of the employees in defined benefit pension

plans can retire before normal retirement age and receive an

immediate, but reduced, pension (tables 125-126). Early retirement is mostly at the employee’s option; few plans require employer approval for early retirement benefits. The

amount of an early retirement pension is reduced because

benefits begin at an earlier age, and the retiree is expected to

receive plan payments over a longer period.

Early retirement benefits are generally computed based on

Defined Benefit Plans

102
the normal retirement formula. The benefit is then reduced

by a percentage (factor) for each year between the actual and

normal retirement ages. If a plan’s normal retirement age is

62, for example, and the reduction factor is 6 percent, a person retiring at age 59 would receive 82 percent of the normal

formula amount (that is, the person loses 6 percent for every

year under the normal age). In addition to the 18-percent reduction for early retirement, the annuity in this example would

be based on fewer years of service and possibly lower earnings than at age 62.

The reduction factor may be uniform or may vary by age

or service. For example, reduction factors may differ for each

year of early retirement, based on the employee’s life expectancy at that age (actuarial reductions), or the reduction factor

may differ for age brackets of several years instead of changing each year. Many participants with early retirement opportunities have uniform reduction factors, for example, 4 or

6 percent, for each year of early retirement. In plans with a

lower uniform reduction, such as 3 percent per year, the employer subsidizes some of the early retirement benefit by

making the reduction less severe than if benefits are computed actuarially.

Most employees are covered by plans permitting early retirement at age 55; generally, 5 or 10 years of service are

required. However, some participants can retire earlier than

age 55, with a service requirement.

A small number of pension plans provide additional

monthly payments to supplement the early retirement pension if employees retire after meeting a specified age or lengthof-service requirement generally higher than the minimum

needed to retire. Plan sponsors include these supplementary

benefits either to induce older workers to retire or as a reward for long service. Supplements generally last until

Social Security benefits are payable.24

Disability retirement

A career-ending disability may allow an employee to receive a pension before retirement age. If the disability satisfies the plan’s definition of total disability, for example, the

employee can no longer perform the required duties, pension

benefits often begin immediately. When an employer provides

other sources of disability income, such as long-term disability insurance, the plan might defer disability retirement benefits until the other forms of income have ceased. Most pension plan participants are covered by some type of disability

retirement provision (tables 127-128).

It is more common for blue-collar workers with disability

retirement coverage to be in plans with immediate benefits.

Many white-collar workers are in plans that defer benefits.

Workers with deferred benefits often receive long-term disability insurance (LTD) benefits that typically provide 50 or

60 percent of earnings at the time of disability; this frequently

exceeds the amount that pension plans with immediate

Defined Benefit Plans

disability retirement provide. Furthermore, most deferred retirement benefits are greater than immediate pensions, primarily because the time during which LTD benefits are paid

is typically added to an employee’s length of service for calculation of pension benefits. (See chapter 3 for details of LTD

benefit plans.)

Eligibility for disability retirement benefits usually depends

on length of service; often 10 years or more are required.

Some participants, however, have no age or service requirement or have to meet the qualifications of their LTD plans,

which usually imposes service requirements of 6 months or

less.

Vesting

Even when an employee leaves an employer before becoming eligible for either a normal, early, or disability retirement benefit, a plan may pay a deferred pension (tables 129-

130). If certain conditions are satisfied at the time of separation, workers have a vested interest in all or a portion of their

accrued pension benefits and may begin receiving benefits

years later.

Although all pension participants are entitled to vested benefits under ERISA, some variations exist as to when vesting

occurs. As a result of the Tax Reform Act of 1986, however,

most plan sponsors have shortened their vesting schedules in

the past few years.25 For example, most participants in defined benefit pension plans have to complete 5 years of service at any age before benefits are guaranteed (cliff vesting).

Most of the remaining participants are in plans requiring 10

years of service. Participants not in plans with cliff vesting

are usually covered by a graduated vesting provision, which

increases the portion of guaranteed benefits as years of service accumulate. Frequently, participants accrue years of

vested service regardless of age, although a few are affected

by the plan sponsor’s right to exclude years of service before

a specified age in determining vesting eligibility.

Full vested pension payments begin at normal retirement

age, as specified by the plan, based on the benefit formula in

effect when the employee left the plan. As an alternative, terminated and vested participants may receive a reduced pension prior to normal retirement age if the participant has satisfied the early retirement service requirement before leaving the plan.

For terminated and vested employees who wish to receive

a pension prior to normal retirement age, ERISA requires the

benefit to be at least the actuarial equivalent of what would

have been received at age 65. The actuarial equivalent benefit is a reduced amount determined by the life expectancy at

the age that pension payments begin. Although under ERISA

the reduction factor used in determining the pension for terminated and vested employees can be more severe than for

early retirement, the same factor is used in plans covering

many participants with early retirement provisions. When

103
reductions differ, it is common to provide actuarial reductions to deferred vested benefits, eliminating the subsidy employers give to employees choosing early retirement.26

Portability

When employees change employers, the employer frequently holds vested pension benefits until the employee

reaches retirement age. Alternatively, a plan may include a

portability provision, that is, the option to transfer years of

credited service or accumulated benefits from one employer

to another. Currently, only a few full-time employees with a

defined benefit pension plan are covered by a portability provision (table 131). Most of these participants are covered by

either a multiemployer plan established by a union or a single

employer plan offered by an establishment that has a reciprocity agreement with related establishments, such as in the

utilities industry. In these plans, if a vested employee goes to

work for another employer, years of credited service or assets are usually transferred over to the new employer. Some

participants covered under a portability provision may have

an option to cash out vested pension benefits valued at greater

than $3,500.27

Postretirement pension increases

Inflation can severely erode the purchasing power of a fixed

pension over a worker’s retirement years. To guard against

this, some pensions are adjusted on a discretionary basis, and

others are subject to automatic increases specified in the pension plans. The Employee Benefits Survey collects data on

automatic increases and discretionary, or ad hoc, increases

granted during the 5-year period prior to the survey (table

132).

Because the survey counts the number of current employees covered by defined benefit pension plans and not the number of retirees, the survey cannot specify the proportion of

annuitants actually receiving postretirement pension increases.

Thus, the measures discussed in this section describe the incidence of postretirement increases among active plan participants.

Ad hoc pension increases are not directly linked to a costof-living index. Instead, retirees’ current pensions usually increase by a percent of the present benefit, commonly a uniform amount. For example, a plan may provide a 5-percent

pension increase to all individuals who retired prior to the

year in which the survey was conducted. Other plans may

provide greater pension increases for individuals retired

longer. For instance, a plan might grant a 5-percent pension

increase if retired 10 years or less, and a 10-percent increase

if retired more than 10 years.

A small number of plans grant automatic increases in pension benefits to compensate for increases in the cost of living. In most instances, these cost-of-living-adjustment formulas are based on changes in the BLS Consumer Price

Index. Adjustments are often restricted, however, by provisions that limit the benefit change to a portion of the CPI

change or by ceilings (generally 3 percent or less) on the periodic increase that can be applied. Plans providing cost-ofliving increases most often call for annual adjustments.28

Employee contributions

The employer almost always pays the full cost of defined

benefit pension plans for private sector participants (table

133). For employees who have to pay part of the cost, contributions are most commonly expressed as a percent of earnings. Participants in contributory plans usually pay a flat percent of all earnings, for example, 3 or 4 percent. Participants

in other contributory plans often pay one rate (for example,

2.5 or 4 percent) on earnings above a specified level, and a

lower rate (or frequently zero) below that earnings level. The

annual earnings level at which this break occurs is either a

flat amount stated by the plan, or the Social Security taxable

wage base. Plans with varying employee contributions usually coordinate private benefits with Social Security payments,

and as discussed earlier, pension benefit computation rates

used in these plans are often higher on earnings above the

Social Security taxable wage base.

Participation requirements

Some employees with defined benefit pension plans have

immediate coverage when they are hired (table 134). Others

can participate regardless of age but have to meet a service

requirement, usually 1 year. However, most employees with

eligibility requirements normally can not enter the pension

plan until they reach age 21 and complete 1 year of service;

this is the most restrictive requirement permitted under the

Internal Revenue Code.29

104

Defined Benefit Plans
20 Replacement rates, which are used to measure how retirement pay

compares with preretirement earnings, are not available for the 1995 EBS.

For a comprehensive analysis of employer-provided retirement plans, including a comparison of income and expenditures of older working persons and retirees, see Report on American Workforce (U.S. Department of

Labor 1997), pp. 99-145.

21 The Social Security taxable wage base increases annually. In 1995, it

was $61,200.

22 For a comprehensive analysis of pension benefit formulas integrated

with Social Security, see Avy D. Graham, “Coordinating Private Pension

Benefits with Social Security,” Monthly Labor Review, March 1994, pp.

35-38.

23 Survivor benefits are discussed in more detail in Donald Bell and Avy

Graham, “Surviving Spouse’s Benefits in Private Pension Plans,” Monthly

Labor Review, April 1984, pp. 23-31. 24 For more information about early retirement provisions, see Ann C.

Foster, “Early Retirement Provisions in Defined Benefit Penion Plans,”

Compensation and Working Conditions, December 1996, pp. 12-16.

25 The Pension Simplification Act of 1996 eliminated the 10-year vesting

requirement beginning in January of 1997. Only multiemployer plans may

continue to use 10-year vesting schedules pursuant to a collectively bargained

agreement.

26 For additional details on plan vesting requirements, see Avy D.

Graham, “How Has Vesting Changed Since Passage of Employee Retirement Income Security Act?,” Monthly Labor Review, August 1988, pp.

 20-25.

27 For more information on portability provisions, see Ann C. Foster,

 “Portability of Pension Benefits Among Jobs,” Monthly Labor Review, July

1994.

28 For more information on postretirement pension increases, see Harriet

Weinstein, “Post-retirement Pension Increases,” Compensation and Working Conditions, Fall, 1997. 29 However, some plans, such as those in religious institutions, are

exempt from certain restrictions in the Internal Revenue Code and may

require employees to meet greater age or length-of-service levels before

coverage begins.

Defined Benefit Plans

—ENDNOTES—

105
Table 113. Defined benefit plans: Summary of plan

provisions, full-time employees, medium and large private

establishments, 1995

Provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

Basic provisions

Employee contribution

required .......................... 3 3 2 3

Benefits based on earnings .. 70 84 76 57

Benefits integrated with

Social Security ................ 51 58 58 42

Benefits subject to

maximum1 ...................... 35 40 42 27

Early retirement benefits

available ......................... 96 97 95 96

Disability retirement benefits

available ......................... 73 64 70 81

Portability provisions ............. 8 3 9 9

Availability of lump sum

benefits at retirement ...... 15 14 22 12

Other provisions

Normal retirement

supplement available ...... 3 3 1 4

Early retirement supplement

available ......................... 8 10 4 9

Minimum benefits provision .. 4 3 5 3

Early retirement requires

employer approval .......... 3 4 3 2

Deferred vested benefits

available prior to normal

retirement age ................ 93 92 95 92

Lump-sum postretirement

survivor benefits ............. 7 7 4 9

Lump-sum preretirement

survivor benefits ............. 2 1 2 3

Full pension restored if

spouse predeceases

retiree ............................. 13 13 11 13

Survivor benefits for children 4 3 5 4

1 Provisions that restrict benefits, such as limits on the number of years

of service included in benefit computations.

NOTE: Where applicable, dash indicates no employees in this category.
Table 114. Defined benefit plans: Primary formula and

availability of alternative formula, full-time employees, medium

and large private establishments, 1995

Benefit

formula1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

Percent of terminal earnings 58 71 67 46

With alternative formula .... 18 24 17 15

Percent of career earnings ... 11 13 9 11

With alternative formula .... 5 5 4 5

Dollar amount formula .......... 23 10 14 37

With alternative formula .... 2 ( ) 2 ( ) 1 2 ( )

Percent of contribution

formula ............................ 2 2 ( ) 1 4

With alternative formula .... 2 ( ) - 2 ( ) 2 ( )

Cash account ........................ 3 4 5 2

With alternative formula .... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Other ..................................... 2 1 4 1

1 Alternative formulas are generally designed to provide a minimum

benefit for employees with short service or low earnings. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 115. Defined benefit plans: Terminal earnings formula,

full-time employees, medium and large private establishments,

1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

terminal earnings formula ... 10,186 3,559 2,988 3,639

Percent

Total with terminal earnings

formula ................................ 100 100 100 100

Flat percent per year of

service ............................ 37 38 29 43

Less than 1.00 percent ..... 2 1 2 5

1.00 - 1.24 percent ........... 10 10 6 12

1.25 - 1.49 percent ........... 5 4 6 5

1.50 - 1.74 percent ........... 13 16 9 13

1.75 - 1.99 percent ........... 3 4 2 4

2.00 - 2.24 percent ........... 4 3 5 5

2.25 percent or greater ..... ----

Percent per year varies ........ 62 62 71 57

By service ......................... 8 8 14 4

By earnings ....................... 41 42 46 36

By age .............................. 1 ( ) 1 ( ) 1 ( ) 1 ( )

By earnings and service ... 13 12 10 17

Other ..................................... 1 ( ) 1 1 ( ) -

Average2

Average flat percent per year of

service ................................ 1.45 1.48 1.49 1.39

1 Less than 0.5 percent. 2 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 116. Defined benefit plans: Definition of terminal

earnings, full-time employees, medium and large private

establishments, 1995

Definition

of

earnings

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

terminal earnings formula ... 10,186 3,559 2,988 3,639

Percent

Total with terminal earnings

formula ................................ 100 100 100 100

One year ............................... 2 2 1 2

Three years .......................... 17 25 9 17

Last 3 ................................ 1 ( ) 1 ( ) 1 ( ) 1 ( )

High 3 ............................... 5 7 2 6

Of last 10 ...................... 2 3 1 1

Of career ....................... 3 4 1 5

Of other time period ...... 1 ( ) 1 ( ) 1 ( ) 1 ( )

High consecutive 3 ........... 12 18 7 11

Of last 10 ...................... 6 10 3 5

Of career ....................... 4 5 3 5

Of other time period ...... 1 3 1 ( ) 1

Five years ............................. 78 70 89 77

Last 5 ................................ 3 1 3 4

High 5 ............................... 11 10 9 14

Of last 10 ...................... 6 7 4 8

Of career ....................... 4 2 4 6

Of other time period ...... 1 1 1 1 ( )

High consecutive 5 ........... 64 59 77 59

Of last 10 ...................... 48 45 62 40

Of career ....................... 15 13 13 17

Of other time period ...... 1 1 1 1

Other period2 ........................ 3 3 1 5

1 Less than 0.5 percent. 2 Formulas based on earnings during period other than 3 or 5 years’

service, or period not immediately before retirement (for example, first 5 of

last 10 years’ service).

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 117. Defined benefit plans: Types of earnings included

in earnings-based formulas, full-time employees, medium and

large private establishments, 1995

Definition

of

earnings

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

earnings-based formula ...... 12,113 4,196 3,393 4,525

Percent

Total with earnings-based

formula ................................ 100 100 100 100

Straight-time earnings only ... 62 64 66 59

Straight-time earnings plus

other earnings ................. 38 37 35 41

Overtime ........................... 32 32 29 35

Shift differentials ............... 24 28 18 26

Commissions .................... 18 17 16 21

Other ................................. 10 9 9 12

NOTE: Sums of individual items may be greater than totals because more

than one type of earnings may be included in this definition. Where

applicable, dash indicates no employees in this category.
Table 118. Defined benefit plans: Dollar

amount formula, full-time employees, medium

and large private establishments, 1995

Item

All

employees

Bluecollar

and

service

employees

Number (in thousands) with

dollar amount formula ......... 4,049 2,953

Percent

Total with dollar amount

formula ................................ 100 100

Flat monthly amount per year

of service ........................ 94 96

Less than $5.00 ................ 4 5

$5.00 - $9.99 .................... 2 3

$10.00 - $14.99 ................ 4 5

$15.00 - $19.99 ................ 9 7

$20.00 - $24.99 ................ 15 19

$25.00 - $29.99 ................ 9 11

$30.00 - $34.99 ................ 23 23

$35.00 - $39.99 ................ 19 16

$40.00 or more ................. 9 9

Dollar amount varies ............. 6 4

By service ......................... 6 4

Average1

Average flat dollar amount per

year of service .................... $28.47 $27.47

1 The average is presented for all covered workers;

averages exclude workers without the plan provision.

NOTE: Data were insufficient to show professional,

technical, and related employees and clerical and sales

employees separately. Because of rounding, sums of

individual items may not equal totals. Where applicable,

dash indicates no employees in this category.
Table 119. Defined benefit plans: Integration with Social

Security, full-time employees, medium and large private

establishments, 1995

Intregration

with Social

Security

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit pension ...... 17,417 4,987 4,450 7,979

Percent

Total with defined benefit

pension ............................... 100 100 100 100

With integrated formula ........ 51 58 58 42

Step-rate excess1 ............. 37 42 42 30

Social Security

breakpoint ............... 33 36 39 27

Dollar amount

breakpoint ............... 4 5 3 4

Offset by Social Security2 14 16 16 12

Without integrated formula ... 49 42 42 58

1 Formula applies lower benefit rate to earnings subject to FICA (Social

Security) taxes or below a specific dollar breakpoint. 2 Benefit as calculated by formula is reduced by portion of primary Social

Security payments, for example, 50 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates that no data were reported.
Table 120. Defined benefit plans: Maximum benefit

provisions,1 full-time employees, medium and large private

establishments, 1995

Maximum

benefit

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

Subject to maximum ............. 35 40 42 27

Limit on years of credited

service ........................ 33 38 41 26

Less than 30 ................. 5 8 4 3

30 .................................. 7 6 7 8

31 - 34 .......................... 1 2 2 ( ) 2 ( )

35 .................................. 16 18 22 11

36 - 39 .......................... 2 ( ) - 2 ( ) 2 ( )

40 .................................. 4 4 7 2

Greater than 40 ............ 1 2 ( ) 2 ( ) 1

Other maximum3 .............. 1 2 2 1

Not subject to maximum ....... 65 60 58 73

Average4

Average credited service

maximum (in years) ............ 33.1 32.6 34.0 32.9

1 These maximum provisions are independent of Internal Revenue Code

ceilings on pensions payable from defined benefit plans. 2 Less than 0.5 percent. 3 The benefit yielded under the formula is limited to a percent of terminal

earnings or to a flat dollar amount. 4 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Sums of individual items may not equal totals because some benefit

formulas contain a limit on years of credited service and another maximum

provision. Where applicable, dash indicates no employees in this category.
Table 121. Defined benefit plans: Availability of lump sum

benefits at retirement, full-time employees, medium and large

private establishments, 1995

Option

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With lump sum available ....... 15 14 22 12

Full lump sum available .... 15 14 22 10

Limited to specified

amount .................... 5 5 8 3

No limit .......................... 10 9 14 8

Partial lump sum with

reduced annuity .......... 1 1 ( ) 1 ( ) 1

Other ................................. 1 ( ) 1 ( ) 1 ( ) -

No lump sum available ......... 85 86 78 88

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 122. Defined benefit plans: Postretirement survivor

benefits, full-time employees, medium and large private

establishments, 1995

Survivor

benefit

provisions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With postretirement survivor

benefits ........................... 100 100 100 100

Joint and survivor annuity1 98 98 99 98

50 percent only ............. 30 26 31 31

51 - 99 percent only ...... 2 1 1 4

100 percent only ........... 2 ( ) 2 ( ) 2 ( ) 1

Retiree choice of

percentages ............ 66 70 66 63

Highest:

50 percent ............. 2 ( ) - 2 ( ) 2 ( )

51 - 99 percent ..... 4 2 4 4

100 percent ........... 62 67 63 58

Percent of unreduced

accrued benefits ......... 2 2 1 2

1 An annuity that provides income during the lifetime of both the retiree

and the surviving spouse. The accrued pension will usually be actuarially

reduced at retirement because of the longer time that payments are expected

to be made. Employees and their spouses are required to waive the spouse

annuity in writing if they desire a pension during the employee’s lifetime only

or another option offered by the plan, such as guarantee of payment for a

specified period. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 123. Defined benefit plans: Preretirement survivor

benefits, full-time employees, medium and large private

establishments, 1995

Survivor

benefit

provisions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With preretirement survivor

benefits1 ......................... 98 99 96 98

Equivalent to

joint-and-survivor

annuity2 ...................... 96 96 95 96

50 percent of

employee’s pension 82 81 80 85

With additional

employee cost3 ... 6 8 6 6

Other percent of

employee’s

pension4 ................. 4 5 3 5

With additional

employee cost3 ... 1 1 5 ( ) 2

Employee choice of

percent6 .................. 9 10 12 7

With additional

employee cost3 ... 1 3 5 ( ) 5 ( )

Percent of accrued

benefits ....................... 2 3 1 2

Other7 ............................... 5 ( ) 5 ( ) 5 ( ) -

No preretirement survivor

benefits ........................... 2 1 4 2

1 Survivor annuity is based upon the benefit the employee would have

received if retirement had occurred on the date of death. 2 The spouse annuity is computed as if the employee had retired with a

joint-and-survivor annuity. That is, the accrued pension is first reduced

because of the longer time that payments were expected to be made to both

the retiree and the surviving spouse. The spouse’s share is then the

specified percent of the reduced amount. 3 Plan reduces the accrued employee pension benefit for each year

survivor protection is in force. 4 Other percentages range from 51 - 100 percent of retiree’s pension. 5 Less than 0.5 percent. 6 Alternative percentages were usually 50 or 100 percent. 7 Includes annuity based on a dollar amount formula or percent of

earnings.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 124. Defined benefit plans: Requirements for normal

retirement, full-time employees, medium and large private

establishments, 1995

Requirements

for normal

retirement1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

No age requirement .............. 6 4 5 6

30 years of service ........... 5 4 5 6

35 years of service ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

At age 55 .............................. 4 4 5 4

No service requirement .... 2 ( ) 2 ( ) - 1

5 years of service ............. 2 ( ) 2 ( ) 1 2 ( )

20 years of service ........... 2 ( ) 2 ( ) 1 2 ( )

21 - 24 years of service .... 2 ( ) 2 ( ) 2 ( ) 2 ( )

25 years of service ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

30 years of service ........... 3 4 3 2

More than 30 years of

service ........................ 2 ( ) - 2 ( ) 2 ( )

At age 56 - 59 ....................... 2 ( ) 2 ( ) 2 ( ) 1

20 years of service ........... 2 ( ) 2 ( ) 2 ( ) -

30 years of service ........... 2 ( ) - - 1

At age 60 .............................. 8 10 8 6

No service requirement .... 1 1 2 1

5 years of service ............. 1 2 ( ) 1 1

10 years of service ........... 3 5 3 3

15 years of service ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

20 years of service ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

25 years of service ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

30 years of service ........... 2 3 2 1

More than 30 years of

service ........................ 2 ( ) 2 ( ) 2 ( ) 2 ( )

At age 61 .............................. 2 ( ) - - 2 ( )

15 years of service ........... 2 ( ) - - 2 ( )

At age 62 .............................. 26 19 22 32

No service requirement .... 3 4 2 4

5 years of service ............. 4 5 4 4

6 - 9 years of service ........ 2 ( ) 2 ( ) 2 ( ) -

10 years of service ........... 9 6 4 13

15 years of service ........... 3 3 3 3

20 years of service ........... 4 1 7 3

25 years of service ........... 1 2 ( ) 1 1

See footnotes at end of table.
Table 124. Defined benefit plans: Requirements for normal

retirement, full-time employees, medium and large private

establishments, 1995 — Continued

Requirements

for normal

retirement1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Total with defined benefit plan

At age 62

26 - 29 years of service .... 2 ( ) - - 1

30 years of service ........... 2 2 ( ) 1 3

More than 30 years of

service ........................ 2 ( ) 2 ( ) 2 ( ) -

At age 63 - 64 ....................... 2 ( ) - 1 2 ( )

No service requirement .... 2 ( ) - 1 2 ( )

At age 65 .............................. 48 53 51 43

No service requirement .... 36 39 39 32

1 - 4 years of service ........ 2 ( ) 1 1 2 ( )

5 years of service ............. 9 11 9 8

10 years of service ........... 2 2 1 2

15 years of service ........... 2 ( ) 2 ( ) - 2 ( )

25 years of service ........... 2 ( ) - 2 ( ) 1

30 years of service ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Sum of age plus service3 ...... 9 10 8 8

Equals less than 80 .......... 1 1 1 1

Equals 80 .......................... 1 1 1 2 ( )

Equals 81 - 89 .................. 6 7 4 6

Equals 90 .......................... 1 2 ( ) 1 1

Equals more than 90 ........ 2 ( ) 2 ( ) 2 ( ) -

1 Normal retirement is defined as the point at which the participant could

retire and immediately receive all accrued benefits by virtue of service and

earnings, without reduction due to age. If a plan had alternative age and

service requirements, the earliest age and associated service were tabulated;

if one alternative did not specify an age, it was the requirement tabulated. 2 Less than 0.5 percent. 3 In some plans, participants must also satisfy a minimum age or service

requirement.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 125. Defined benefit plans: Requirements for early

retirement, full-time employees, medium and large private

establishments, 1995

Requirements

for early

retirement1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With early retirement

available ......................... 96 97 95 96

No age requirement2 ........ 7 7 4 9

Less than 20 years of

service .................... 3 ( ) 3 ( ) 3 ( ) 3 ( )

20 - 29 years of service 1 2 3 ( ) 1

30 years of service ....... 6 4 4 9

Less than age 55 .............. 9 8 13 8

No service requirement2 3 ( ) 3 ( ) 3 ( ) 3 ( )

5 years of service ......... 3 1 6 3

6 - 9 years of service .... 3 ( ) 3 ( ) - 3 ( )

10 years of service ....... 2 1 2 2

15 years of service ....... 1 1 1 1

20 years of service ....... 3 ( ) 3 ( ) 3 ( ) 3 ( )

25 years of service ....... 3 4 4 2

At age 55 .......................... 67 70 69 65

No service requirement2 4634

1 - 4 years of service .... 3 ( ) 3 ( ) 3 ( ) 3 ( )

5 years of service ......... 21 23 27 16

6 - 9 years of service .... 3 ( ) 3 ( ) 3 ( ) 3 ( )

10 years of service ....... 31 29 25 35

11 - 14 years of service 3 ( ) 3 ( ) 3 ( ) -

15 years of service ....... 9 10 12 8

20 years of service ....... 1 1 2 3 ( )

25 years of service ....... 1 3 ( ) 1 1

Between ages 56 - 59 ....... 1 3 1 3 ( )

10 years of service ....... 3 ( ) 3 ( ) 3 ( ) -

30 years of service ....... 1 2 3 ( ) 3 ( )

See footnotes at end of table.
Table 125. Defined benefit plans: Requirements for early

retirement, full-time employees, medium and large private

establishments, 1995 — Continued

Requirements

for early

retirement1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Percent

Total with defined benefit plan

With early retirement

available

At age 60 .......................... 6 3 4 10

No service requirement2 3 ( ) 3 ( ) 3 ( ) 3 ( )

5 years of service ......... 2 2 1 2

10 years of service ....... 1 3 ( ) 1 2

15 years of service ....... 2 1 1 3

20 years of service ....... 3 ( ) 3 ( ) 3 ( ) 3 ( )

30 years of service ....... 1 3 ( ) 1 2

At age 62 .......................... 1 1 1 1

10 years of service ....... 3 ( ) 3 ( ) 3 ( ) 1

15 years of service ....... 1 1 1 3 ( )

Sum of age plus service4 .. 4 6 2 3

Equals less than 80 ...... 3 5 2 3

Equals 80 ...................... 3 ( ) 1 3 ( ) 3 ( )

Equals 81 - 89 .............. 3 ( ) 3 ( ) 3 ( ) 3 ( )

Early retirement not available 4 3 5 4

1 Early retirement is defined as the point at which a worker could retire

and immediately receive accrued benefits based on service and earnings but

reduced for each year prior to normal retirement age. If a plan had

alternative age and service requirements, the earliest age and associated

service were tabulated; if one alternative did not specify an age, it was the

requirement tabulated. 2 Where no service requirement is specified for early retirement, the

service required for full vesting, usually 5 years, applies. 3 Less than 0.5 percent. 4 In most plans, participants must satisfy a minimum age or service

requirement.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 126. Defined benefit plans: Early retirement reduction,

full-time employees, medium and large private establishments,

1995

Early

retirement

reduction1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

early retirement available ... 16,738 4,837 4,214 7,687

Percent

Total with early retirement

available ............................. 100 100 100 100

Uniform percentage

reduction2 ....................... 40 41 32 43

Less than 3.0 .................... 4 6 3 3

3.0 ..................................... 3 4 3 3

3.1 - 3.9 ............................ 1 1 1 2

4.0 ..................................... 4 6 4 3

4.1 - 4.9 ............................ 2 3 ( ) 1 3

5.0 ..................................... 7 7 6 7

5.1 - 5.9 ............................ 3 ( ) - 1 3 ( )

6.0 ..................................... 14 11 12 16

6.1 - 6.9 ............................ 2 1 2 3

7.0 ..................................... 1 1 - 1

Greater than 7.0 ............... 2 4 3 ( ) 1

Reduction varies ................... 60 59 67 57

By service ......................... 3 4 4 3

By age .............................. 57 55 63 54

Other reduction4 ................... 3 ( ) 3 ( ) 3 ( ) 3 ( )

Average5

Average uniform reduction

percentage .......................... 5.0 4.8 4.9 5.1

1 Reduction for each year prior to normal retirement. 2 In specific cases, uniform percentage reductions may approximate

actuarial reductions, such as early retirement at age 55 with a reduction of 6

percent per year between age 55 and the plan’s normal retirement age of 62. 3 Less than 0.5 percent. 4 Reduced amount was not derived from normal retirement formula. 5 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 127. Defined benefit plans: Method of calculating

disability retirement benefits, full-time employees, medium and

large private establishments, 1995

Benefit

provisions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With disability retirement

available ......................... 73 64 70 81

Immediate disability

retirement1 .................. 45 34 36 57

Unreduced normal

benefits2 ................. 29 22 26 35

Reduced normal

benefits3 ................. 12 10 8 16

Other than normal

benefits4 ................. 3 1 2 5

Not deteminable ........... 5 ( ) 5 ( ) 5 ( ) 5 ( )

Deferred disability

retirement ................... 28 31 34 24

With benefits based on:

Service when

disabled .............. 4 4 3 4

Service to retirement

age ...................... 24 26 30 20

Other ......................... 5 ( ) 5 ( ) 1 5 ( )

Not determinable ...... 5 ( ) 5 ( ) 5 ( ) 5 ( )

Disability retirement not

available ......................... 27 36 30 19

1 Immediate disability pensions may be supplemented by additional

allowances until an employee reaches a specified age or becomes eligible for

Social Security. 2 The disabled worker’s pension is computed under the plan’s normal

benefit formula and is paid as if retirement had occurred on the plan’s normal

retirement date, either based on years of service actually completed or

projected to a later date. 3 The disabled worker’s pension is computed under plan’s normal benefit

formula, based on years of service actually completed, and then reduced for

early receipt. 4 The disabled worker’s benefit is not computed by the plan’s normal

benefit formula. The methods used include flat amount benefits, dollar

amount formulas, percent of unreduced normal benefits less Social Security,

and percent of earnings formula both with and without Social Security offsets. 5 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 128. Defined benefit plans: Requirements for disability

retirement, full-time employees, medium and large private

establishments, 1995

Requirements for

disability

retirement1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With disability retirement

available ......................... 73 64 70 81

No minimum requirements 11 9 12 12

No age requirement .......... 28 21 22 36

Less than 5 years of

service .................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

5 years of service ......... 1 1 2 ( ) 2

6 - 9 years of service .... 2 ( ) - - 2 ( )

10 years of service ....... 16 13 12 21

11 - 14 years of service 2 ( ) - 2 ( ) 1

15 years of service ....... 10 8 9 12

Greater than 15 years of

service .................... 2 ( ) 2 ( ) 1 -

Less than age 40 .............. 1 2 ( ) 1 1

No service requirement 2 ( ) 2 ( ) 2 ( ) 2 ( )

Less than 10 years of

service .................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

10 years of service ....... 2 ( ) 2 ( ) 2 ( ) -

Ages 40 - 49 ..................... 1 2 1 1

10 years of service ....... 1 2 1 1

Greater than 10 years of

service .................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Age 50 or more ................. 7 7 4 8

No service requirement 2 ( ) 2 ( ) 2 ( ) 2 ( )

Less than 10 years of

service .................... 2 1 1 2

10 years of service ....... 3 3 2 3

Greater than 10 years of

service .................... 2 2 1 2

Sum of age plus service ... 1 2 ( ) 1 1

Receipt of long-term

disability insurance

benefits ....................... 17 19 24 12

Minimum vesting

requirement3 ............... 7 5 4 10

Disability retirement not

available ......................... 27 36 30 19

1 If a plan had alternative age and service requirements, the earliest age

and associated service were tabulated; if one alternative did not specify an

age, it was the requirement tabulated. 2 Less than 0.5 percent. 3 An employee may be entitled to pension benefits after satisfying vesting

service requirements, usually 5 years.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 129. Defined benefit plans: Vesting requirements,

full-time employees, medium and large private establishments,

1995

Vesting

requirements

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

Immediate full vesting ........... 1 2 1 ( ) 1

Cliff vesting2 ......................... 96 95 95 97

With full vesting:

At any age .................... 93 93 91 94

Less than 5 years ..... 1 ( ) 1 1 ( ) 1 ( )

5 years ...................... 87 91 86 84

6 - 9 years ................. 1 ( ) 1 ( ) 1 ( ) -

10 years .................... 6 2 4 10

After specified age3 ...... 3 2 3 3

5 years ...................... 3 2 3 3

Graduated vesting4 ............... 3 3 5 2

With full vesting after:

Less than 7 years ......... 1 1 2 1

7 years .......................... 1 1 3 1

More than 7 years ......... 1 ( ) 1 - -

1 Less than 0.5 percent. 2 Under a cliff vesting schedule, an employee is not entitled to any

benefits accrued under a pension plan until satisfying the requirement for

100-percent vesting (usually after 5 years). 3 Sponsors may exclude years of service completed before age 18 from

counting towards satisfaction of minimum vesting standards. 4 Graduated vesting schedules give an employee rights to a gradually

increasing share of pension benefits determined by years of service,

eventually reaching 100-percent vesting status (usually after 7 years).

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 130. Defined benefit plans: Provisions for early receipt

of deferred vested benefits, full-time employees, medium and

large private establishments, 1995

Receipt of

deferred vested

benefits

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

Deferred vested benefits

available prior to normal

retirement age ................ 93 92 95 92

Reduced same as early

retirement ................... 60 56 66 59

Other reduction ................. 33 36 29 33

Actuarial reduction ........ 23 22 24 23

Uniform percent

reduction ................. 7 10 4 7

Other ............................. 3 4 1 2

Deferred vested benefits not

available prior to normal

retirement age ................ 7 8 5 8

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 131. Defined benefit plans: Portability provisions,

full-time employees, medium and large private establishments,

1995

Portability

provisions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With portability provisions ..... 8 3 9 9

Transfer of service credits 2 1 4 2

Transfer of assets ............. 1 ( ) 1 1 ( ) 1 ( )

Transfer of service credits

and assets .................. 1 ( ) 1 ( ) 1 ( ) -

Lump sum over $3,500

paid out to separated

employee .................... 1 ( ) 1 ( ) 1 ( ) -

Multi-employer plans ........ 5 2 4 7

Reciprocity with other

plans/jurisdictions ... 3 1 3 3

Contribution sent to

home fund ........... 1 1 ( ) 1 1

Pro rata pension paid

by several funds 2 1 2 2

Other ......................... 1 ( ) - - 1 ( )

No reciprocity ................ 2 1 ( ) 1 4

Other ................................. 1 ( ) 1 ( ) 1 ( ) 1 ( )

No portability provisions ....... 92 97 91 91

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 132. Defined benefit plans: Postretirement pension

increases, full-time employees, medium and large private

establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

With postretirement increase

available1 ........................ 7 6 6 8

Automatic cost-of-living

increase ...................... 3 4 4 3

Discretionary increase

granted to retirees in

the last 5 years ........... 4 2 2 5

No postretirement increase .. 93 94 94 92

1 Total may exceed sum of individual items because employees may be

covered by more than one type of postretirement increase.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 133. Defined benefit plans: Employee contribution

requirements, full-time employees, medium and large private

establishments, 1995

Employee

contributions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

Employee contribution

required .......................... 3 3 2 3

Pretax contribution

allowed ....................... 1 2 1 ( ) 1 ( )

Pretax contribution not

allowed ....................... 2 2 1 3

No employee contribution

required .......................... 97 97 98 97

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 134. Defined benefit plans: Eligibility requirements,

full-time employees, medium and large private establishments,

1995

Eligibility

requirements1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

defined benefit plan ............ 17,417 4,987 4,450 7,979

Percent

Total with defined benefit plan .. 100 100 100 100

Plan participation available to

new employees ............... 100 100 100 99

With minimum age and/or

service requirement .... 69 66 82 62

Service requirement

only ......................... 27 22 25 30

3 months and less .... 1 1 3 1

4 - 5 months .............. 2 2 ( ) 1 3

6 months ................... 1 1 2 1

1 year ........................ 21 18 18 24

13 - 23 months .......... 2 ( ) 2 ( ) 2 ( ) 2 ( )

2 years ...................... 1 2 1 1

Age 20 or less ............... 3 3 3 2

No service

requirement ........ 1 2 1 1

1 - 11 months ............ 2 ( ) 2 ( ) - 2 ( )

1 year ........................ 1 1 1 2 ( )

Over 1 year ............... 2 ( ) - 1 2 ( )

Age 213 ......................... 39 40 53 30

No service

requirement ........ 2 4 1 2

1 - 11 months ............ 2 3 1 3

1 year ........................ 34 34 51 26

Over 1 year ............... 2 ( ) 2 ( ) 2 ( ) -

Age 22 and over ........... 1 2 ( ) 1 2 ( )

1 year ........................ 1 2 ( ) 1 2 ( )

No minimum age or

service requirement .... 31 33 18 37

Plan participation not

available to new

employees ...................... 2 ( ) 2 ( ) - 1

Average4

Average service requirement (in

months) ............................... 11.6 11.9 11.6 11.5

1 Excludes administrative time lags. 2 Less than 0.5 percent. 3 The Internal Revenue Code requires that nearly all plans must allow

participation to full-time employees who have reached the age of 21 who

have completed one year of service. Plans that provide immediate vesting of

accrued benefits may require up to three years. Church plans are exempt

from the Internal Revenue Code. 4 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Defined contribution plans specify the level of

employer contributions to a plan, but not the formula

for determining eventual benefits as in a defined benefit plan. Instead, personal accounts are set up for participants, and benefits depend on amounts credited to these accounts, plus investment earnings. Although employers normally guarantee they will make contributions, the employee

bears the risk of fluctuation in investment earnings.

This chapter examines details of defined contribution plans,

including:

• Types of defined contribution plans;

• Provisions, such as contributions and distributions, associated with several types of plans; and

• Pretax arrangements, known as 401(k) plans, and their

unique features.

Since 1975, when the Employee Retirement Income

Security Act (ERISA) became effective, the number of participants in private defined contribution plans has risen

steadily, while the number of participants in defined benefit

plans has increased only slightly. Most of the recent participation growth in defined contribution plans is occurring in

new plans, particularly in 401(k) type plans, which offer cash

or tax-deferred options on currently taxable compensation.30

Defined contribution plans primarily provide retirement

benefits. Most retirement plans do not allow withdrawal of

employer contributions until retirement age, death, disability, separation from service, age 591/2, or hardship. However,

some plans may impose less stringent restrictions for withdrawal of employer contributions, for example, permitting

one or two withdrawals per year, or allowing withdrawal after 2 or 5 years of service.31 Nevertheless, these defined contribution plans may also furnish retirement income because

withdrawals of the employer’s contributions are voluntary,

not mandatory. For purposes of the Employee Benefits Survey, all defined contribution plans are considered retirement

plans.

Plan types

Defined contribution plans may be classified by type of

plan (table 1). The survey provides data on the following

types of plans: Savings and thrift, deferred profit sharing,

money purchase pension, employee stock ownership plans

(ESOP’s), and stock bonus.32 Savings and thrift and money

Chapter 7.

Defined Contribution Plans

purchase pension plans are common among white-collar workers, while deferred profit-sharing plans are common among

both white-collar and blue-collar workers. Stock plans, however, cover only a small portion of employees.

Most participants in defined contribution plans make contributions to their plans. All savings and thrift plan participants are required to make contributions as a condition of

joining the plan, with the employer matching some or all of

the employee contribution. In contrast, nearly all participants

in private defined benefit plans have all contributions made

by the employer.

Employees may receive retirement benefits from defined

benefit plans, defined contribution plans, or both.

Another type of plan frequently encountered is a 401(k)

plan (named after the applicable section of the Internal

Revenue Code). Such plans, also called cash or deferred arrangements, are usually features of other defined contribution plans that give employees the opportunity to defer income and taxes into the future. The features of these plans

are discussed in more detail at the end of this chapter.

Savings and thrift plans

Savings and thrift plans enroll a large number of employees in medium and large private establishments. Under these

plans, employees may contribute a predetermined portion of

earnings (usually pretax) to an account, all or part of which

the employer matches (table 135). Contributions are invested

in various investment options, such as stocks, bonds, and

money market funds, as directed by the employee or employer,

depending upon the provisions of the plan. Although usually

designed as a long-term savings vehicle, savings and thrift

plans may allow withdrawals for specified conditions (such

as medical and educational expenses) and may allow participants to borrow funds from their account. Also many savings

and thrift plans allow participants to transfer or “rollover”

amounts received from a plan of a former employer (table

136). Such a rollover continues the tax deferral on money

that was sheltered from taxes before the terminated employee

received it.

Employee contributions. (See tables 137-139.) Savings and

thrift plans allow employees to choose from a range of contribution rates. A plan, for example, might allow employee

contributions of any amount from 5 to 20 percent of pay.

Maximum contributions are commonly 10, 12, 15, and 16

percent.

119
The ability to make employee contributions on a pretax

basis, known as salary reduction, has only recently become a

dominant feature of savings and thrift plans. Participants in

savings and thrift plans are usually allowed to make pretax

contributions.

The provisions governing pretax contributions vary widely.

For example, many participants in plans allowing pretax contributions are allowed to make only pretax contributions; some

other plans have an option to make either pretax or posttax

contributions; and others must make at least some of their

contributions on a pretax basis.

The tax status of employee contributions is important

not only because of the current deferral of income taxes, but

also because an employee may not withdraw pretax contributions from his or her account__except in limited circumstances__without tax penalties.

Employer-matching contributions. (See tables 140-141.)

Employers give incentives for participating in a savings and

thrift plan by matching all or a portion of the employee’s contribution (adding this amount to the employee’s account).

Usually the employer matches a portion of the employee’s

contribution up to a specified percent of the employee’s earnings. For example, an employer may match half of the

employee’s contribution up to the first 6 percent of earnings.

Assuming the employee contributes 8 percent of earnings,

the employer would add 3 percent (half of the first 6 percent

of the employee’s earnings) for a total contribution of 11 percent to the employee’s account. In contrast with these straight

percentage matches, some participants receive matching contribution rates varying by length of service, level of employee

contribution, or company profits.33

In some savings and thrift plans, the employer may also

provide discretionary profit-sharing contributions to the

employee’s account (table 142).

Investment decisions. (See tables 143-146.) Most participants in savings and thrift plans can choose how to invest

their own contributions. Investment options offered by these

plans include company stock, common stock funds, guaranteed investment contracts, government securities, money

market funds, and long-term interest bearing securities such

as corporate bonds and U.S. Treasury notes. The number of

choices in these plans varies from 2 to 10 or more. Employees are usually allowed to split their contributions among the

various options__typically in multiples of 10 or 25 percent.

For example, a participant may choose to invest 50 percent

in company stock and 50 percent in government securities.

In addition, plans often permit participants to change their

investment choices periodically, such as two or four times

per year.

In most cases, employees have less of a choice in how

employer contributions are invested. When no choice is

Defined Contribution Plans

allowed, the plan typically specifies that the matching contribution is invested in company stock.

Withdrawals and loans. (See tables 147-154.) Prior to normal payout at retirement, disability, or termination of employment, many participants in savings and thrift plans are

allowed to withdraw all or a portion of employer contributions. As withdrawal provisions are canceled or further restricted (typically due to the tax penalties associated with

withdrawals), loan provisions (discussed later in this section)

have become more available.

Many participants in plans allowing withdrawal of

employer contributions can only access their funds for hardship reasons, such as medical or educational expenses. The

remaining participants can withdraw employer contributions

for any reason.

Withdrawals of employer contributions may also be subject to a variety of other restrictions. For example, some participants who can make withdrawals may only withdraw part

of their employer’s contribution. Additionally, many of those

who do make withdrawals, have a penalty imposed. Penalties usually involve suspending employer matching contributions for a given period, such as 6 months or 1 year, or

suspending employee contributions and employer matching

contributions. Other penalties include forfeiting nonvested

employer contributions.

Another method of accessing an employee’s account prior

to final payout is a loan. Loans usually have to be repaid within

5 years, but longer payment periods may apply for home

purchase or renovation loans.

Distribution. (See table 155.) At retirement, savings and thrift

plans commonly allow for payout in the form of a lump sum.

Many participants can choose from among a lump sum and

other options, such as a lifetime annuity or installments over

a specified period.

Participation requirements. (See table 156.) Minimum age

and/or service requirements are frequently imposed on new

participants in savings and thrift plans, typically 1 year. However, participants are usually not required to reach a minimum age as is common in defined benefit plans.

Vesting. (See table 157.) Saving and thrift plans are subject to

the same vesting rules under ERISA as defined benefit plans.

Vesting schedules vary significantly, however, between defined benefit and savings and thrift plans. All vesting schedules apply to employer contributions; employee contributions

(including pretax contributions) are always 100-percent

vested.

Savings and thrift plans often include immediate full vesting. In addition, graduated vesting, in which an employee’s

nonforfeitable percentage increases over time until it reaches

120
100 percent, commonly after 5 years, applies to a large

number of participants in savings and thrift plans. In contrast, few defined benefit plan participants have either immediate full vesting or graduated vesting.

“Cliff vesting”, in which no vesting occurs until an employee satisfies the service requirements for 100-percent vesting, is more common in defined benefit plans than in savings

and thrift plans. Savings and thrift plan participants covered

under a cliff-vesting schedule are usually fully vested after

reaching 5 years of service.

Finally, class-year vesting__under which employer contributions for a particular year (class) become nonforfeitable

after a specific period of time, usually 3 years__applies to

few saving and thrift plan participants.

Deferred profit-sharing plans

Deferred profit-sharing plans, although not as widespread

as savings and thrift plans, are available to a significant number of employees. Most deferred profit-sharing plans hold

money in employee accounts until retirement or another condition stipulated by the plan (for example, disability or death).

In some plans, however, the employee may have a choice to

receive a portion of the profits in cash, with the remainder

placed in a deferred account.34

Most participants in deferred profit-sharing plans have employer contributions determined by a specified formula, such

as 4 percent of profits if annual sales were $2 million to $5

million, and 8 percent if sales exceeded $5 million. The remaining participants are in plans in which the employer determines its contribution with no predetermined formula

(table 158).

Once the employer contribution is determined, the plan may

allocate it to individual participants in a number of ways (table

159). The most common way is as a proportion of salary.

Other allocation methods include formulas based on both

earnings and service, participants’ contributions as a proportion of total contributions, and equal allocations to all participants. Plan features, such as loans and withdrawals from

employee accounts, are available to participants in deferred

profit-sharing plans less commonly than to those in savings

and thrift plans (table 160).

Deferred profit-sharing plans may allow employees to

contribute to their plan as a means of increasing the value of

their account. However, it is infrequent that employees are

required to contribute to such plans. Plans frequently give

employees only limited opportunities to make investment

choices. Plan participation and vesting requirements tend to

be similar to those in saving and thrift plans (tables 161-162).

Money purchase pension plans

Another type of defined contribution plan, available to a

small percent of full-time employees in medium and large

private establishments, is a money purchase pension plan.

These plans accumulate funds through a fixed contribution to accounts set up for each employee. Normally, employer

contributions are a percent of an employee’s salary, such as 3

percent per year. These contributions, plus earnings, are available at retirement. In general, employee contributions are

neither required nor allowed, employees do not participate in

investment decisions, and accounts may not be accessed by

either withdrawal or loan__prior to retirement.

These plans are referred to as pension plans because they

often provide a periodic payment to employees at retirement.

This is accomplished by using the funds accumulated in each

employee’s account to purchase an annuity__often from an

insurance company__that guarantees a periodic payment for

life. Other payment arrangements may be available, including a lump sum or installments.

Stock plans

Two types of stock plans are found in the defined contribution plans__stock bonus plans and employee stock ownership plans.35 A stock bonus plan specifies employer or employee and employer contributions to a trust fund that invests

in various securities. Employee stock ownership plans, however, are generally entirely employer financed and must be

designed to invest primarily in company stock. ESOP’s may

be used as the means by which employees purchase their own

company, with stock distributed to individual employee accounts periodically as loans used to finance the purchase are

repaid.

Both types of stock plans make benefit distributions in

either company stock or cash. Stock plans are not usually

found among full-time employees in medium and large

private establishments.

Cash or deferred arrangements

Plans with a cash or deferred arrangement enroll many employees within the scope of the survey.36 These arrangements,

also known as 401 (k) plans, allow participants to choose between receiving currently taxable income or deferring taxation by placing the money in a retirement account. Cash or

deferred arrangements usually take the form of either salary

reduction plans or deferrals of profit-sharing allocations.

Salary reduction plans allow employees to contribute a part

of their earnings to a retirement plan, and defer income taxes

on those contributions and their earnings until distribution

(table 163). Such contributions are referred to as “employee

elective deferrals” or “pretax contributions.”

Salary reduction features, more common among white-collar employees than among blue-collar employees, are available through several types of defined contribution plans. The

most common salary reduction mechanism is a savings and

thrift plan. Other such mechanisms usually call for salary

reduction contributions through a profit-sharing plan or a freestanding plan, that is, a plan set up for employee salary

Defined Contribution Plans

121
reduction with no employer contribution.

Deferrals of profit-sharing allocations give employees the

choice of receiving an employer’s profit-sharing contribution

immediately in cash, or deferring the contribution and postponing taxation until distribution. Such arrangements are infrequent.

In addition to data on provisions of individual defined contribution plans, information is also available on the provisions of 401(k) salary reduction plans that include employer

contributions. Data on the following plan provisions appear

in tables 164-170:

• Plan participation requirements;

• Investment choices;

Defined Contribution Plans

• Vesting schedules;

• Transfer and rollover provision;

• Availability of withdrawals and loans; and

• Distributions at retirement.

The growth of 401(k) plans has helped to expand the defined contribution plan as a savings vehicle for retirement.

Unlike some defined contribution plans, 401(k) plans

normally require employee contributions as a condition of

participation and then require the employee to decide how

much pay to save. Finally, the participant must determine

where to invest the aggregated funds, including matching

employer contributions, to enhance retirement income.

30 Data taken from U.S. Department of Labor, Pension and Welfare

Benefits Administration, Private Pension Plan Bulletin, No. 6, Winter 1997. 31 Such withdrawals, while permitted by the plan, may trigger current income tax liability and tax penalties for the recipient.

32 Information was not collected on stock purchase and stock option plans

in the 1995 EBS. They are considered separate employee benefits rather

than defined contribution plans designed for retirement purposes.

33 For more information on savings and thrift contributions and benefits,

see Michael Bucci, “Contributions to Savings and Thrift Plans,” Monthly

Labor Review, November 1990, pp. 28-36.

34 Profit-sharing plans that pay all benefits directly to the participants in

cash are not considered defined contribution plans; they are reported in

chapter 1.

35 Stock purchase plans and stock option plans are considered separate

employee benefits. Currently, they are not being studied.

36 For 401(k) plans with no employer contribution, participants are those

workers actually making pretax contributions. For other plans, participants

are those workers in plans offering cash or deferred arrangements, whether

or not workers actually made pretax contributions.

—ENDNOTES—

122
Table 135. Savings and thrift plans: Summary of provisions,

full-time employees, medium and large private establishments,

1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Pre-tax contributions

allowed1 .......................... 90 92 89 91

Transfer/rollover

contributions allowed ...... 37 43 42 28

Employee choice of

investments for employee

contributions ................... 74 79 77 68

Employee choice of

investments for employer

contributions ................... 58 64 56 53

Immediate full vesting ........... 33 33 31 33

Loans permitted .................... 44 46 48 40

Withdrawals permitted .......... 43 46 50 35

1 Participants in savings and thrift plans usually are allowed to make

pretax contributions. In the 1995 survey, provisions governing pretax

contributions were not determinable for about one-tenth of the employees

with savings and thrift plans. 

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 136. Savings and thrift plans: Transfer and rollover

provisions,1 full-time employees, medium and large private

establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Transfers/rollovers allowed ... 37 43 42 28

Transfers/rollovers not

allowed ........................... 48 45 44 54

Not determinable .................. 15 13 13 17

1 Relates to the allowance of transfers/rollovers of contributions and

earnings from the previous employer’s plan.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 137. Savings and thrift plans: Maximum employee

contributions,1 full-time employees, medium and large private

establishments, 1995

Maximum employee

contributions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Percent of employee

earnings .......................... 83 84 85 80

5 percent or less ............... 2 1 2 3

6 percent ........................... 2 2 3 1

7 percent ........................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

8 percent ........................... 2 3 1 1

9 percent ........................... 1 1 1 1

10 percent ......................... 10 5 10 14

11 percent ......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

12 percent ......................... 10 10 6 12

13 percent ......................... 1 2 1 1

14 percent ......................... 2 1 1 2

15 percent ......................... 21 19 26 18

16 percent ......................... 18 18 21 15

17 percent ......................... 3 3 3 4

17.01 - 17.99 percent ....... 2 ( ) 2 ( ) 2 ( ) 2 ( )

18 percent ......................... 4 5 4 3

18.01 - 18.99 percent ....... 2 ( ) 2 ( ) - 2 ( )

19 percent ......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

20 percent ......................... 5 7 4 4

20.01 - 24.99 percent ....... 2 ( ) 2 ( ) 2 ( ) 2 ( )

25 percent or more ........... 1 4 2 ( ) 2 ( )

Specified dollar amount ........ 1 2 ( ) 2 ( ) 1

Up to the Internal Revenue

Code limit ........................ 14 14 11 16

Not determinable .................. 3 2 4 3

Average3

Average maximum contribution

(percent of earnings) .......... 14.3 15.2 14.2 13.6

1 Includes contributions that are not matched by the employer. If

maximum contributions vary, such as by length of service, the highest

possible contribution was tabulated. 2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 138. Savings and thrift plans: Method of determining

pretax contribution, full-time employees, medium and large

private establishments, 1995

Pretax contributions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Pretax contributions allowed 90 92 89 91

All contributions must be

pretax .......................... 52 48 50 58

All contributions may be

pretax .......................... 26 31 23 24

Contributions up to

specified percent may

be pretax ..................... 6 9 5 4

Initial contributions must

be pretax; additional

contributions can not

be pretax ..................... 5 2 10 4

Initial contributions must

be pretax; all additional

contributions may be

pretax .......................... 1 1 1 1

Initial contributions must

be pretax; additional

contributions up to a

specified percent may

be pretax ..................... 1 ( ) 1 ( ) 1 ( ) 1 ( )

Other ................................. 1 ( ) - 1 ( ) -

No pretax contributions

allowed ........................... 1 1 ( ) 2 1 ( )

Not determinable .................. 9 8 10 9

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 139. Savings and thrift plans: Maximum pretax

employee contributions,1 full-time employees, medium and

large private establishments, 1995

Maximum pretax contributions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans that

allow pretax contributions ... 12,267 4,303 3,359 4,605

Percent

Total with savings and thrift

plans that allow pretax

contributions ....................... 100 100 100 100

Percent of employee

earnings .......................... 84 85 86 81

5 percent or less ............... 3 2 2 3

6 percent ........................... 4 3 10 2

7 percent ........................... 2 ( ) 1 1 2 ( )

8 percent ........................... 4 5 5 3

9 percent ........................... 1 1 1 1

9.01 - 9.99 percent ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

10 percent ......................... 12 8 12 16

11 percent ......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

12 percent ......................... 10 11 5 13

13 percent ......................... 2 2 1 2

14 percent ......................... 2 2 1 3

15 percent ......................... 22 19 28 20

16 percent ......................... 14 16 12 13

17 percent ......................... 2 ( ) 2 ( ) 1 2 ( )

17.01 - 17.99 percent ....... 2 ( ) 2 ( ) 2 ( ) 2 ( )

18 percent ......................... 3 5 3 2

18.01 - 18.99 percent ....... 2 ( ) 2 ( ) - 2 ( )

19 percent ......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

20 percent ......................... 5 10 3 2

25 percent or more ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Specified dollar amount ........ 1 2 ( ) 2 ( ) 1

Up to the Internal Revenue

Code limit ........................ 15 15 11 18

Not determinable .................. 1 2 ( ) 2 2 ( )

Average3

Average maximum pretax

contribution (percent of

earnings .............................. 13.2 14.0 12.6 12.9

1 Includes contributions that are not matched by the employer. If

maximum contributions vary, such as by length of service, the highest

possible contribution was tabulated. 2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 140. Savings and thrift plans: Methods of employer

matching contributions, full-time employees, medium and

large private establishments, 1995

Employer matching rates

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Specified matching percent1 84 81 84 88

Varies by service .................. 4 7 4 3

Varies by amount of

contribution ..................... 9 10 9 7

Varies by investment choice 1 2 ( ) 2 ( ) 1

Varies by profit level ............. 2 2 3 1

1 These are plans where the employer matches a specified percent of

employee contributions. For example, the employer matches 50 percent of

employee earnings up to 6 percent. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 141. Savings and thrift plans: Employee contributions by

employer specified matching percentage, full-time employees, medium

and large private establishments, 1995

Employee contribution1 Total2

Specified matching percentage

1 - 49

percent

50

percent

51 - 99

percent

100

percent

Percent

All employees

Total ...................................... 100 22 45 14 17

Up to the first:

0.01 - 2.00 percent ....... 6 1 3 3 ( ) 2

2.01 - 3.00 percent ....... 13 2 4 3 ( ) 6

3.01 - 4.00 percent ....... 11 5 4 3 ( ) 2

4.01 - 5.00 percent ....... 103322

5.01 - 6.00 percent ....... 47 8 27 8 4

6.01 - 7.00 percent ....... 1 - 3 ( ) 3 ( ) 3 ( )

7.01 - 8.00 percent ....... 7133 3 ( )

8.01 - 9.00 percent ....... 3 ( ) - 3 ( ) - 3 ( )

9.01 - 10.00 percent ..... 3111 3 ( )

11.01 - 12.00 percent ... 3 ( ) - 3 ( ) - -

Greater than 12 percent 1 1 3 ( ) - -

Professional, technical, and

related

Total ...................................... 100 18 47 16 16

Up to the first:

0.01 - 2.00 percent ....... 4 1 1 3 ( ) 2

2.01 - 3.00 percent ....... 15 2 5 3 ( ) 6

3.01 - 4.00 percent ....... 8 2 3 3 ( ) 2

4.01 - 5.00 percent ....... 102322

5.01 - 6.00 percent ....... 46 9 27 7 2

6.01 - 7.00 percent ....... 1 - 1 3 ( ) 3 ( )

7.01 - 8.00 percent ....... 12 3 ( ) 6 5 3 ( )

8.01 - 9.00 percent ....... 3 ( ) - 3 ( ) - 3 ( )

9.01 - 10.00 percent ..... 2 3 ( ) 1 1 3 ( )

11.01 - 12.00 percent ... 3 ( ) - 3 ( ) - -

Greater than 12 percent 1 1 - - -

Clerical and sales

Total ...................................... 100 19 42 14 24

Up to the first:

0.01 - 2.00 percent ....... 5 3 ( ) 2 3 ( ) 3

2.01 - 3.00 percent ....... 12 3 3 3 ( ) 6

3.01 - 4.00 percent ....... 10 4 3 3 ( ) 3

4.01 - 5.00 percent ....... 114312

5.01 - 6.00 percent ....... 54 6 28 10 9

6.01 - 7.00 percent ....... 1 - 3 ( ) 3 ( ) 3 ( )

7.01 - 8.00 percent ....... 3111 3 ( )

8.01 - 9.00 percent ....... 3 ( ) - 3 ( ) - 3 ( )

9.01 - 10.00 percent ..... 3111 3 ( )

Greater than 12 percent 3 ( ) 3 ( ) - - -

See footnotes at end of table.
Table 141. Savings and thrift plans: Employee contributions by

employer specified matching percentage, full-time employees, medium

and large private establishments, 1995 — Continued

Employee contribution1 Total2

Specified matching percentage

1 - 49

percent

50

percent

51 - 99

percent

100

percent

Percent

Blue collar and service

Total ...................................... 100 28 47 13 12

Up to the first:

0.01 - 2.00 percent ....... 8 1 5 3 ( ) 2

2.01 - 3.00 percent ....... 13 3 3 3 ( ) 6

3.01 - 4.00 percent ....... 14 8 5 3 ( ) 1

4.01 - 5.00 percent ....... 92421

5.01 - 6.00 percent ....... 43 8 27 6 2

6.01 - 7.00 percent ....... 3 ( ) - 3 ( ) 3 ( ) 3 ( )

7.01 - 8.00 percent ....... 6 3 2 2-

8.01 - 9.00 percent ....... 3 ( ) - 3 ( ) - 3 ( )

9.01 - 10.00 percent ..... 4 3 3 ( ) 1 3 ( )

Greater than 12 percent 1 1 3 ( ) - -

1 Employee may contribute a percent of salary up to a specified maximum; ceilings

on contributions to be matched by employers generally are lower. 2 Total includes workers with an employer matching percentage of greater than 100

percent, but those matching percentages are not presented separately. 3 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category.
Table 142. Savings and thrift plans: Discretionary

profit-sharing contributions,1 full-time employees, medium and

large private establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

With discretionary

profit-sharing

contributions ................... 13 11 15 14

No discretionary

profit-sharing

contributions ................... 77 79 77 75

Not determinable .................. 10 10 8 11

1 Employer contributions in addition to matching funds, provided at

employer discretion based on profitability.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 143. Savings and thrift plans: Investment choices, full-time employees, medium and large private establishments,

1995

Investment choices

All employees

Professional,

technical, and

related employees

Clerical and sales

employees

Blue-collar and

service employees

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Number (in thousands) with

savings and thrift plans ....... 13,562 13,562 4,702 4,702 3,788 3,788 5,072 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100 100 100 100 100

Employee permitted to

choose investments ........ 74 58 79 64 77 56 68 53

Two choices ...................... 3 3 2 2 3 3 5 5

Three choices ................... 13 10 13 12 14 10 12 9

Four choices ..................... 21 13 19 12 26 15 20 12

Five choices ...................... 11 10 17 16 11 12 5 4

Six choices ....................... 5 4 4 3 6 5 5 5

Seven choices .................. 5 5 6 6 5 3 5 5

Eight choices .................... 7 7 7 7 4 4 11 11

Nine choices ..................... 1 ( ) 1 ( ) 1 1 1 ( ) 1 ( ) 1 ( ) 1 ( )

Ten choices ...................... 4 2 5 2 3 1 3 2

More than ten choices ...... 4 3 5 4 6 4 2 1

Employee not permitted to

choose investments ........ 7 24 5 19 6 27 10 25

Not determinable .................. 18 18 16 16 17 17 22 22

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category.
Table 144. Savings and thrift plans: Types of investments allowed in plans permitting employees to choose investments,

full-time employees, medium and large private establishments, 1995

Investment

All employees

Professional,

technical, and

related employees

Clerical and sales

employees

Blue-collar and

service employees

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Number (in thousands) with

savings and thrift plans ....... 13,562 13,562 4,702 4,702 3,788 3,788 5,072 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100 100 100 100 100

Total with employee

investment choice

allowed ........................... 74 58 79 64 77 56 68 53

Company stock ................. 40 27 42 29 40 25 39 27

Common stock fund .......... 59 48 64 55 60 47 53 42

Long-term interest bearing

securities .................... 48 36 54 43 50 36 40 31

Diversified stock and bond

fund ............................. 41 31 47 38 43 31 33 25

Government securities ...... 17 13 19 15 11 8 19 15

Guaranteed investment

contracts ..................... 25 20 24 21 22 16 28 23

Money market funds ......... 30 25 34 29 22 18 32 28

Certificates of deposit ....... 4 2 5 1 5 3 3 1

Other1 ............................... 19 15 19 15 18 14 19 16

Deteriminable by trustee ... 2 ( ) - 2 ( ) - 2 ( ) - 2 ( ) -

Not determinable .............. 5 4 5 4 6 4 4 4

Investment choice not

allowed ........................... 7 24 5 19 6 27 10 25

Investment choice not

determinable ................... 18 18 16 16 17 17 22 22

1 Includes purchase of life insurance, annuities, real estate,

mortgage, and deposits in credit unions or savings accounts. 2 Less than 0.5 percent.

NOTE: Sums of individual items do not equal totals because employees

are often offered a number of investment choices. Where applicable,

dash indicates no employees in this category.
Table 145. Savings and thrift plans: Method of allocating contributions to investment options, full-time employees,

medium and large private establishments, 1995

Item

All employees

Professional,

technical, and

related employees

Clerical and sales

employees

Blue-collar and

service employees

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Number (in thousands) with

savings and thrift plans ...... 13,562 13,562 4,702 4,702 3,788 3,788 5,072 5,072

Percent

Total with savings and thrift

plans .................................. 100 100 100 100 100 100 100 100

Total with employee

investment choice

allowed ........................... 74 58 79 64 77 56 68 53

Any multiple ...................... 34 27 38 31 35 23 31 26

Specified multiples ............ 35 26 38 29 37 27 32 21

Other ................................. 1 2 1 1 1 2 2 2

Not determinable .............. 4 4 3 3 4 4 4 4

Investment choice not

allowed ........................... 7 24 5 19 6 27 10 25

Investment choice not

determinable ................... 18 18 16 16 17 17 22 22

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category.
Table 146. Savings and thrift plans: Frequency of investment changes, full-time employees, medium and large private

establishments, 1995

Item

All employees

Professional,

technical, and

related employees

Clerical and sales

employees

Blue-collar and

service employees

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Number (in thousands) with

savings and thrift plans ....... 13,562 13,562 4,702 4,702 3,788 3,788 5,072 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100 100 100 100 100

Total with employee

investment choice

allowed ........................... 74 58 79 64 77 56 68 53

At any time ........................ 38 32 43 37 34 25 37 32

Specified number of times

per year ...................... 31 21 32 23 38 27 25 15

One ............................... 3 2 4 3 3 2 3 2

Two ............................... 7 5 9 6 6 4 5 5

Three ............................ 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 ( )

Four .............................. 13 10 12 9 18 15 10 6

Five or more ................. 8 4 7 5 11 6 7 2

Other ................................. 1 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 1 ( )

Never ................................ - 1 ( ) - 1 ( ) - 1 - 1 ( )

Not determinable .............. 5 5 4 4 5 4 5 6

Investment choice not

allowed ........................... 7 24 5 19 6 27 10 25

Investment choice not

determinable ................... 18 18 16 16 17 17 22 22

1 Less than 0.5 percent. NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this category.
Table 147. Savings and thrift plans: Withdrawal availability,

full-time employees, medium and large private establishments,

1995

Withdrawal provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Withdrawals permitted .......... 43 46 50 35

Any reason ....................... 16 19 20 9

Hardship reasons only1 .... 28 27 30 27

Withdrawals not permitted .... 43 41 36 49

Not determinable .................. 14 13 14 15

1 Hardship reasons may include death or illness of a family member,

education expenses, sudden uninsured losses, or purchase of a primary

residence.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 148. Savings and thrift plans: Withdrawal requirements

in plans permitting withdrawals, full-time employees, medium

and large private establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans with

withdrawals permitted ......... 5,883 2,183 1,902 1,799

Percent

Total with savings and thrift

plans with withdrawals

permitted ............................. 100 100 100 100

At any time ............................ 41 38 44 40

After meeting an age and/or

service requirement ........ 9 13 7 5

Once per time period ............ 32 32 28 34

Other limit ............................. 9 7 15 5

Not determinable .................. 10 9 7 16

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 149. Savings and thrift plans: Maximum amount that

may be withdrawn in plans permitting withdrawals, full-time

employees, medium and large private establishments, 1995

Maximum amount of

withdrawal

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans with

withdrawals permitted ......... 5,883 2,183 1,902 1,799

Percent

Total with savings and thrift

plans with withdrawals

permitted ............................. 100 100 100 100

Full account balance ............. 53 55 66 38

Partial account balance ........ 38 37 26 51

Not determinable .................. 9 8 7 11

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 150. Savings and thrift plans: Penalties imposed upon

withdrawal of funds in plans permitting withdrawals, full-time

employees, medium and large private establishments, 1995

Penalties for withdrawals

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans with

withdrawals permitted ......... 5,883 2,183 1,902 1,799

Percent

Total with savings and thrift

plans with withdrawals

permitted ............................. 100 100 100 100

With penalty .......................... 44 40 49 43

Employer contributions

suspended .................. 21 22 23 18

All contributions

suspended .................. 18 13 21 19

Other ................................. 5 4 5 6

No penalty ............................ 44 50 44 38

Not determinable .................. 12 10 6 20

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 151. Savings and thrift plans: Loan availability, full-time

employees, medium and large private establishments, 1995

Loan availability

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Loans permitted .................... 44 46 48 40

Any reason ....................... 41 44 43 37

Hardship reasons only1 .... 3 3 5 2

Loans not permitted .............. 42 41 38 45

Not determinable .................. 14 13 14 15

1 Hardship reasons may include death or illness of a family member,

education expenses, sudden uninsured losses, or purchase of a primary

residence.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 152. Savings and thrift plans: Loan requirements in

plans permitting loans, full-time employees, medium and large

private establishments, 1995

Loan provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans with

loans permitted ................... 6,003 2,182 1,816 2,004

Percent

Total with savings and thrift

plans with loans permitted .. 100 100 100 100

At any time ............................ 57 54 51 65

After meeting an age/or

service requirement ........ 2 1 3 2

Once per time period ............ 36 40 38 31

Other limit ............................. 3 4 5 2

Not determinable .................. 2 2 3 1

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 153. Savings and thrift plans: Maximum amount that

may be borrowed in plans permitting loans, full-time

employees, medium and large private establishments, 1995

Loan provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans with

loans permitted ................... 6,003 2,182 1,816 2,004

Percent

Total with savings and thrift

plans with loans permitted .. 100 100 100 100

Full account balance

available ......................... 5 4 8 5

Partial account balance

available ......................... 91 94 89 90

Not determinable .................. 4 3 4 5

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 154. Savings and thrift plans: Repayment provisions in

plans permitting loans, full-time employees, medium and large

private establishments, 1995

Repayment provisions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans with

loans permitted ................... 6,003 2,182 1,816 2,004

Percent

Total with savings and thrift

plans with loans permitted .. 100 100 100 100

Repayment after specified

period .............................. 80 82 81 78

For purchase of a home1 .. 43 51 39 37

Less than 15 years ....... 16 12 20 16

15 years ........................ 13 17 11 12

20 years ........................ 6 11 3 2

25 years ........................ 5 7 2 4

Greater than 25 years ... 1 1 2 1

Not determinable .......... 3 3 2 3

For any reason ................. 38 30 43 41

Less than 5 years ......... 17 11 16 23

5 years .......................... 21 19 27 17

Greater than 5 years

and less than 10

years ....................... 2 ( ) - 2 ( ) 1

At discretion of plan

administrators ................. 4 3 3 5

Other ..................................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Not determinable .................. 15 15 15 16

1 Plan specifies longer repayment period for purchase of a home than for

other reasons. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 155. Savings and thrift plans: Methods of distribution,

full-time employees, medium and large private establishments,

1995

Methods of distribution1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

Lump sum ............................. 85 87 84 83

Annuity .................................. 17 18 15 18

Installments .......................... 30 32 24 32

Other ..................................... 2 3 3 1

Not determinable .................. 7 7 8 7

1 Sums of individual items may exceed totals because plans frequently

permit more than one distribution option.

NOTE: Where applicable, dash indicates no employees in this category.
Table 156. Savings and thrift plans: Service requirements1,

full-time employees, medium and large private establishments,

1995

Eligibility requirements2

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with savings and thrift

plans ................................... 100 100 100 100

With minimum service

requirement .................... 67 61 80 62

3 months ........................... 3 5 2 1

6 months ........................... 8 5 7 10

7 - 11 months .................... 3 ( ) 3 ( ) - 3 ( )

1 year ................................ 55 49 68 49

2 years .............................. 2 2 2 1

3 years .............................. 3 ( ) 3 ( ) 3 ( ) 3 ( )

No minimum service

requirement .................... 26 32 15 29

Not determinable .................. 7 7 5 9

Average4

Average service requirement (in

months) ............................... 11.3 11.2 11.5 11.2

1 In many of these plans, there is also an age requirement. For example,

some plans have participation requirements of age 21 and 12 months of

service. This table’s eligibility requirements are based on when the employee

can first join the plan, not when the employer first begins contributing. In past

surveys the eligibility requirements were based on when the employer first

contributes to the plan. Thus this table is not strictly comparable to the same

table from past surveys. 2 If a plan had alternate eligibility requirements, one of which was service

only, the service only requirement was tabulated. 3 Less than 0.5 percent. 4 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 157. Savings and thrift plans: Vesting provisions,

full-time employees, medium and large private establishments,

1995

Vesting provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

savings and thrift plans ....... 13,562 4,702 3,788 5,072

Percent

Total with with savings and thrift

plans ................................... 100 100 100 100

Immediate full vesting ........... 33 33 31 33

Cliff vesting1 ......................... 25 26 24 24

With full vesting after:

1 -2 years ...................... 1 1 1 2

3 - 4 years ..................... 5 5 9 3

5 years .......................... 18 20 14 18

More than 5 years ......... 2 ( ) 2 ( ) 2 ( ) 1

Graduated vesting3 ............... 24 24 27 22

With full vesting after:

4 years or less .............. 3 2 4 4

5 years .......................... 12 14 16 9

6 years .......................... 3 4 3 2

7 years .......................... 5 5 4 7

10 years ........................ 2 ( ) 2 ( ) - 2 ( )

Class years vesting4 ............. 2 2 1 2

With each class vested

after:

1 year ............................ 2 ( ) 2 ( ) 2 ( ) 1

2 years .......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

3 years .......................... 1 2 2 ( ) 1

More than 3 years ......... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Other ..................................... 1 2 ( ) 2 1

Not determinable .................. 15 13 15 18

1 Under cliff vesting, an employee is not entitled to any benefits until

satisfying requirements for 100 percent vesting. 2 Less than 0.5 percent. 3 Under graduated vesting, an employee’s rights to benefits increase

 with length of service, eventually reaching 100 percent. 4 Under class year vesting, employee contributions for a given year

(class) become nonforfeitable after meeting vesting requirements. 

Subsequent contributions must meet similar requirements.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 158. Deferred profit-sharing plans: Employer

contributions, full-time employees, medium and large private

establishments, 1995

Employer contributions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

deferred profit-sharing plans 4,205 1,306 1,235 1,664

Percent

Total with deferred

profit-sharing plans ............. 100 100 100 100

Based on stated formula ....... 62 59 49 73

Fixed percent of profits ..... 24 30 16 25

Based on unit profitability 4 4 5 3

Fixed percent of profits in

excess of reserved

amount ........................ 4 4 4 5

Sliding percentage based

on profits, sales, or

return on assets .......... 21 14 15 31

Other stated formula ......... 8 7 9 9

No predetermined formula .... 31 36 41 19

Not determinable .................. 8 6 10 7

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 159. Deferred profit-sharing plans: Allocation of

employer contributions to individual employee accounts,

full-time employees, medium and large private establishments,

1995

Allocation of employer

contributions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

deferred profit-sharing plans 4,205 1,306 1,235 1,664

Percent

Total with deferred

profit-sharing plans ............. 100 100 100 100

Equally to all participants ...... 6 3 5 9

Proportional to earnings ....... 56 61 46 61

Proportional to employee

contributions ................... 17 18 20 14

Based on earnings and

service ............................ 7 8 5 7

Based on earnings and unit

performance ................... 1 ( ) 1 ( ) 1 ( ) -

Other allocation formula ....... 3 1 6 3

Allocation formula not

available ......................... 11 10 18 5

Employee permitted to

receive part of allocation

in cash ............................ 15 14 10 19

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 160. Deferred profit sharing plans: Selected plan

features, full-time employees, medium and large private

establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

deferred profit sharing plans 4,205 1,306 1,235 1,664

Percent

Total with deferred profit

sharing plans ...................... 100 100 100 100

Loans permitted .................... 33 38 28 34

Withdrawals permitted .......... 24 16 30 25

Employee contributions

required .......................... 6 6 12 2

Employee contribution not

required but allowed ....... 36 29 27 47

Pretax contributions allowed 38 30 40 43

Employee permitted to

choose investments ........ 55 63 50 54

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 161. Deferred profit-sharing: Service requirements1,

full-time employees, medium and large private establishments,

1995

Eligibility requirements2

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

deferred profit-sharing plans 4,205 1,306 1,235 1,664

Percent

Total with deferred

profit-sharing plans ............. 100 100 100 100

With minimum service

requirement .................... 76 84 78 67

3 months ........................... 2 2 1 4

6 months ........................... 6 9 2 7

1 year ................................ 59 66 72 45

2 years .............................. 7 7 3 10

3 years .............................. 1 3 ( ) 1 1

No minimum service

requirement .................... 24 16 21 33

Not determinable .................. 3 ( ) 3 ( ) 3 ( ) -

Average4

Average service requirement (in

months) ............................... 12.5 12.1 12.5 13.0

1 In many of these plans, there is also an age requirement. For example,

some plans have participation requirements of age 21 and 12 months of

service. This table’s eligibility requirements are based on when the employee

can first join the plan, not when the employer first begins contributing. In past

surveys the eligibility requirements were based on when the employer first

contributes to the plan. Thus this table is not strictly comparable to the same

table from past surveys. 2 If a plan had alternate eligibility requirements, one of which was service

only, the service only requirement was tabulated. 3 Less than 0.5 percent. 4 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 162. Deferred profit-sharing plans: Vesting provisions,

full-time employees, medium and large private establishments,

1995

Vesting provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

deferred profit-sharing plans 4,205 1,306 1,235 1,664

Percent

Total with deferred

profit-sharing plans ............. 100 100 100 100

Immediate full vesting ........... 37 30 31 49

Cliff vesting1 ......................... 22 30 24 14

With full vesting after:

1 -2 years ...................... 2 5 2 -

3 - 4 years ..................... 2 5 1 1

5 years .......................... 17 20 20 13

More than 5 years ......... 2 ( ) 2 ( ) 2 ( ) 1

Graduated vesting3 ............... 34 35 41 28

With full vesting after:

4 years or less .............. 1 1 1 2

5 years .......................... 4 2 11 1

6 years .......................... 10 14 15 2

7 years .......................... 18 18 13 21

More than 10 years ....... 1 - 2 ( ) 2

Other ..................................... 2 ( ) 2 ( ) - 2 ( )

Not determinable .................. 6 6 4 8

1 Under cliff vesting, an employee is not entitled to any benefits until

satisfying requirements for 100 percent vesting. 2 Less than 0.5 percent. 3 Under graduated vesting, an employee’s rights to benefits increase

 with length of service, eventually reaching 100 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 163. 401(k) salary reduction plans: Maximum pretax

employee contributions,1 full-time employees, medium and

large private establishments, 1995

Maximum pretax contributions

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 5,056 3,979 5,611

Percent

Total with 401(k) pretax salary

reduction plans ................... 100 100 100 100

Percent of employee

earnings .......................... 83 83 85 81

5 percent or less ............... 4 3 4 3

5.01 - 5.99 percent ........... 2 ( ) 2 ( ) - -

6 percent ........................... 4 2 10 2

7 percent ........................... 2 ( ) 2 ( ) 1 2 ( )

8 percent ........................... 5 5 5 5

9 percent ........................... 1 1 1 1

9.01 - 9.99 percent ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

10 percent ......................... 12 9 12 15

11 percent ......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

12 percent ......................... 10 11 5 12

13 percent ......................... 1 2 1 1

13.01 - 13.99 percent ....... 2 ( ) 2 ( ) - 2 ( )

14 percent ......................... 2 2 1 2

15 percent ......................... 20 17 26 19

16 percent ......................... 12 14 10 11

17 percent ......................... 1 1 3 1

17.01 - 17.99 percent ....... 2 ( ) 2 ( ) 2 ( ) 2 ( )

18 percent ......................... 6 6 4 7

18.01 - 18.99 percent ....... 2 ( ) 2 ( ) - 2 ( )

19 percent ......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

20 percent ......................... 5 9 2 2

25 percent or more ........... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Specified dollar amount ........ 1 2 ( ) 2 ( ) 1

Up to the Internal Revenue

Code limit ........................ 16 16 12 17

Not determinable .................. 1 1 3 2 ( )

Average3

Average maximum pretax

contribution (percent of

earnings) ............................. 13.1 13.7 12.4 13.0

1 Includes contributions that are not matched by the employer. If

maximum contributions vary, such as by length of service, the highest

possible contribution was tabulated. 2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 164. 401(k) salary reduction plans: Service

requirements,1 full-time employees, medium and large private

establishments, 1995

Eligibility requirements2

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 5,056 3,979 5,611

Percent

Total with 401(k) salary

reduction plans ................... 100 100 100 100

With minimum service

requirement .................... 67 63 82 61

3 months ........................... 3 4 2 2

6 months ........................... 8 6 7 10

7 - 11 months .................... 3 ( ) 3 ( ) - 3 ( )

1 year ................................ 52 48 69 44

2 years .............................. 3 3 3 4

3 years .............................. 1 1 1 1

Over 3 years ..................... 3 ( ) 3 ( ) 3 ( ) -

No minimum service

requirement .................... 27 32 16 32

Not determinable .................. 5 5 3 7

Average4

Average service requirement (in

months) ............................... 11.8 11.9 11.8 11.8

1 In many of these plans, there is also an age requirement. For example,

some plans have participation requirements of age 21 and 12 months of

service. This table’s eligibility requirements are based on when the employee

can first join the plan, not when the employer first begins contributing. In past

surveys the eligibility requirements were based on when the employer first

contributes to the plan. Thus this table is not strictly comparable to the same

table from past surveys. 2 If a plan had alternate eligibility requirements, one of which was service

only, the service only requirement was tabulated. 3 Less than 0.5 percent. 4 The averages are presented for all covered workers; averages exclude

workers without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 165. 401(k) salary reduction plans: Investment choices, full-time employees, medium and large private

establishments, 1995

Investment choices for

employer contributions

All employees

Professional,

technical, and

related employees

Clerical and sales

employees

Blue-collar and

service employees

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Employee

contributions

Employer

contributions

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 14,646 5,056 5,056 3,979 3,979 5,611 5,611

Percent

Total with 401(k) salary

reduction plans ................... 100 100 100 100 100 100 100 100

Employee permitted to

choose investments ........ 83 64 87 70 85 62 77 61

Two choices ...................... 4 3 4 2 3 3 5 4

Three choices ................... 15 11 14 12 19 13 13 9

Four choices ..................... 26 16 23 14 27 17 29 17

Five choices ...................... 11 13 19 18 11 12 5 8

Six choices ....................... 6 5 5 5 7 6 5 5

More than six choices ....... 20 17 23 19 17 12 20 18

Employee not permitted to

choose investments ........ 8 26 5 22 7 31 11 27

Not determinable .................. 9 9 8 8 7 7 11 11

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category. 

 
Table 166. 401(k) salary reduction plans: Vesting provisions,

full-time employees, medium and large private establishments,

1995

Vesting provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 5,056 3,979 5,611

Percent

Total with 401(k) salary

reduction plans ................... 100 100 100 100

Immediate full vesting ........... 39 40 35 41

Cliff vesting1 ......................... 24 26 23 23

With full vesting after:

1 -2 years ...................... 1 1 1 2

3 - 4 years ..................... 5 4 9 3

5 years .......................... 17 20 13 17

More than 5 years ......... 1 2 ( ) 2 ( ) 1

Graduated vesting3 ............... 27 26 32 24

With full vesting after:

4 years or less .............. 3 2 4 4

5 years .......................... 13 14 18 9

6 years .......................... 3 4 4 2

7 years .......................... 7 6 6 9

10 years ........................ 2 ( ) 2 ( ) - 2 ( )

Class years vesting4 ............. 2 2 1 2

With each class vested

after:

1 year ............................ 2 ( ) 2 ( ) 2 ( ) 1

2 years .......................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

3 years .......................... 1 1 2 ( ) 1

More than 3 years ......... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Other ..................................... 1 1 2 1

Not determinable .................. 7 5 7 9

1 Under cliff vesting, an employee is not entitled to any benefits until

satisfying requirements for 100 percent vesting. 2 Less than 0.5 percent. 3 Under graduated vesting, an employee’s rights to benefits increase

 with length of service, eventually reaching 100 percent. 4 Under class year vesting, employee contributions for a given year

(class) become nonforfeitable after meeting vesting requirements. 

Subsequent contributions must meet similar requirements.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 167. 401(k) salary reduction plans: Transfer and

rollover provisions,1 full-time employees, medium and large

private establishments, 1995

Item

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 5,056 3,979 5,611

Percent

Total with 401(k) salary

reduction plans ................... 100 100 100 100

Transfers/rollovers allowed ... 38 43 44 28

Transfers/rollovers not

allowed ........................... 52 50 48 57

Not determinable .................. 10 7 8 15

1 Relates to the allowance of transfers/rollovers of contributions and

earnings from the previous employer’s plan.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 168. 401(k) salary reduction plans: Withdrawal

availability, full-time employees, medium and large private

establishments, 1995

Withdrawal provision

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 5,056 3,979 5,611

Percent

Total with 401(k) salary

reduction plans ................... 100 100 100 100

Withdrawals permitted .......... 46 47 55 38

Any reason ....................... 16 19 23 9

Hardship reasons only1 .... 30 28 32 29

Withdrawals not permitted .... 49 48 40 56

Not determinable .................. 5 5 5 6

1 Hardship reasons may include death or illness of a family member,

education expenses, sudden uninsured losses, or purchase of a primary

residence.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 169. 401(k) salary reduction plans: Loan availability,

full-time employees, medium and large private establishments,

1995

Loan availability

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 5,056 3,979 5,611

Percent

Total with 401(k) salary

reduction plans ................... 100 100 100 100

Loans permitted .................... 49 49 52 46

Any reason ....................... 44 45 45 43

Hardship reasons only1 .... 4 4 7 3

Loans not permitted .............. 46 47 42 48

Not determinable .................. 5 5 5 6

1 Hardship reasons may include death or illness of a family member,

education expenses, sudden uninsured losses, or purchase of a primary

residence.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category.
Table 170. 401(k) salary reduction plans: Methods of

distribution, full-time employees, medium and large private

establishments, 1995

Methods of distribution1

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Number (in thousands) with

401(k) salary reduction

plans ................................... 14,646 5,056 3,979 5,611

Percent

Total with 401(k) salary

reduction plans ................... 100 100 100 100

Lump sum ............................. 92 95 90 90

Annuity .................................. 21 22 18 21

Installments .......................... 34 36 29 36

Other ..................................... 7 11 4 5

Not determinable .................. 9 7 8 11

1 Sums of individual items may exceed totals because plans frequently

permit more than one distribution option.

NOTE: Where applicable, dash indicates no employees in this category.
Employers have traditionally offered their workers

 benefit plans in a number of areas, such as medical

 care, life insurance, and retirement benefits. Employees can choose from among a number of plans in a given

benefit area. For example, an employee may chose between a

traditional fee-for-service medical plan and a health maintenance organization. In recent years, new approaches to offering benefits have emerged. BLS currently collects data on

flexible benefits plans and reimbursement accounts. Both

arrangements are governed by Internal Revenue Code section 125.37

Plans, also known as cafeteria plans, allow employees to

design individual benefit packages by choosing from among

several types of benefits. Over half of all full-time employees

in medium and large private establishments are offered these

plans (table 3). In a flexible benefits plan, employers provide

each worker with “benefits credits.” These credits may equal

a fixed dollar amount for each worker, or an amount that varies according to the employee’s earnings, length of service,

size of family, or other characteristics. The employee then

chooses from various benefits and benefit levels, using credits to purchase the desired benefits. If the credits are not sufficient to pay for the benefit, employees may have the option

to fund the difference with pretax contributions.

Several options are usually available in flexible benefits

plans, including various levels of life insurance, separate dental choices, participation in fee-for-service medical plans (with

varying deductibles and out-of-pocket maximums) or in alternative medical plans (such as health maintenance organizations and preferred provider organizations), varying levels

of accidental death and dismemberment insurance, and longterm disability insurance coverage. Employees covered by

flexible benefits plans may receive cash in place of benefits

or deposit unused credits into reimbursement accounts, a fund

from which employees pay for expenses not covered by their

regular benefits package. Or they may choose to purchase

short-term disability coverage, deposit credits in a 401(k) plan,

or buy and sell vacation days. Participants are often required

Chapter 8.

Flexible Benefits Plans and

Reimbursement Accounts

to purchase minimum levels of coverage, a basic level of life

insurance, for example.

Reimbursement accounts are offered to a significant

number of full-time employees in medium and large private

establishments. Coverage for this type of account is more

common among white-collar employees. These accounts are

also called flexible spending accounts. Reimbursement accounts are usually funded by employee pretax contributions,

although some accounts may be partially funded by employers. Reimbursement accounts may be part of a flexible benefits plan, or they may stand alone.

Many employees eligible for reimbursement accounts may

allocate funds for health care deductibles, coinsurances, and

the cost of services not covered by their medical care plan,

such as dental expenses and vision exams (table 171). Eligible employees often use money from these accounts to pay

for dependent care expenses, usually both child care and care

for elderly or disabled relatives. Reimbursement account funds

may also be used for the payment of the employees’ share of

health care premiums, and other insurance premiums, such

as life insurance or a spouse’s insurance premiums.

Some accounts, known as premium conversion plans, are

established to specifically allow medical plan participants to

pay required plan premiums with pretax dollars. Although

such arrangements differ from the usual reimbursement accounts, where employees are reimbursed with pretax money

after a payment is made, these arrangements meet the

Internal Revenue Code requirements for a section 125 plan.

Most employees participating in flexible benefits plans or

reimbursement accounts are required to contribute toward the

cost of their benefits, or are allowed to contribute to obtain

additional benefits. These contributions are usually made as

a salary reduction, which results in lower income tax liabilities.

Individual benefit plans offered through a flexible benefits

plan are included in the tabulations for specific benefit areas

in this bulletin.38

143
37 Previously, reimbursement accounts included separate accounts and those

under flexible plans. Also, premium conversion plans were reported as reimbursement accounts.

38 For information on flexible benefits plans in medium and large private

—ENDNOTES—

Results of the 1995 Survey

establishments, see Joseph R. Meisenheimer and William J. Wiatrowski, “

Flexible Benefits Plans: Employees Who Have a Choice,” Monthly Labor

Review, December 1989, pp. 17-23.

144
Table 171. Reimbursement accounts: Expenses covered,

full-time employees, medium and large private establishments,

1995

Expenses

All

employees

Professional,

technical,

and

related

employees

Clerical

and

sales

employees

Bluecollar

and

service

employees

Total eligible for reimbursement

accounts1 ............................ 12,686 4,976 3,738 3,972

Percent

Number (in thousands) eligible

for reimbursement accounts 100 100 100 100

Expenses known .................. 95 94 93 97

Health premiums .............. 56 52 54 63

Other health expenses ..... 78 79 74 81

Dependent care expenses 77 81 74 76

Legal expenses ................ 2 ( ) 2 ( ) 2 ( ) 2 ( )

Other Premiums ............... 10 11 7 11

Other ................................. 2 2 2 3

Expense not determinable .... 5 6 7 3

1 Total is less than the sum of individual items because many plans allow

funds to be used for multiple purposes. 2 Less than 0.5 percent.

NOTE: Where applicable, dash indicates no employees in this category.
This chapter presents data on the frequency of employee

benefits by region, major industry segment, union status, and part-time employment.

Data on employee benefits for full-time employees is presented in tables 172 and 173 for four regions: Northeast, South,

North Central, and West.39 In general, benefit plan incidence

varied little by region. Establishments in the Northeast employed about 7.1 million full-time workers, the South, 10.9

million, the North Central, 9.2 million, and the West, 6.2

million.

Overall, the occurrence of benefits provided to workers in

goods-producing industries was higher than that provided to

workers in service-producing industries. Service-producing

industries accounted for about three-fifths of those employed

full time in 1995.40 (See tables 174-177.)

Retirement benefits for union workers were usually provided in the form of defined benefit pension plans, whereas

for non-union workers they were normally provided in the

form of defined contribution plans. Twenty-three percent of

full-time employees in medium and large private establishments were covered by collective bargaining agreements.

Tables 178 and 179 show the incidence of employee benefits

for full-time workers by union status.41

Finally, tables 180 and 181 present incidence of benefits

for part-time workers in medium and large private establishments.42 Part-time workers within the scope of the Employee

Benefits Survey were far less likely to be covered by benefit

plans than full-time workers. Part-time workers account for

about one-sixth of the 40.2 million employees in medium and

large private establishments.

Region

The incidence of paid leave benefits usually varied little

by region. Life insurance benefits were slightly more prevalent in the Northeast and North Central regions. The incidence of other benefits, such as employee assistance programs,

educational assistance, and reimbursement accounts also varied little among regions.

Industry

The incidence of benefits provided to full-time workers in

goods-producing industries was usually higher than for those

in service-producing industries. Workers in service-producing industries were more likely to receive sick leave, while in

service-producing industries, short-term disability coverage

was much more common.

Chapter 9.

Benefits by Selected Characteristics

In the goods-producing industries, 84 percent of full-time

workers received medical care, 93 percent had life insurance,

and 86 percent were in retirement plans—in each case, a

slightly higher proportion of coverage than in service-producing industries. However, workers in service-producing

industries were more likely to have long-term disability insurance.

Union status

Workers covered by collective bargaining agreements were

more likely than those who were not to receive medical care

and retirement coverage. Sick leave and long-term disability

insurance were the only benefits nonunion workers were more

likely to receive. However, short-term disability coverage was

far more common among union employees.

About 9 in 10 union workers received medical care and

retirement benefits, a slightly greater incidence of coverage

than for nonunion workers. Nonunion workers, however, were

more commonly provided long-term disability insurance coverage.

The method for providing retirement income coverage varied considerably between union and nonunion workers. Union

workers were more likely to receive a defined benefit pension plan than nonunion workers (79 percent compared with

44 percent, respectively). However, 37 percent of union workers could avail themselves of defined contribution plans compared with 61 percent of nonunion workers.

Most other benefits, such as travel accident insurance and

Section 125 cafeteria benefits, were more likely to be available to nonunion employees than to union employees.

Part-time employees

Paid vacations and holidays were the most common benefits available to part-time workers; insurance protection was

much less common. Full-time employees in medium and large

private establishments were approximately twice as likely to

have retirement plans and unpaid family leave, and about four

times as likely as part-time employees to be covered by medical care and life insurance benefits.

Because of both the limited sample size and incidence of

benefits among part-time workers, plan provisions could not

be examined to the same extent as for full-time workers.

Paid time off was the most prevalent type of benefit program available to the part-time workforce. Almost one-half

of all part-time employees were eligible for paid vacations,

paid holidays, and paid jury duty leave. Paid time off was

146
commonly prorated based on the work schedule of the parttime employee. For example, an employee working 4 hours

per day would receive 4 hours of pay for each vacation day

granted.

Other types of leave were less common. Just under onefifth of part-time employees were eligible for paid sick leave.

Unpaid family leave was provided to 4 out of 10 part-time

workers.

Benefits by Selected Characteristics

39 Geographic regions are defined as follows: Northeast—Connecticut,

Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont; South—Alabama, Arkansas,

Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana,

Maryland, Mississippi, North Carolina, Oklahoma, South Carolina,

Tennessee, Texas, Virginia, West Virginia; North Central—Illinois,

Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North

Dakota, Ohio, South Dakota, Wisconsin; West—Alaska, Arizona,

California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico,

Oregon, Utah, Washington, Wyoming.

40 Goods-producing industries include manufacturing, mining, and construction. Service-producing industries include transportation, comInsurance benefits__short-term disability coverage and

long-term disability insurance, medical care, dental care, and

life insurance__were available to no more than one-fifth of

part-time workers. About one-third of part-time workers were

eligible to participate in a retirement plan.

The incidence of other benefits, such as severance pay,

health promotion programs, and educational assistance was

also lower than for full-time workers.

munications, electric, gas and sanitary services; wholesale trade; retail trade;

finance, insurance, and real estate; and services. See Appendix A for additional information on survey scope.

41 Occupations are categorized as union or nonunion at the time of data

collection. To be categorized as union, the occupations must meet the

following criteria: 1) A labor organization must be recognized as the bargaining agent for workers in the occupation; 2) wage and salary rates must

be determined through collective bargaining or negotiations; and, 3) settlement terms must be embodied in a signed, mutually-binding collective bargaining agreement.

42 Employees are classified as full-time or part-time in accordance with

the practices of surveyed establishments.

—ENDNOTES—

147
Table 172. Summary: Participation1 in selected employee benefit programs,

full-time employees, by geographic region, medium and large private

establishments, 1995

(In percent)

Benefit Northeast South North

Central West

Paid time off:

Holidays .......................................... 91 88 91 86

Vacations ........................................ 96 96 96 93

Personal leave ................................ 40 18 18 14

Funeral leave .................................. 85 74 86 77

Jury duty leave ............................... 93 83 89 74

Military leave ................................... 51 39 48 41

Family leave ................................... 3 1 1 2

Unpaid family leave .......................... 87 87 80 81

Disability benefits2:

Paid sick leave .............................. 68 55 47 69

Short-term disability ...................... 79 46 59 28

Long-term disability insurance ...... 45 39 43 45

Survivor benefits:

Life insurance ............................. 90 84 92 83

Accidental death and

dismemberment ........................ 64 60 78 65

Survivor income benefits ............ 1 2 13 7

Health care benefits:

Medical care ............................... 82 73 78 75

Dental care ................................. 62 46 58 66

Vision care .................................. 27 14 25 38

Outpatient prescription drug

coverage ................................... 81 70 75 73

See footnotes at end of table.
Table 172. Summary: Participation1 in selected employee benefit programs,

full-time employees, by geographic region, medium and large private

establishments, 1995

(In percent) — Continued

Benefit Northeast South North

Central West

Retirement income benefits:

All retirement3 ................................. 83 77 80 80

Defined benefit ........................... 61 44 57 49

Defined contribution4 .................. 52 56 52 62

Savings and thrift .................... 36 40 38 52

Deferred profit sharing ............ 10 14 15 10

Employee stock ownership ..... 3 6 5 7

Money purchase pension ....... 10 4 11 5

Stock bonus ............................ 5 ( ) 3 2 5 ( )

Simplified employee pension .. 5 ( ) 1 5 ( ) 5 ( )

Other ....................................... 1 5 ( ) 5 ( ) 3

Cash or deferred arrangements

(401(k) plans):

With employer contributions ....... 36 44 46 57

Salary reduction ...................... 36 43 43 56

Savings and thrift6 .............. 30 37 33 50

Deferred profit sharing ........ 4 5 7 4

Other ................................... 2 1 3 2

Deferral of profit sharing

allocation .............................. 5 ( ) 2 3 5 ( )

Other7 ..................................... 5 ( ) 5 ( ) 5 ( ) 1

No employer contributions .......... 10 8 10 9

1 Participants are workers covered by a paid time off, insurance, or retirement plan. Employees

subject to a minimum service requirement before they are eligible for benefit coverage are counted

as participants even if they have not met the requirement at the time of the survey. If employees are

required to pay part of the cost of a benefit, only those who elect the coverage and pay their share

are counted as participants. Except for family leave, benefits for which the employee must pay the

full premium are outside the scope of the survey. Only current employees are counted as

participants; retirees are excluded. 2 The definitions for paid sick leave and short-term disability (previously sickness and accident

insurance) were changed for the 1995 survey. Paid sick leave now only includes plans that either

specify a maximum number of days per year or unlimited days. Short-term disability now includes

all insured, self-insured, and state-mandated plans available on a per disability basis as well as the

unfunded per disability plans previously reported as sick leave. Sickness and accident insurance,

reported in years prior to this survey, only included insured, self-insured, and state-mandated plans

providing per disability benefits at less than full pay. 3 Includes defined benefit pension plans and defined contribution retirement plans. The total is

less than the sum of the individual items because many employees participated in both types of

plans. 4 The total is less than the sum of the individual items because some employees participated in

more than one type of plan. 5 Less than 0.5 percent. 6 Participants in savings and thrift plans usually are allowed to make pretax contributions. In the

1995 survey, provisions governing pretax contributions were not determinable for about one-tenth of

the employees with savings and thrift plans. 7 Includes required contributions made to money purchase pension plans on a pretax basis.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash

indicates that no data were reported.
Table 173. Other benefits: Eligibility for specified benefits, full-time

employees, by geographic region, medium and large private establishments,

1995

(In percent)

Benefit Northeast South North

Central West

Income continuation plans:

Severance pay ...................... 41 30 36 36

Supplemental unemployment

benefits ............................... 1 1 10 1

Family benefits:

Employer assistance for child

care1 ................................... 12 7 5 8

Employer provided funds .. 6 4 1 5

On-site child care .............. 6 3 2 4

Off-site child care .............. 3 1 2 ( ) 1

Adoption assistance ............. 11 7 8 20

Long-term care insurance ..... 9 6 4 7

Flexible workplace ................ 2 2 4 1

Health promotion programs:

Wellness programs ............... 34 33 38 29

Employee assistance

programs ............................ 60 51 63 61

Fitness center ....................... 24 15 12 27

Miscellaneous benefits:

Job-related travel accident

insurance ............................ 47 37 39 46

Nonproduction bonuses ........ 38 38 39 42

Subsidized commuting ......... 4 3 3 10

Education assistance:

Job-related ........................ 68 61 67 64

Not job-related .................. 25 17 15 16

Section 125 cafeteria benefits3: 55 59 53 52

Flexible benefit plans ............ 14 12 9 15

Reimbursement plans ........... 37 38 40 35

Premium conversion plans ... 4 8 4 2

1 Occupations may have access to more than one type of assistance for child care. Not all

types of assistance are shown separately. Therefore, the sums of individual items may not

equal the totals. 2 Less than 0.5 percent. 3 Includes all types of plans under Internal Revenue Code Section 125. Flexible benefits

plans include reimbursement account features.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates that no data were reported.
Table 174. Summary: Participation1 in selected employee benefit programs,

full-time employees in goods-producing industries, medium and large private

establishments, 1995

(In percent)

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Paid time off:

Holidays .......................................... 95 99 99 93

Vacations ........................................ 96 99 100 94

Personal leave ................................ 16 21 22 13

Funeral leave .................................. 82 88 81 80

Jury duty leave ............................... 83 91 82 81

Military leave ................................... 53 76 56 45

Family leave ................................... 1 4 3 1

Unpaid family leave .......................... 87 93 91 85

Disability benefits2:

Paid sick leave .............................. 40 72 66 25

Short-term disability ...................... 68 60 59 72

Long-term disability insurance ...... 36 57 53 26

Survivor benefits:

Life insurance ............................. 93 97 97 91

Accidental death and

dismemberment ........................ 74 78 80 71

Survivor income benefits ............ 9 13 8 8

Health care benefits:

Medical care ............................... 84 83 81 84

Dental care ................................. 58 73 61 53

Vision care .................................. 22 32 19 19

Outpatient prescription drug

coverage ................................... 81 81 80 82

See footnotes at end of table.
Table 174. Summary: Participation1 in selected employee benefit programs,

full-time employees in goods-producing industries, medium and large private

establishments, 1995

(In percent) — Continued

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Retirement income benefits:

All retirement3 ................................. 86 90 86 84

Defined benefit ........................... 62 67 63 61

Defined contribution4 .................. 58 75 65 51

Savings and thrift .................... 44 61 54 37

Deferred profit sharing ............ 14 17 14 13

Employee stock ownership ..... 6 6 4 6

Money purchase pension ....... 5 7 4 4

Simplified employee pension .. 5 ( ) 1 – 5 ( )

Other ....................................... 2 4 1 2

Cash or deferred arrangements

(401(k) plans):

With employer contributions ....... 52 71 61 45

Salary reduction ...................... 50 68 58 42

Savings and thrift6 .............. 40 57 47 33

Deferred profit sharing ........ 7 6 8 7

Other ................................... 3 5 3 2

Deferral of profit sharing

allocation .............................. 3 3 3 2

No employer contributions .......... 11 16 7 10

1 Participants are workers covered by a paid time off, insurance, or retirement plan. Employees

subject to a minimum service requirement before they are eligible for benefit coverage are counted

as participants even if they have not met the requirement at the time of the survey. If employees are

required to pay part of the cost of a benefit, only those who elect the coverage and pay their share

are counted as participants. Except for family leave, benefits for which the employee must pay the

full premium are outside the scope of the survey. Only current employees are counted as

participants; retirees are excluded. 2 The definitions for paid sick leave and short-term disability (previously sickness and accident

insurance) were changed for the 1995 survey. Paid sick leave now only includes plans that either

specify a maximum number of days per year or unlimited days. Short-term disability now includes

all insured, self-insured, and state-mandated plans available on a per disability basis as well as the

unfunded per disability plans previously reported as sick leave. Sickness and accident insurance,

reported in years prior to this survey, only included insured, self-insured, and state-mandated plans

providing per disability benefits at less than full pay. 3 Includes defined benefit pension plans and defined contribution retirement plans. The total is

less than the sum of the individual items because many employees participated in both types of

plans. 4 The total is less than the sum of the individual items because some employees participated in

more than one type of plan. 5 Less than 0.5 percent. 6 Participants in savings and thrift plans usually are allowed to make pretax contributions. In the

1995 survey, provisions governing pretax contributions were not determinable for about one-tenth of

the employees with savings and thrift plans.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash

indicates that no data were reported.
Table 175. Other benefits: Eligibility for specified benefits, full-time

employees in goods-producing industries, medium and large private

establishments, 1995

(In percent)

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Income continuation plans:

Severance pay ...................... 40 68 59 28

Supplemental unemployment

benefits ............................... 7 3 2 8

Family benefits:

Employer assistance for child

care1 ................................... 4 11 3 1

Employer provided funds .. 3 10 2 1

On-site child care .............. 2 6 1 -

Off-site child care .............. 1 1 2 ( ) 2 ( )

Adoption assistance ............. 12 26 12 8

Long-term care insurance ..... 5 10 7 3

Flexible workplace ................ 1 1 1 1

Health promotion programs:

Wellness programs ............... 39 55 40 34

Employee assistance

programs ............................ 61 80 59 55

Fitness center ....................... 17 37 18 10

Miscellaneous benefits:

Job-related travel accident

insurance ............................ 46 76 52 35

Nonproduction bonuses ........ 47 48 47 46

Subsidized commuting ......... 5 13 6 2

Education assistance:

Job-related ........................ 68 86 72 61

Not job-related .................. 20 30 22 16

Section 125 cafeteria benefits3: 51 77 63 40

Flexible benefit plans ............ 11 25 12 6

Reimbursement plans ........... 34 48 44 28

Premium conversion plans ... 5 4 7 5

1 Occupations may have access to more than one type of assistance for child care. Not all

types of assistance are shown separately. Therefore, the sums of individual items may not

equal the totals. 2 Less than 0.5 percent. 3 Includes all types of plans under Internal Revenue Code Section 125. Flexible benefits

plans include reimbursement account features.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates that no data were reported.
Table 176. Summary: Participation1 in selected employee benefit programs,

full-time employees in service-producing industries, medium and large private

establishments, 1995

(In percent)

All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Paid time off:

Holidays .......................................... 85 82 92 81

Vacations ........................................ 96 95 99 93

Personal leave ................................ 26 26 36 17

Funeral leave .................................. 79 81 86 70

Jury duty leave ............................... 86 91 91 77

Military leave ................................... 39 51 43 23

Family leave ................................... 2 3 2 1

Unpaid family leave .......................... 82 87 85 74

Disability benefits2:

Paid sick leave .............................. 70 74 80 57

Short-term disability ...................... 44 42 51 39

Long-term disability insurance ...... 46 62 53 26

Survivor benefits:

Life insurance ............................. 83 91 88 72

Accidental death and

dismemberment .................... 62 66 63 58

Survivor income benefits ............ 4 3 3 5

Health care benefits:

Medical care ............................... 72 78 75 64

Dental care ................................. 55 63 56 48

Vision care .................................. 25 27 23 26

Outpatient prescription drug

coverage ............................... 70 75 73 62

See footnotes at end of table.
Table 176. Summary: Participation1 in selected employee benefit programs,

full-time employees in service-producing industries, medium and large private

establishments, 1995

(In percent) — Continued

All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Retirement income benefits:

All retirement3 ................................. 76 85 85 60

Defined benefit ........................... 46 47 53 37

Defined contribution4 .................. 54 63 63 36

Savings and thrift .................... 39 45 45 26

Deferred profit sharing ............ 12 13 15 7

Employee stock ownership ..... 5 5 7 2

Money purchase pension ....... 9 16 6 6

Stock bonus ............................ 2 2 4 1

Simplified employee pension .. 1 1 1 5 ( )

Other ....................................... 5 ( ) 5 ( ) 5 ( ) 5 ( )

Cash or deferred arrangements

(401(k) plans):

With employer contributions ....... 41 48 48 28

Salary reduction ...................... 40 47 47 27

Savings and thrift6 .............. 35 41 41 24

Deferred profit sharing ........ 4 4 6 2

Other ................................... 1 2 1 1

Deferral of profit sharing

allocation .......................... 1 1 1 1

Other7 ..................................... 5 ( ) 1 5 ( ) 5 ( )

No employer contributions .......... 8 12 8 5

1 Participants are workers covered by a paid time off, insurance, or retirement plan. Employees

subject to a minimum service requirement before they are eligible for benefit coverage are counted

as participants even if they have not met the requirement at the time of the survey. If employees are

required to pay part of the cost of a benefit, only those who elect the coverage and pay their share

are counted as participants. Except for family leave, benefits for which the employee must pay the

full premium are outside the scope of the survey. Only current employees are counted as

participants; retirees are excluded. 2 The definitions for paid sick leave and short-term disability (previously sickness and accident

insurance) were changed for the 1995 survey. Paid sick leave now only includes plans that either

specify a maximum number of days per year or unlimited days. Short-term disability now includes

all insured, self-insured, and state-mandated plans available on a per disability basis as well as the

unfunded per disability plans previously reported as sick leave. Sickness and accident insurance,

reported in years prior to this survey, only included insured, self-insured, and state-mandated plans

providing per disability benefits at less than full pay. 3 Includes defined benefit pension plans and defined contribution retirement plans. The total is

less than the sum of the individual items because many employees participated in both types of

plans. 4 The total is less than the sum of the individual items because some employees participated in

more than one type of plan. 5 Less than 0.5 percent. 6 Participants in savings and thrift plans usually are allowed to make pretax contributions. In the

1995 survey, provisions governing pretax contributions were not determinable for about one-tenth of

the employees with savings and thrift plans. 7 Includes required contributions made to money purchase pension plans on a pretax basis.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash

indicates that no data were reported.
Table 177. Other benefits: Eligibility for specified benefits, full-time

employees in service-producing industries, medium and large private

establishments, 1995

(In percent)

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Income continuation plans:

Severance pay ...................... 32 38 40 20

Supplemental unemployment

benefits ............................... 2 1 ( ) 1 4

Family benefits:

Employer assistance for child

care2 ................................... 10 17 8 6

Employer provided funds .. 4 6 5 2

On-site child care .............. 5 9 3 3

Off-site child care .............. 2 3 2 1

Adoption assistance ............. 10 14 12 4

Long-term care insurance ..... 7 7 10 5

Flexible workplace ................ 3 6 2 1 ( )

Health promotion programs:

Wellness programs ............... 31 44 30 19

Employee assistance

programs ............................ 56 69 60 40

Fitness center ....................... 19 28 16 16

Miscellaneous benefits:

Job-related travel accident

insurance ............................ 38 50 46 21

Nonproduction bonuses ........ 34 37 36 30

Subsidized commuting ......... 4 6 5 3

Education assistance:

Job-related ........................ 63 75 64 50

Not job-related .................. 17 22 16 14

Section 125 cafeteria benefits3: 58 76 67 33

Flexible benefit plans ............ 13 17 15 7

Reimbursement plans ........... 40 55 46 21

Premium conversion plans ... 5 4 5 5

1 Less than 0.5 percent. 2 Occupations may have access to more than one type of assistance for child care. Not all

types of assistance are shown separately. Therefore, the sums of individual items may not

equal the totals. 3 Includes all types of plans under Internal Revenue Code Section 125. Flexible benefits

plans include reimbursement account features.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates that no data were reported.
Table 178. Summary: Participation1 in selected

employee benefit programs, by union status, full-time

employees, medium and large private

establishments, 1995

(In percent)

Benefit Union

workers

Nonunion

workers

Paid time off:

Holidays .................................. 92 88

Vacations ................................ 94 96

Personal leave ........................ 20 23

Funeral leave .......................... 86 78

Jury duty leave ....................... 87 84

Military leave ........................... 42 45

Family leave ........................... 1 2

Unpaid family leave .................. 82 85

Disability benefits2:

Paid sick leave ...................... 40 64

Short-term disability .............. 73 47

Long-term disability

insurance ............................ 21 49

Survivor benefits:

Life insurance ..................... 90 86

Accidental death and

dismemberment ................ 75 64

Survivor income benefits .... 10 4

Health care benefits:

Medical care ....................... 85 74

Dental care ......................... 62 55

Vision care .......................... 38 20

Outpatient prescription drug

coverage ........................... 82 72

Retirement income benefits:

All retirement3 ......................... 87 78

Defined benefit ................... 79 44

See footnotes at end of table.
Table 178. Summary: Participation1 in selected

employee benefit programs, by union status, full-time

employees, medium and large private

establishments, 1995

(In percent) — Continued

Benefit Union

workers

Nonunion

workers

Defined contribution4 .......... 37 61

Savings and thrift ............ 23 46

Deferred profit sharing .... 9 14

Employee stock

ownership ..................... 3 6

Money purchase pension 5 8

Stock bonus .................... 5 ( ) 2

Simplified employee

pension ......................... – 1

Other ............................... 1 1

Cash or deferred

arrangements (401(k) plans):

With employer contributions 29 50

Salary reduction .............. 26 49

Savings and thrift6 ...... 20 42

Deferred profit sharing 4 5

Other ........................... 1 2

Deferral of profit sharing

allocation ...................... 3 1

Other7 ............................. 5 ( ) 5 ( )

No employer contributions .. 10 9

1 Participants are workers covered by a paid time off,

insurance, or retirement plan. Employees subject to a minimum

service requirement before they are eligible for benefit coverage

are counted as participants even if they have not met the

requirement at the time of the survey. If employees are required

to pay part of the cost of a benefit, only those who elect the

coverage and pay their share are counted as participants. Except

for family leave, benefits for which the employee must pay the full

premium are outside the scope of the survey. Only current

employees are counted as participants; retirees are excluded. 2 The definitions for paid sick leave and short-term disability

(previously sickness and accident insurance) were changed for

the 1995 survey. Paid sick leave now only includes plans that

either specify a maximum number of days per year or unlimited

days. Short-term disability now includes all insured, self-insured,

and state-mandated plans available on a per disability basis as

well as the unfunded per disability plans previously reported as

sick leave. Sickness and accident insurance, reported in years

prior to this survey, only included insured, self-insured, and

state-mandated plans providing per disability benefits at less than

full pay. 3 Includes defined benefit pension plans and defined

contribution retirement plans. The total is less than the sum of

the individual items because many employees participated in both

types of plans. 4 The total is less than the sum of the individual items

because some employees participated in more than one type of

plan. 5 Less than 0.5 percent. 6 Participants in savings and thrift plans usually are allowed to

make pretax contributions. In the 1995 survey, provisions

governing pretax contributions were not determinable for about

one-tenth of the employees with savings and thrift plans. 7 Includes required contributions made to money purchase

pension plans on a pretax basis.

NOTE: Because of rounding, sums of individual items may not

equal totals. Where applicable, dash indicates that no data were

reported.
Table 179. Other benefits: Eligibility for specified

benefits, by union status, full-time employees,

medium and large private establishments, 1995

(In percent)

Benefit Union

employees

Nonunion

employees

Income continuation plans:

Severance pay ...................... 32 36

Supplemental unemployment

benefits ............................... 12 1

Family benefits:

Employer assistance for child

care1 ................................... 3 9

Employer provided funds .. 1 5

On-site child care .............. 1 4

Off-site child care .............. 2 ( ) 2

Adoption assistance ............. 6 12

Long-term care insurance ..... 7 6

Flexible workplace ................ 1 3

Health promotion programs:

Wellness programs ............... 30 35

Employee assistance

programs ............................ 61 57

Fitness center ....................... 8 22

Miscellaneous benefits:

Job-related travel accident

insurance ............................ 33 44

Nonproduction bonuses ........ 40 38

Subsidized commuting ......... 1 6

Education assistance:

Job-related ........................ 62 66

Not job-related .................. 21 17

Section 125 cafeteria benefits3: 33 62

Flexible benefit plans ............ 4 15

Reimbursement plans ........... 26 42

Premium conversion plans ... 3 6

1 Occupations may have access to more than one type of

assistance for child care. Not all types of assistance are shown

separately. Therefore, the sums of individual items may not equal

the totals. 2 Less than 0.5 percent. 3 Includes all types of plans under Internal Revenue Code

Section 125. Flexible benefits plans include reimbursement

account features.

NOTE: Because of rounding, sums of individual items may not

equal totals. Where applicable, dash indicates that no data were

reported.
Table 180. Summary: Participation1 in selected employee benefit programs,

part-time employees, medium and large private establishments, 1995

(In percent)

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Paid time off:

Holidays .................................. 44 26 54 40

Vacations ................................ 50 47 50 50

Personal leave ........................ 13 5 22 8

Funeral leave .......................... 37 41 44 30

Jury duty leave ....................... 42 50 40 41

Military leave ........................... 14 16 16 11

Family leave ........................... 2 ( ) 2 ( ) 1 2 ( )

Unpaid family leave .................. 42 42 44 39

Disability benefits3:

Paid sick leave ...................... 19 25 21 14

Short-term disability .............. 16 11 14 19

Long-term disability

insurance ............................ 7 16 10 1

Survivor benefits:

Life insurance ..................... 20 33 21 15

Accidental death and

dismemberment ................ 14 19 16 10

Survivor income benefits .... 1 1 1 2 ( )

Health care benefits:

Medical care ....................... 19 31 20 15

Dental care ......................... 13 24 12 10

Vision care .......................... 8 11 9 6

Outpatient prescription drug

coverage ........................... 19 31 21 14

See footnotes at end of table.
Table 180. Summary: Participation1 in selected employee benefit programs,

part-time employees, medium and large private establishments, 1995

(In percent) — Continued

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Retirement income benefits:

All retirement4 ......................... 37 53 45 23

Defined benefit ................... 22 24 28 15

Defined contribution5 .......... 24 33 32 13

Savings and thrift ............ 15 20 23 6

Deferred profit sharing .... 6 1 9 5

Employee stock

ownership ..................... 2 ( ) 2 ( ) 2 ( ) 2 ( )

Money purchase pension 4 13 3 3

Cash or deferred

arrangements (401(k) plans):

With employer contributions 17 22 27 7

Salary reduction .............. 17 21 26 7

Savings and thrift6 ...... 14 20 21 5

Deferred profit sharing 3 2 ( ) 5 2

Other ........................... 2 ( ) 1 1 2 ( )

Deferral of profit sharing

allocation ...................... 2 ( ) – 1 2 ( )

Other7 ............................. 2 ( ) 1 2 ( ) 2 ( )

No employer contributions .. 5 10 4 3

1 Participants are workers covered by a paid time off, insurance, or retirement plan. 

Employees subject to a minimum service requirement before they are eligible for benefit

coverage are counted as participants even if they have not met the requirement at the time of

the survey. If employees are required to pay part of the cost of a benefit, only those who elect

the coverage and pay their share are counted as participants. Except for family leave,

benefits for which the employees must pay the full premium are outside the scope of the

survey. Only current employees are counted as participants; retirees are excluded. 2 Less than 0.5 percent. 3 The definitions for paid sick leave and short-term disability (previously sickness and

accident insurance) were changed for the 1995 survey. Paid sick leave now only includes

plans that either specify a maximum number of days per year or unlimited days. Short-term

disability now includes all insured, self-insured, and state-mandated plans available on a per

disability basis as well as the unfunded per disability plans previously reported as sick leave. 

Sickness and accident insurance, reported in years prior to this survey, only included insured,

self-insured, and state-mandated plans providing per disability benefits at less than full pay. 4 Includes defined benefit pension plans and defined contribution retirement plans. The

total is less than the sum of the individual items because many employees participated in both

types of plans. 5 The total is less than the sum of the individual items because some employees

participated in more than one type of plan. 6 Participants in savings and thrift plans usually are allowed to make pretax contributions. 

In the 1995 survey, provisions governing pretax contributions were not determinable for about

one-tenth of the employees with savings and thrift plans. 7 Includes required contributions made to money purchase pension plans on a pretax

basis.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates that no data were reported.
Table 181. Other benefits: Eligibility for specified benefits, part-time

employees, medium and large private establishments, 1995

(In percent)

Benefit All

employees

Professional,

technical,

and related

employees

Clerical

and sales

employees

Blue-collar

and

service

employees

Income continuation plans:

Severance pay ...................... 10 13 14 5

Supplemental unemployment

benefits ............................... 1 ( ) – 1 1 ( )

Family benefits:

Employer assistance for child

care2 ................................... 6 16 4 5

Employer provided funds .. 2 4 1 2

On-site child care .............. 3 12 1 1

Off-site child care .............. 2 1 ( ) 1 2

Adoption assistance ............. 4 3 7 1

Long-term care insurance ..... 4 2 8 2

Flexible workplace ................ 1 ( ) 2 1 ( ) 1 ( )

Health promotion programs:

Wellness programs ............... 13 32 12 7

Employee assistance

programs ............................ 34 54 39 24

Fitness center ....................... 13 36 12 6

Miscellaneous benefits:

Job-related travel accident

insurance ............................ 25 22 41 11

Nonproduction bonuses ........ 19 22 17 19

Subsidized commuting ......... 1 1 2 1

Education assistance:

Job-related ........................ 36 60 37 27

Not job-related .................. 7 7 6 8

Section 125 cafeteria benefits3: 19 36 25 7

Flexible benefit plans ............ 5 12 7 1

Reimbursement plans ........... 13 23 18 6

Premium conversion plans ... 1 1 1 1

1 Less than 0.5 percent. 2 Occupations may have access to more than one type of assistance for child care. Not all

types of assistance are shown separately. Therefore, the sums of individual items may not

equal the totals. 3 Includes all types of plans under Internal Revenue Code Section 125. Flexible benefits

plans include reimbursement account features.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates that no data were reported.
Scope of survey

The Employee Benefits Survey tracks the incidence and

characteristics of employee benefit plans and is conducted jointly with the Bureau's Employment Cost

Index (ECI). The portion of the survey from which the EBS

estimates are made covers all private-sector establishments1

in the United States employing 100 workers or more at the

time of sample selection.2 All private-sector industries are

included in the survey with the exception of farms and

private households.

The industrial and establishment size coverage of the

survey varies on a rotating basis. All surveys cover full-time

and part-time workers in all 50 States and the District of

Columbia. In even-numbered years, EBS data are collected

for small private establishments (those employing fewer than

100 workers) and State and local governments, regardless of

employment size. In odd-numbered years, data are collected

in medium and large private establishments (those employing 100 workers or more).

The industrial coverage, establishment size coverage, and

geographic coverage for the survey were different prior to

1990. The 1979 through 1986 surveys covered only medium

and large private establishments and excluded most of the

service industries. Establishments employing at least 50, 100,

or 250 workers, depending on the industry, were included.

The 1987 survey consisted of State and local government

establishments with 50 or more employees. The 1988 and

1989 surveys included all private-sector establishments of 100

or more employees. Surveys from 1979 to 1989 excluded parttime employees and establishments in Alaska and Hawaii.

Data in Appendix B indicate the estimated number of fulland part-time employees within the scope of the survey, the

number of responding sample establishments, and the number of sampled (and responding) occupational quotes3

 within

those establishments that are actually studied for each major

industry division.

Occupational groups

Each of the narrowly defined occupations selected for study

is classified into one of the following three broad occupational groups:

Professional, technical, and related. Includes professional,

technical, executive, administrative, managerial, and related

occupations.

Clerical and sales. Includes clerical, administrative support,

and sales occupations.

Appendix A: Technical Note

Blue-collar and service. Includes precision production, craft,

and repair occupations; machine operators and inspectors;

transportation and material moving occupations; handlers,

equipment cleaners, helpers, and laborers; and service occupapations.

Excluded from the survey are self-employed persons, proprietors, major stockholders, members of a corporate board

who are not otherwise officers of the corporation, volunteers,

unpaid workers, family members who are paid token wages,

the permanently disabled, partners in unincorporated firms,

and U.S. citizens working overseas.

Benefit areas

BLS requests that sampled establishments provide data for

a sample of their occupations on work schedules and details

of plans in each of the following benefit areas: Paid holidays,

paid vacations, paid personal leave, paid funeral leave, paid

military leave, paid jury-duty leave, paid and unpaid family

leave, paid sick leave, short term disability insurance, longterm disability insurance, medical care, dental care, vision

care, life insurance, defined benefit pension plans, defined

contribution plans, and Section 125 cafeteria benefits, which

include flexible benefits plans, reimbursement accounts, and

premium conversion plans.

Data are also collected on the incidence of the following

additional benefits: Severance pay, supplemental unemployment benefits, travel accident insurance, nonproduction cash

bonuses, child care, adoption assistance, long-term care insurance, wellness programs, fitness centers, job-related and

non-job-related educational assistance, employee assistance

programs, flexible workplace, and subsidized commuting.

Sample design

The State Unemployment Insurance (UI) reports for the

50 States and the District of Columbia is the list of establishments from which the sample is selected (called the sampling

frame). The sample design for this survey and the Employment Cost Index (ECI) is a 2-stage probability sample of detailed occupations. The first stage of sample selection is a

probability sample of establishments; the second stage is a

probability sample of occupations within those establishments.

The sample of establishments is a subset of the ECI sample

that covers establishments having 100 employees or more at

the time of selection. The ECI sample is updated over a 5-

year cycle. Each year, new sample establishments are introduced into the survey, replacing previously selected sample

units.

To ensure that the sample is representative of all estab162
lishments that began business after the various industry

samples were selected, a sample of "births" (newly opened

establishments) is added to the existing sample each year.

The sample of establishments is selected by first stratifying the sampling frame by industry group, and then by region

and establishment employment. The industry groups usually

consist of 3-digit Standard Industrial Classification groups,

as defined by the Office of Management and Budget.

The number of sample establishments allocated to each

stratum (defined by industry) reflects the ratio of employment in the stratum to employment in all sampling frame establishments. Thus, a stratum that contains 1 percent of the

total employment within the scope of the survey receives

approximately 1 percent of the total sample establishments.

Some industries are sampled at a higher rate than other industries because of publication requirements or highly variable data.

Each sampled establishment within an industry group (stratum) has a probability of selection proportional to its employment. For example, consider two establishments, A and

B, with respective employment of 5,000 and 1,000. Establishment A is five times more likely to be selected than establishment B.

At the beginning of each visit by a Bureau field economist

to a sampled establishment, a second-stage probability sample

of occupations is selected from the establishment. Data are

then collected for these sampled occupations. The number of

occupations selected from an establishment varies from four

in the smallest establishments to eight in the largest

establishments. The probability of an occupation being selected is proportional to its employment size within the establishment.

The narrowly defined occupations are based on the

 Standard Occupational Classification (SOC) system compiled

by the Department of Commerce. They are then classified

into the three occupational groups shown in this bulletin.

The sample design will undergo change in 1997, as some

units will be selected on an area basis to reflect the transition

to the National Compensation Survey design.

Data collection

Bureau field economists visit or contact sampled establishments by telephone to collect data for the survey. To reduce the reporting burden, respondents are asked to provide

documents describing their flexible benefits plans; reimbursement accounts; defined benefit pensions; defined contribution plans; medical, dental, and vision care plans; and insurance plans. BLS analyzes these plans in Washington to garner the required data on plan provisions. Data on paid leave

benefits generally are obtained directly from the employer at

the time of the visit.

Data calculation

Tabulations in this bulletin show the percent of all ememployees who receive specified benefits, such as paid holidays or medical care, as well as information on the provisions of many of these benefits. To present provision data,

tabulations generally indicate the percent of all employees

receiving a benefit (participants) who are covered by specified features. For example, tabulations may show the percent

of workers with medical care benefits who are covered by a

health maintenance organization.

The majority of tables in the bulletin indicate the percent

of employees covered by a particular benefit plan or provision. In addition, average benefit provisions—such as the

average number of paid holidays per year—are presented. In

some cases, tabulations indicate both the percent of employees with a given provision and the average value of that provision. For example, EBS tabulations indicate the percent of

employees in fee-for-service medical care plans who must

pay selected deductibles (such as $100, $150, and $200 per

year), as well as the average deductible. (All tabulations of

averages include only those employees actually covered by

the provision being averaged.)

Most tables in this bulletin also include the number of employees receiving the benefit. This provides the reader with

additional information on the prevalence of various benefit

plans and provisions.

Survey estimation methods

The survey design uses an estimator that assigns the

inverse of each sample unit's probability of selection as a

weight to the unit's data at each of the two stages of sample

selection. Three weight-adjustment factors are applied to the

establishment data. The first factor is introduced to account

for establishment non-response, a second factor—for occupational non-response, and a third poststratification factor is

introduced to adjust the estimated employment totals to actual counts of the employment by industry for the survey reference date.

The general form of the estimator for a population total

Y is:

 

where,

n' number of responding sample establishments;

oi occupation sample size selected from the ith establishment;

Yij value for the characteristics of the jth selected occupation in the ith selected establishment;

 Pi the probability of including the ith establishment in

the sample;

Appendix A: Technical Note

=

=

=

=

163
Pij the probability of including the jth occupation in the

sample of occupations from the ith establishment;

f1i weight adjustment factor for nonresponse for the ith

establishment;

f

2i weight adjustment factor for poststratification totals

for the ith establishment.

Fij weight adjustment factor for nonresponse for jth occupation in the ith establishment.

Appropriate employment or establishment totals are used

to calculate the proportion, mean, or percentage that is desired.

Reliability of estimates

The statistics in this bulletin are estimates derived from a

sample of usable occupation quotes selected from the responding establishments. They are not tabulations based on data

from all employees in medium and large establishments within

scope of the survey. Consequently, the data are subject to sampling and nonsampling errors.

Sampling errors are the differences that can arise between

results derived from a sample and those computed from observations of all units in the population being studied. When

probability techniques are used to select a sample, as in

the Employee Benefits Survey, statistical measures called

"standard errors" can be calculated to measure possible sampling errors.

=

=

=

=

Appendix A: Technical Note

This evaluation of survey results involves forming confidence intervals that can be interpreted in the following

manner: Assume that repeated random samples of the same

size were drawn from a given population and an estimate of

some value, such as a mean or percentage, was made from

each sample. Then, the intervals described by one standard

error below each sample's estimate and one standard error

above the estimate would include the population's value for

68 percent of the samples. Confidence rises to 90 percent if

the intervals surrounding the sample estimates are widened

to plus and minus 1.6 standard errors, and to 95 percent if the

intervals are increased to plus and minus 2 standard errors.

Nonsampling errors also affect survey results. They can be

attributed to many sources: Inability to obtain information

about all establishments in the sample; definitional difficulties; differences in the interpretation of questions; inability or

unwillingness of respondents to provide correct information;

mistakes in recording or coding the data; and other errors of

collection, response, processing, coverage, and estimation for

missing data.

Computer edits of the data and professional review of both

individual and summarized data reduce the nonsampling

errors in recording, coding, and processing the data. However, to the extent that the characteristics of nonrespondents

are not the same as those of respondents, nonsampling errors

are introduced in the development of estimates. Because the

influence of these limitations on the EBS estimates is unknown, reliability measurements are incomplete.

1 BLS defines an establishment as an economic unit that produces goods

or services (such as a factory or a store) at a single location. An establishment is not necessarily a firm; it may be a branch plant, for example, or a

warehouse.

2 The establishments included in this survey had to be determined in advance of the actual collection because BLS only surveyed the larger

establishments. BLS classified establishments by size as of the reference

date of the sampling frame. All establishments of 100 employees or more

that were sampled are included in the survey, even if they employed fewer

workers at the time of data collection.

3

Data are collected individually for narrowly defined occupations that are

sampled within establishments. All of the employees in the detailed occupation selected may not be surveyed. Data for a group (manageable number) of employees in the detailed occupation that included the selected

employee position are collected. This group is called a quote.

—ENDNOTES—

164
Information on 1995 survey response

Data for the 1995 Employee Benefits Survey in

medium and large—those employing 100 workers

and more—private establishments were collected

from November 1994 to October 1995, reflecting an average

reference period of June 1995. A sample of 3,462 establishments was chosen from Unemployment Insurance reports with

reference dates from 1989 to 1993; also included was the

"birth" sample, which represents establishments beginning

operations through 1994. (A description of sampling procedures appears in appendix A.) Respondents were asked for

information as of the time of the data collection contact.

The following summary is a composite of establishment

responses to the survey:

Establishments Number

In sample 3,462

Out of business and out of scope 513

Refusing to respond 894

Responding fully or partially 2,055

The 2,055 responding establishments in the sample of

3,462 establishments studied (tables A1-A2) yielded 11,038

occupational observations (quotes) for which data were collected.

There were four procedures used to adjust for missing data

from partial and full refusals. First, imputations for the number of plan participants are made for cases in which this number is not reported (approximately 32 percent of participants

in health plans, 35 percent in retirement plans, and 2 percent

of participants in all other types of plans). Each of these participant values is imputed by selecting a similar plan from

another establishment with similar employment in a similar

industry. The participant rate from this selected plan is then

used to approximate the number of participants for the plan

that is missing a participation value.

Second, imputations for plan provisions are made when

they or not available in a responding establishment. These

plan provisions are imputed by selecting a plan from another

establishment with similar characteristics. Provisions from this

selected plan are then used to represent the missing data. (This

was necessary for about 8 percent of the participants in shortterm disability plans; 15 percent of flexible benefits plan participants; 30 percent of medical, dental, and vision care participants; 11 percent of long- term disability insurance participants; 30 percent of retirement plan participants; and 5

percent of life insurance plan participants.)

Appendix B: Survey Response

For establishments that refuse or are unable to provide the

minimum amount of usable data, a weight adjustment is made

using the sample unit employment. This technique assumes

that the mean value of the nonrespondents equals the mean

value of the respondents at some "detailed" cell level. These

cells are defined in a manner that groups establishments

together that are homogeneous with respect to the characteristics of interest. In most cases, these cells are the same as

those used for sample selection.

For establishments that refuse, or are unable to provide

data for a specific occupation, a similar cell approach is used

to make adjustments to the sampled occupation weights in

responding establishments. The characteristics of interest include the major occupation group of the unreported occupations.

The survey data do not relate to 7 percent of the estimated

43.1 million employees in the universe of medium and large

private establishments. Almost all employees were in sampled

occupations that were discontinued in their reporting establishments after participation in the survey began. No replacement occupations were selected, nor were adjustments made

to the survey estimates to reflect these missing data.

Standard errors

Chart A-1 provides standard errors for use in evaluating

the estimates in the tables shown in chapters 1-9 of this bulletin containing percentage estimates. For example, table 1

shows that 55 percent of all employees participated in defined contribution retirement plans in 1995. Chart A-1 shows

a standard error of approximately 2.2 percent for this estimate. Thus, at the 95-percent level, the confidence interval

for this estimate is 50.6 percent to 59.4 percent (55 percent

plus and minus 2 times 2.2 percent).

Standard errors for average leave days that appear in tables

14, 15, 17, and 18 are presented in table A-7. Standard errors for tables 8, 13, 21, and 23 could not be represented

graphically. They are presented as tables A3-A6. For example,

the first entry in table 21 shows an average of 11.5 days of

paid sick leave annually after 1 year of service. The standard

error for this estimate is .50 days.

Charting estimates and generalized standard errors

Each estimate used in the production of the tables in this

bulletin has approximately a normal distribution.

Standard errors for the percentage estimates were computed

from a representative portion of the 1995 survey estimates

using a method called "balanced repeated replication." Estimates are produced for each of 64 half-sample replicates, and

165
the variability or standard error is calculated from these

estimates. To simplify their presentation, a curve was fitted

to the standard error estimates using regression techniques

(chart A-1).

The curve's equation is:

where:

 S = standard error

Appendix B: Survey Response

 P = percentage estimate from the bulletin

 e = exponential function

ln = natural logarithm function.

For the 1995 Employee Benefits Survey,

a = -1.05523539, b = 0.06710558, c = -0.05234468, and

d = - 0.01175850; f = -0.04949575

These are regression coefficients. The curve fits the data

with R2 = 0.85741 and no definite pattern in the residuals.

The equation of the curve was obtained empirically, using

the following equation:

Chart A-1. Generalized standard errors, medium & large private 

establishments, 1995

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

2

2.2

2.4

2.6

2.8

3

0 10 20 30 40 50 60 70 80 90 100

Percent estimate

Standard error

Percent estimate

 Chart A-1. Generalized standard errors, medium & large private

 establishments, 1995 Standard error

 0 10 20 30 40 50 60 70 80 90 100

 3

 2.8

 2.6

 2.4

 2.2

 2

 1.8

 1.6

 1.4

 1.2

 1

 0.8

 0.6

 0.4

 0.2

 0

166
Table A-1: Number of establishments and full-time occupational quotes studied and estimated number of full-time

workers within scope of survey, medium and large private establishments, United States, 1995

Industry division1

Number of

establishments

studied

Number of occupational quotes studied2

Total

Professional,

technical, and related

Clerical and

sales

Blue-collar and

service

All industries ............................. 3,462 9,561 3,078 2,915 3,568

Manufacturing ....................... 504 2,005 482 201 1,322

Nonmanufacturing ................ 2,957 7,556 2,596 2,714 2,246

Mining ............................... 22 90 30 6 54

Construction ..................... 113 165 34 13 118

Transportation,

communications,

electric, gas, and

sanitary services ......... 457 1,320 280 434 606

Wholesale trade ................ 163 445 85 179 181

Retail trade ....................... 410 650 88 381 181

Finance, insurance, and

real estate ................... 661 1,593 541 977 75

Services ............................ 1,132 3,293 1,538 724 1,031

Estimated number of full-time workers within scope of survey

All industries ............................. 33,373,969 9,366,025 8,104,860 15,903,083

Manufacturing ....................... 11,651,504 2,682,162 1,091,282 7,878,060

Nonmanufacturing ................ 21,722,465 6,683,863 7,013,579 8,025,023

Mining ............................... 271,855 88,463 18,767 164,625

Construction ..................... 897,126 172,715 69,750 654,660

Transportation,

communications,

electric, gas, and

sanitary services ......... 2,574,869 542,043 535,717 1,497,110

Wholesale trade ................ 1,304,485 253,836 551,170 499,480

Retail trade ....................... 3,075,284 336,336 1,817,567 921,382

Finance, insurance, and

real estate ................... 2,581,631 618,698 1,820,898 142,035

Services ............................ 11,017,214 4,671,773 2,199,710 4,145,731

1 As defined in the 1987 edition of the Standard Industrial

Classification Manual, U.S. Office of Management and Budget. 

Industry data are shown for informational purposes only and are

subject to larger than normal sample error. See section on reliability

of estimates. 2 These figures refer to all respondents to the survey, whether or

not they provided data for all items studied. See the section on

survey response.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this

category.
Table A-2: Number of establishments and part-time occupational quotes studied and estimated number of part-time

workers within scope of survey, medium and large private establishments, United States, 1995

Industry division1

Number of

establishments

studied

Number of occupational quotes studied2

Total

Professional,

technical, and related

Clerical and

sales

Blue-collar and

service

All industries ............................. 3,462 1,477 285 646 546

Manufacturing ....................... 504 28 4 13 11

Nonmanufacturing ................ 2,957 1,449 281 633 535

Mining ............................... 22 1 - 1 -

Construction ..................... 113 4 - 2 2

Transportation,

communications,

electric, gas, and

sanitary services ......... 457 54 6 27 21

Wholesale trade ................ 163 23 - 7 16

Retail trade ....................... 410 505 1 336 168

Finance, insurance, and

real estate ................... 661 78 2 66 10

Services ............................ 1,132 784 272 194 318

Estimated number of part-time workers within scope of survey

All industries ............................. 6,828,011 994,502 2,801,317 3,032,192

Manufacturing ....................... 222,236 53,883 80,936 87,417

Nonmanufacturing ................ 6,605,775 940,619 2,720,381 2,944,775

Mining ............................... 1,060 - 1,060 -

Construction ..................... 48,402 - 39,847 8,555

Transportation,

communications,

electric, gas, and

sanitary services ......... 211,869 19,959 83,929 107,981

Wholesale trade ................ 65,397 - 18,075 47,322

Retail trade ....................... 2,610,823 1,906 1,460,985 1,147,933

Finance, insurance, and

real estate ................... 411,101 1,574 395,713 13,815

Services ............................ 3,257,124 917,180 720,773 1,619,170

1 As defined in the 1987 edition of the Standard Industrial

Classification Manual, U.S. Office of Management and Budget. 

Industry data are shown for informational purposes only and are

subject to larger than normal sample error. See section on reliability

of estimates. 2 These figures refer to all respondents to the survey, whether or

not they provided data for all items studied. See the section on

survey response.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this

category.
The tables published in this bulletin present the major

 findings of the Employee Benefits Survey of medium

and large private establishments. Survey data are also

available in research articles, special bulletins and reports,

short publications, and electronic media.

Articles based on Employee Benefits Survey data are published periodically in the Bureau's Monthly Labor Review and

Compensation and Working Conditions. The following is a

list of recent articles:

Kramer, Natalie. "Employee Benefits for Older Workers,"

Monthly Labor Review, April 1995

Foster, Ann C. "Employee Benefits in the United States,

1993-94," Compensation and Working Conditions, Spring

1997

Wiatrowski, William J. "Methods of Providing Child-care

Benefits to Employees," Compensation and Working

Conditions, May 1995

Simpson, Hilery. "Paid Lunch and Paid Rest Time Benefits," Compensation and Working Conditions, December

1996

Wiatrowski, William J. "Small Businesses and Their

Employees," Monthly Labor Review, October 1994

Wiatrowski, William J. "Counting the Incidence of

Employee Benefits," Compensation and Working Conditions, June 1996

Foster, Ann C. "Employee Contributions for Medical Care

Coverage," Compensation and Working Conditions,

September 1996

Bucci, Michael and Grant, Robert B. "Employer-Sponsored Health Insurance: What's Offered; What's Chosen?"

Monthly Labor Review, October 1995

Wiatrowski, William J. "Who Really Has Access to

Employer-provided Health Benefits?" Monthly Labor

Review, June 1995

Simpson, Hilery. "Short-term Disability Benefits," Compensation and Working Conditions, Summer 1997

Appendix C. Availability of Survey Data

Foster, Ann C. "Employee Participation in Savings and

Thrift Plans, 1993" Monthly Labor Review, March 1996

Foster, Ann C. "Defined Contribution Retirement Plans

Become More Prevalent," Compensation and Working

Conditions, June 1996

Foster, Ann C. "Early Retirement Provisions in Defined

Benefit Pension Plans," Compensation and Working

Conditions, December 1996

Foster, Ann C. "Public and Private Sector Defined Benefit Pension Plans: A Comparison," Compensation and

Working Conditions, Summer 1997

Weinstein, Harriet. "Post-retirement Pension Increases,"

Compensation and Working Conditions, Fall 1997

Special bulletins and reports focus on a single topic or

combine related themes. Recent publications include:

Employee Benefits for Union and Nonunion Workers,

1991-92, Summary 94-7, July 1994

Health Insurance: Employer Offering and Employee

Choice in State and Local Governments, 1992, Summary

94-12, September 1994

Payouts from Employee Benefit Plans, Bulletin 2436,

December 1993

Employee Benefits in the United States, Summary 93-4,

June 1993

Employee Benefits in a Changing Economy: A BLS

Chartbook, Bulletin 2394, September 1992

Substance Abuse Provisions in Employee Benefit Plans,

Bulletin 2412, August 1992

Issues in Labor Statistics is one of a series of BLS occasional reports that present information of current interest.

Recent reports on employee benefits include:

Parental Leave Benefits Provided by Employers, Summmary Employers, Summary 93-1, March 1993 Health

Care Benefits Under Close Scrutiny, Summary 93-2,

March 1993

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Electronic data are also available. Through the BLS

LABSTAT on-line data service, users may access Employee

Benefits Survey news releases and historical data on major

benefit incidences and provisions.

More information may be obtained by writing the Emloyee

Benefits Survey, Bureau of Labor Statistics, 2 Massachusetts Avenue, NE., Room 4160, Washington, DC 20212-0001.

Public information is also available by telephone at 202-

606-6222.

Appendix C: Availability of Survey Data

173