U.S. BUREAU OF LABOR STATISTICS COMPENSATION AND WORKING CONDITIONS

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Access to and Participation in Employer-Provided Health Care Plans, Private

Industry, 2005

by Paul A. Welcher

Bureau of Labor Statistics

Originally Posted: January 25, 2006

The 2005 National Compensation Survey (NCS) benefits data reveal that access1 to and participation2 in employer-provided

health care plans vary notably among worker and establishment characteristics. Data on health care plans collected by the

NCS are categorized into the following types of plans: medical, dental, vision, and prescription drug.

• Among private industry workers, access and participation rates vary widely among the different types of health care.

As chart 1 shows, 70 percent of private workers have access to medical care plans, 46 percent have access to dental

care plans, 29 percent have access to vision care plans, and 64 percent have access to outpatient prescription drug

coverage. • The chart also shows that participation rates are notably lower than access rates for medical care, dental care, vision

care, and prescription drug plans. Still, participation follows the same general pattern as access, with medical care

having the highest rate of participation among private workers and vision care having the lowest rate of participation.
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• The term take-up rate refers to the percent of workers with access to a plan who participate in the plan. As chart 2

shows, take-up rates vary considerably among different categories of workers. For example, the take-up rate on

medical care plans for part-time workers is only 54 percent, compared with a take-up rate of 77 percent for full-time

workers. At the same time, take-up rates between different types of health care plans for a given worker or

establishment characteristic vary little (except among part-time workers). Among full-time workers, for example, the

take-up rates are 77 percent for medical care plans, 80 percent for dental care plans, 76 percent for vision care plans,

and 76 percent for prescription drug coverage. • The participation rate for a group of workers (such as full-time workers) is calculated by dividing the number of workers

who participate in a plan by the total number of workers in a group; the result is multiplied by 100 to yield a

percentage. A participation rate reflects both access and take-up rates: the higher the take-up rate, the closer the

participation rate will be to the access rate.3
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• Employer-provided medical plan access varies markedly by establishment size. As chart 3 shows, 84 percent of

workers in large establishments (defined as having 100 or more workers) are offered access to medical care plans,

while only 59 percent of workers in small establishments (those with less than 100 workers) are offered access to

medical care plans. • Because access and participation rates are closely connected, it is not surprising that the level of participation in large

establishments is greater than it is in small establishments. The chart shows that 65 percent of workers employed in

large establishments participate in employer-provided medical plans, compared with only 43 percent of workers

employed in small establishments. • The difference in participation rates between large and small firms is not limited to medical plans but can be found

among other types of health coverage as well. For example, 65 percent of the workers in large establishments are

offered access to dental care benefits (with 51 percent of the employees participating), while only 31 percent of the

workers in small establishments are offered such benefits (with 24 percent of the employees participating). • Chart 3 also reveals differences in access and participation among different types of health care within an

establishment size classification. For example, of workers in small establishments: 43 percent participate in medical

plans, 24 percent participate in dental plans, 14 percent participate in vision plans, and 37 percent participate in

prescription drug plans.

• There are marked differences in health care benefit access and participation between full-time workers and part-time

workers. Chart 4 shows, for example, that 85 percent of full-time workers have access to medical care benefits,

compared with only 22 percent of part-time workers. The chart also shows that 66 percent of full-time workers

participate in employer-provided medical care plans, compared with only 12 percent of part-time workers. • The chart also shows that large differences exist between full-time and part-time workers in terms of access to and

participation in dental, vision, and prescription drug plans. For example, 56 percent of full-time workers have access to

dental benefits (with 45 percent participating), compared with only 14 percent of part-time workers (with 9 percent

participating). • Chart 4 also reveals differences in access and participation among different types of health care plans within particular

worker classifications. Among full-time workers, for example, 66 percent participate in medical plans, 45 percent

participate in dental plans, 27 percent participate in vision plans, and 59 percent participate in prescription drug plans.
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• The National Compensation Survey divides workers into two wage groups: workers in occupations that average $15 or

more per hour and those averaging less than $15 per hour. But the differences in health care access and participation

rates may be due to factors other than wage status. For example, workers in the lower-wage job category may also be

classified in the nonunion or part-time categories, where access and participation rates are lower than in the union and

full-time categories. • As chart 5 shows, 87 percent of workers who earn $15 or more per hour have access to medical care benefits, with 72

percent participating in such plans. By contrast, only 58 percent of workers who earn less than $15 per hour have

access to medical care plans, with 39 percent participating. Similar patterns can be seen for dental, vision, and

prescription drug coverage. • Within worker wage groupings, notable differences can be seen between the various types of health care plans

offered. Among workers who earn less than $15 per hour, for example, 58 percent have access to medical care, 34

percent have access to dental care, 21 percent have access to vision care, and 53 percent have access to

prescription drug care.
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• The National Compensation Survey also collects data on health benefits by workers’ collective bargaining status.

Union and nonunion workers differ in access to and participation in health care benefits, with union workers having

greater access and participation than nonunion workers. • Chart 6 shows that 92 percent of union workers have access to medical care plans, compared with 68 percent of

nonunion workers; 83 percent of union workers participate in employers’ medical plans, compared with 49 percent of

nonunion workers. • Similarly, large differences can be seen in other types of health care as well. For example, 73 percent of union

workers have access to dental plans (with 67 percent participating), while only 43 percent of nonunion workers have

access to dental benefits (with 33 percent participating). • The chart also reveals differences in access and participation among different types of health care plans within a

worker’s bargaining status. Among nonunion workers, for example, 49 percent participate in medical plans, 33 percent

participate in dental plans, 19 percent participate in vision plans, and 44 percent participate in prescription drug plans.

NOTE: Standard errors have not been calculated for NCS benefits estimates. Consequently, none of the statistical inferences

made in this report could be verified by a statistical test.

SOURCE: Data shown in these charts are from National Compensation Survey: Employee Benefits in Private Industry in the

United States, March 2005, Summary 05-01 (Bureau of Labor Statistics, August 2005); available on the Internet at http://

www.bls.gov/ncs/ebs/sp/ebsm0003.pdf.

Paul A. Welcher

Economist, Division of Compensation Data Estimation, Office of Compensation and Working Conditions, Bureau of Labor

Statistics.

Telephone: (202) 691-7048; E-mail: Welcher.Paul@bls.gov

Notes

1 An employee has access to a benefit plan if the employee is in an occupation that is offered the plan. By definition, either all employees in an

occupation have access to a benefit, or none has access.

2 Participation is the percentage of employees who are enrolled in a given benefit plan.

3 Employees in noncontributory plans are automatically counted as participating. Contributory costs, which BLS does collect, affect take-up

rates.

Data for Chart 1. Percent of Workers Having Access to or Participating in An Employer-Provided Health Care Plan, by

Type of Plan, Private Industry, 2005

Access Participation

Medical Care 70 53

Dental Care 46 36

Vision Care 29 22

Prescription Drug 64 48

Data for Chart 2. Take-Up Rates for Selected Worker and Establishment Characteristics, by Type of Health Plan, Private

Industry, 2005

Overall Full time Part time 100 or more workers 1-99 workers Union Nonunion

Medical Care 75 77 54 77 73 90 73

Dental Care 78 80 62 79 78 92 76

Vision Care 75 76 67 77 73 90 72

Prescription Drug 75 76 54 76 72 89 72
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Data for Chart 3. Percent of Workers Having Access to or Participating in An Employer-Provided Health Care Plan, by

Establishment Size and Type of Plan, Private Industry, 2005

Access Participation

100 or more workers 1-99 workers 100 or more workers 1-99 workers

Medical Care 84 59 65 43

Dental Care 65 31 51 24

Vision Care 41 19 32 14

Prescription Drug 79 52 61 37

Data for Chart 4. Percent of Workers Having Access to or Participating in An Employer-Provided Health Care Plan, by

Full- and Part-Time Status and Type of Plan, Private Industry, 2005

Access Participation

Full time Part time Full time Part time

Medical Care 85 22 66 12

Dental Care 56 14 45 9

Vision Care 35 9 27 6

Prescription Drug 78 20 59 11

Data for Chart 5. Percent of Workers Having Access to or Participating in An Employer-Provided Health Care Plan, by

Average Hourly Wage Status and Type of Health Plan, Private Industry, 2005

Access Participation

Average wage of $15 per

hour or greater

Average wage of less than

$15 per hour

Average wage of $15 per

hour or greater

Average wage of less than

$15 per hour

Medical

Care 87 58 72 39

Dental Care 62 34 52 24

Vision Care 40 21 32 15

Prescription

Drug 80 53 61 35

Data for Chart 6. Percent of Workers Having Access to or Participating in An Employer-Provided Health Care Plan, by

Collective Bargaining Status and Type of Health Plan, Private Industry, 2005

Access Participation

Union Nonunion Union Nonunion

Medical Care 92 68 83 49

Dental Care 73 43 67 33

Vision Care 57 26 51 19

Prescription Drug 87 61 77 44

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