Finally, the nature of the workplace usually means that older members remain in the group for many years while younger members come and go. A large national or regional insurance company makes for a far better risk pool than almost any employer. Although there are some notable exceptions, employers generally are poor at helping workers navigate the health care financing and delivery system. Very few workers are comfortable in confiding their true health care needs and concerns to their employers. If a worker needs mental health services or has a drug addicted spouse, or a daughter who wants an abortion, or a son with AIDS, the employer is close to the last person an employee would confide in.
Employers offer no confidentiality protection like that of doctors, attorneys or ministers.
And employers are not particularly knowledgeable about either health care financing or medical care services. Here there is some truth, but it is often overstated. But a substantial part of this is because larger employers absorb much of the administrative cost that insurers must perform for individuals and small groups. Services such as distributing plan material, answering worker questions, tracking enrollment and collecting premiums are still rendered and paid for, but they show up in the large employer's overhead instead of as part of premium. The one area that makes a big difference is marketing expense.