Odds are, the Pop's employee has no dental plan. Odds are, in fact, the Pop's cashier has no health plan at all and is either skimping on basic medical needs or going broke trying to stay fit. Most are at shops employing fewer than 25, where the high cost of insurance often forces owners to choose between health benefits and decent pay raises. Small-business owners aren't happy about this. At long last, the issue is coming into focus in Congress and has surfaced in the presidential race.
Many owners stop offering coverage or push costs onto employees, who then opt out.
Basically, big companies with thousands of employees get better rates because the underwriter's risks are spread out. One catastrophic illness is easily absorbed. But one big-ticket illness in a pool of 10 or 20 people can make premiums unaffordable. Big firms operate under federal Employee Retirement Income Security Act guidelines, which supersede varying and often baffling state insurance requirements. This lets national employers use one set of rules, simplifying the administration of health benefits.