U.S. Bureau of Labor Statistics

Compensation and Working Conditions Online

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.

• 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

• 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.

• 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.

• 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.