Fronstin Paul, Helman Ruth, Greenwald Mathew
EBRI Issue Brief. 2003 Jan(253):1-21.
Overall, 19 percent of small employers offering health benefits made changes to their health plan between 2001 and 2002. Sixty-five percent increased deductibles and co-pays; 35 percent switched insurers; 30 percent increased the employee share of the premium; and 29 percent cut back on the scope of benefits. Twenty-six percent increased the scope of benefits offered. Nearly one-quarter of small employers offering health benefits think their firm would change coverage and 3 percent think it would drop coverage if the cost were to increase an additional 5 percent. Most small employers offer sound business reasons for offering health benefits to workers. Many report that it helps with employee recruitment and retention, and increases productivity. More than three-quarters report that offering health benefits is "the right thing to do." Most small employers that do offer health benefits report that it has a positive impact on various aspects of the business, such as recruitment, retention, employee attitude and performance, employee health status, and the overall success of the business. Most small employers that do not offer health benefits tend to think that not offering them has no negative impact on the above aspects of their business or the overall success of the business. However, those not offering benefits are more likely than those offering them to report that most of their employees are high-turnover and stay on the job only a few months. Small employers that offer health benefits tend to be distinctly different from those not offering them. Worker income in firms not offering health benefits tends to be considerably lower than in firms that do offer them. Employers not offering health benefits are more likely than those offering them to have a smaller proportion of full-time employees, and employers that do not offer health benefits have a larger proportion of females, workers under age 30, and minority employees. Of small employers that offer dependent coverage, more than 40 percent report that workers do not take coverage for their dependents because the dependents have coverage from somewhere else, but 35 percent report that employees decline dependent coverage because they cannot afford the premiums. Many small employers that do not offer health benefits are potential purchasers. Eleven percent are either extremely or very likely to start offering health benefits in the next two years, and 22 percent are somewhat likely to start offering health benefits.
总体而言,在2001年至2002年期间,提供健康福利的小雇主中有19%对其健康计划进行了调整。65%提高了免赔额和共付额;35%更换了保险公司;30%提高了员工承担的保费份额;29%缩减了福利范围。26%扩大了提供的福利范围。近四分之一提供健康福利的小雇主认为,如果成本再增加5%,他们公司会改变保险范围,3%认为会取消保险范围。大多数小雇主给出了向员工提供健康福利的合理商业理由。许多雇主表示,这有助于招聘和留住员工,并提高生产力。超过四分之三的雇主表示,提供健康福利是“正确之举”。大多数提供健康福利的小雇主报告称,这对企业的各个方面都有积极影响,如招聘、留用、员工态度和绩效、员工健康状况以及企业的整体成功。大多数不提供健康福利的小雇主往往认为,不提供这些福利对企业的上述方面或整体成功没有负面影响。然而,与提供福利的雇主相比,不提供福利的雇主更有可能报告称,他们的大多数员工流动率高,在职时间仅几个月。提供健康福利的小雇主往往与不提供福利的小雇主明显不同。不提供健康福利的公司员工收入往往远低于提供福利的公司。不提供健康福利的雇主比提供福利的雇主更有可能拥有较小比例的全职员工,且不提供健康福利的雇主中女性、30岁以下员工和少数族裔员工的比例更大。在提供家属保险的小雇主中,超过40%报告称员工不为家属参保是因为家属在其他地方已有保险,但35%报告称员工拒绝家属保险是因为他们负担不起保费。许多不提供健康福利的小雇主是潜在购买者。11%的雇主极有可能或非常有可能在未来两年开始提供健康福利,22%的雇主 somewhat likely(此处原文有误,可能是“ somewhat likely”,意为“有点可能”)开始提供健康福利。