STATISTICAL BRIEF #503:
Results from the 2016 MEPS-IC Private-Sector National Tables


July 2017
Patricia Keenan, PhD, G. Edward Miller, PhD and Jessica Vistnes, PhD

Highlights

  • From 2015 to 2016, there was no statistically significant change in either the overall percentage of private-sector employees covered by a health insurance plan offered by their employers (47.2 percent in 2016) or in the number of enrollees (58.2 million in 2016).
  • There was no statistically significant change in the percentage of employees working at establishments that offer insurance ("the offer rate") between 2015 and 2016 (84.3 percent in 2016). However, the offer rate at medium-sized employers (with 50 to 99 employees) increased from 85.3 percent to 88.6 percent in this period. Offer rates at small firms (with fewer than 50 employees) and large firms (with 100 or more employees) were unchanged at 47.7 percent and 98.9 percent, respectively.
  • The eligibility rate for employees at private-sector establishments that offered insurance did not differ significantly between 2015 (76.0 percent) and 2016 (76.5 percent). However, eligibility rates in 2014 through 2016 were lower than from 2008 to 2013.
  • The overall take-up rate declined from 75.0 percent in 2015 to 73.3 percent in 2016, the lowest level in the 2008 through 2016 period.
  • The 2015 to 2016 growth rates for single premiums and employee-plus-one premiums (2.3 percent and 2.7 percent, respectively) were similar to the growth rates from 2014 to 2015 (2.2 percent and 2.6 percent, respectively). The 2015 to 2016 growth rate for family premiums (2.2 percent) was lower than the growth rate for 2014 to 2015 (4.0 percent) (p < 0.10).

Introduction

Employer-sponsored insurance (ESI) is the primary source of health insurance coverage for individuals under age 65. This Statistical Brief uses data for private-sector establishments in the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to describe trends in employer coverage, premiums, and deductibles from 2008 to 2016. The MEPS-IC is an annual survey of private employers and State and local governments and is designed to be representative of all 50 States and the District of Columbia.

The period presented in this Brief, 2008 to 2016, shows trends over time during a period of change in national health care policy that could have affected national ESI trends, as well as trends by firm size. Starting in 2014, most people were required to either obtain health insurance or make an individual shared responsibility payment. The employer shared responsibility provisions began to take effect for employers with 100 or more full-time-equivalent employees in 2015 and for employers with 50 or more employees in 2016.

This Brief describes trends and patterns in ESI for private-sector employees, overall and by three firm size categories (employees in establishments in firms with fewer than 50 employees, 50 to 99 employees, and 100 or more employees, respectively). All differences discussed in the text are at the 0.05 significance level, unless otherwise noted. All dollar estimates are nominal (not adjusted for inflation).

Findings

Enrollment rates and number of covered employees
From 2015 to 2016, there was no significant change in the overall percentage of private-sector employees covered by a health insurance plan offered by their employers (the "enrollment rate") and no significant change in the enrollment rates at small (fewer than 50 employees), medium-sized (50 to 99 employees), or large firms (100 or more employees) (figure 1). There was also no significant change in the number of enrollees overall, or in any firm-size category in this period (figure 2).

In 2016, 47.2 percent of employees were enrolled in a health plan through their employer, 26.5 percent at small employers, 45.4 percent at medium-sized employers, and 56.0 percent at large employers (figure 1). Enrollment rates were lower at smaller (fewer than 100 employees) employers than at large employers throughout the 2008 to 2016 time period, mainly due to lower offer rates (figure 3).

Offer rates
There was no significant change in the overall percentage of employees working at establishments that offer insurance ("the offer rate") between 2015 (83.8 percent) and 2016 (84.3 percent) (figure 3). While the offer rate at large firms (100 or more employees) was unchanged in this period (98.9 percent in 2016), the offer rate at medium-sized employers (50 to 99 employees) increased from 85.3 percent in 2015 to 88.6 percent in 2016, the first year that the federally-mandated employer shared responsibility provisions took effect for firms of this size. With respect to small firms (fewer than 50 employees), the offer rate was unchanged from 2015 to 2016. Over the longer term, however, offer rates at small firms declined from 61.6 percent in 2008 to 47.7 percent in 2016.

Eligibility rates
The overall eligibility rate for employees at private-sector establishments that offered insurance did not change significantly between 2015 (76.0 percent) and 2016 (76.5 percent) and also did not change significantly for small, medium-sized, or large employers (figure 4). Overall eligibility rates in each year from 2014 through 2016 were lower than eligibility rates in any year from 2008 to 2013.

Take-up rates
The overall take-up rate declined from 75.0 percent in 2015 to 73.3 percent in 2016, the lowest level in the 2008 through 2016 period, which began with an overall take-up rate of 78.7 percent in 2008. Take-up rates also declined in 2016 to their lowest levels in the 2008 through 2016 period for small, medium-sized, and large firms (figure 5). For small employers the take-up rate declined from 72.1 percent in 2015 to 70.4 percent in 2016, while for medium-sized employers, the take-up rate declined from 71.7 percent to 67.2 percent. For large firms, the take-up rate declined from 76.0 percent to 74.4 percent between 2015 and 2016.

Premiums
In 2016, average health insurance premiums for enrollees in private-sector employer plans were $6,101 (single coverage) (figure 6), $12,124 (employee-plus-one coverage) (figure 7), and $17,710 (family coverage) (figure 8), representing increases of 2.3 percent for single coverage, 2.7 percent for employee-plus-one coverage, and 2.2 percent for family coverage over 2015 levels (figure 9).

The 2015 to 2016 growth rates for single premiums and employee-plus-one premiums (2.3 percent and 2.7 percent, respectively) were similar to the growth rates from 2014 to 2015 (2.2 percent and 2.6 percent, respectively). The 2015 to 2016 growth rate for family premiums (2.2 percent) was lower than the growth rate for 2014 to 2015 (4.0 percent) (p < 0.10). The 2015–2016 growth rates for single, employee-plus-one coverage, and family coverage were among the lowest growth rates in the entire period, from 2009 through 2016, for each type of coverage.

Employee premium contributions
Average employee contributions to health insurance premiums in 2016 were $1,325 for single coverage (figure 10), $3,376 for employee-plus-one coverage (figure 11), and $4,956 for family coverage (figure 12). From 2015 to 2016, average employee contributions for single, employee-plus-one, and family coverage increased by 5.6 percent, 4.8 percent, and 5.2 percent, respectively (data not shown). The percentage change in employee contributions for single coverage from 2015 to 2016 was larger at small employers (14.2 percent) than at large employers (2.8 percent).

Deductibles
There was no statistically significant change in the overall percentage of enrollees in a health insurance plan with a deductible from 2015 (85.4 percent) to 2016 (84.5 percent) (figure 13). There were also no significant changes in this measure for any of the three firm-size categories. From 2008 to 2015, there was a significant increase in the overall percentage of enrollees with a deductible (at p < 0.10 or better) in every year except from 2010 to 2011.

Among enrolled employees in single-coverage plans with deductibles, average individual deductibles rose from $1,541 in 2015 to $1,696 in 2016 (an increase of 10.1 percent), while average family deductibles rose from $2,915 in 2015 to $3,069 in 2016 (an increase of 5.3 percent) (figures 14 and 15). Average individual deductibles were higher in small ($2,105) and medium-sized firms ($2,173) than in large firms ($1,558) in 2016. Family deductibles were also higher in small ($3,940) and medium-sized firms ($3,840) than in large firms ($2,887) in 2016.

Data Source

This Statistical Brief summarizes data from the 2008 through 2016 MEPS-IC. The data are available on the MEPS Web site at http://www.meps.ahrq.gov/mepsweb/survey_comp/Insurance.jsp or have been produced using special computation runs on the confidential MEPS-IC data available at the U.S. Census Bureau.

Definitions

Single coverage
Single coverage is health insurance that covers the employee only.

Employee-plus-one coverage
Employee-plus-one coverage is health insurance that covers the employee and one other family member at a lower premium level than family coverage. If premiums differed for employee-plus-spouse and employee-plus-child coverage, information for employee-plus-child coverage was collected.

Family coverage
Family coverage is health insurance that covers the employee and one or more family members (spouse and/or children as defined by the plan). For the MEPS-IC survey, family coverage is any coverage other than single and employee-plus-one. Some plans offer more than one rate for family coverage, depending on family size and composition. If more than one rate is offered, survey respondents are asked to report costs for a family of four.

Enrollment rate
The enrollment rate is the percentage of all employees enrolled in their employer's health insurance at establishments both offering and not offering health insurance.

Offer rate
The offer rate is the percentage of employees who work at establishments that offer health insurance.

Eligible employees
Eligible employees are those that are allowed to enroll in employer-sponsored coverage offered by their employer. Common eligibility criteria include a minimum number of hours worked per pay period or a minimum length of service with the employer.

Employee
An employee is a person on the actual payroll. This definition excludes temporary and contract workers but includes the owner or manager if that person works at the firm.

Establishment
An establishment is a single physical location of a business.

Health insurance plan
A health insurance plan is an insurance contract that provides hospital and/or physician coverage to an employee for an agreed-upon fee (premium) for a defined benefit period.

Take-up rate
The take-up rate is the percentage of eligible employees who enroll in health insurance coverage through their employer at establishments that offer insurance.

Deductible
A deductible is a fixed dollar amount during the benefit period—usually a year—that an insured person pays before the insurer starts to make payments for covered medical services. Plans may have both per individual and family deductibles.

About MEPS-IC

The MEPS-IC is a survey of business establishments and governments that collects information on employer-sponsored health insurance, such as whether insurance is offered, enrollments, types of plans, and premiums. The survey is conducted annually by the U.S. Census Bureau under the sponsorship of the Agency for Healthcare Research and Quality (AHRQ). A total sample of approximately 42,000 private-sector establishments was selected for the 2016 survey, with 5.5 percent of the sample determined to be out-of-scope during the data collection process. The response rate for the private sector was 67.6 percent of the remaining in-scope sample units.

Suggested Citation

Keenan, P., Miller, G.E., and Vistnes, J. Results from the 2016 MEPS-IC Private-Sector National Tables. Statistical Brief #503. July 2017. Agency for Healthcare Research and Quality, Rockville, MD. https://meps.ahrq.gov/mepsweb/data_files/publications/st503/stat503.shtml

* * *

AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of health care in the United States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. Please email us at MEPSProjectDirector@ahrq.hhs.gov or send a letter to the address below:

Joel Cohen, PhD, Director
Center for Financing, Access, and Cost Trends
Agency for Healthcare Research and Quality
5600 Fishers Lane, Mail Stop 07W41A
Rockville, MD 20857







Figure data for accessible table follows the image
Figure 1. Enrollment rate: Percentage of all private-sector employees enrolled in employer-sponsored health insurance, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States53.9%53.5%51.8%50.6%49.9%49.4%48.1%47.8%47.2%
Small (< 50 employees)36.8%35.5%34.2%32.0%30.5%30.3%28.3%27.1%26.5%
Medium (50-99 employees)51.1%53.8%48.8%46.9%46.6%47.6%45.2%47.0%45.4%
Large (100+ employees)61.3%60.9%59.5%58.9%58.5%57.7%56.7%56.4%56.0%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016.
Denominator: Within each category, eligible employees at establishments that offer health insurance.

Figure data for accessible table follows the image
Figure 2. Total number (in millions) of private-sector enrollees in employer-sponsored health insurance, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States62.659.256.154.855.456.355.857.358.2
Small (< 50 employees)11.510.610.29.59.39.58.98.98.9
Medium (50-99 employees)4.44.33.83.73.84.04.14.04.0
Large (100+ employees)46.744.342.141.642.342.942.844.445.3
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

Figure data for accessible table follows the image
Figure 3. Offer rate: Percentage of private-sector employees in establishments that offer health insurance, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States87.7%87.6%86.5%85.3%84.7%84.9%83.2%83.8%84.3%
Small (< 50 employees)61.6%59.6%57.8%54.7%52.9%53.1%49.8%47.6%47.7%
Medium (50-99 employees)90.7%89.6%87.3%85.6%84.1%87.0%83.0%85.3%88.6%
Large (100+ employees)98.2%98.8%98.5%98.1%98.2%98.0%97.3%98.8%98.9%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

Figure data for accessible table follows the image
Figure 4. Eligibility rate: Percentage of private-sector employees eligible for health insurance at establishments that offer health insurance, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States78.1%79.5%78.2%78.0%77.8%77.8%75.4%76.0%76.5%
Small (< 50 employees)78.5%79.3%78.6%78.7%77.9%78.0%77.7%79.1%78.7%
Medium (50-99 employees)75.3%79.2%74.5%73.6%76.4%76.2%74.1%77.8%76.2%
Large (100+ employees)78.3%79.6%78.5%78.3%77.9%77.9%75.0%75.2%76.0%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016.
Denominator: Within each category, eligible employees at establishments that offer health insurance.

Figure data for accessible table follows the image
Figure 5. Take-up rate: Percentage of eligible private-sector employees who are enrolled in health insurance at establishments that offer health insurance, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States78.7%76.9%76.5%76.1%75.8%74.8%76.7%75.0%73.3%
Small (< 50 employees)76.0%75.2%75.3%74.4%74.1%73.1%73.0%72.1%70.4%
Medium (50-99 employees)74.9%75.9%75.1%74.5%72.5%71.8%73.5%71.7%67.2%
Large (100+ employees)79.7%77.5%76.9%76.7%76.4%75.5%77.8%76.0%74.4%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016.
Denominator: Within each category, eligible employees at establishments that offer health insurance.

Figure data for accessible table follows the image
Figure 6. Average total single premium per enrolled private-sector employee, overall, and by firm size, 2008-2016
200820092010201120122013201420152016
United States$4,386$4,669$4,940$5,222$5,384$5,571$5,832$5,963$6,101
Small (< 50 employees)$4,501$4,652$4,956$5,258$5,460$5,628$5,886$5,947$6,070
Medium (50-99 employees)$4,215$4,614$4,713$4,861$5,246$5,314$5,549$5,642$5,743
Large (100+ employees)$4,370$4,681$4,959$5,252$5,378$5,584$5,851$6,006$6,146
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

Figure data for accessible table follows the image
Figure 7. Average total employee-plus-one premium per enrolled private-sector employee, overall, and by firm size, 2008-2016
200820092010201120122013201420152016
United States$8,535$9,053$9,664$10,329$10,621$10,990$11,503$11,800$12,124
Small (< 50 employees)$8,631$9,124$9,850$10,253$10,524$11,050$11,386$11,666$11,833
Medium (50-99 employees)$8,421$8,852$9,166$9,615$10,178$10,673$10,845$10,885$11,389
Large (100+ employees)$8,527$9,058$9,669$10,394$10,672$11,006$11,571$11,892$12,225
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

Figure data for accessible table follows the image
Figure 8. Average total family premium per enrolled private-sector employee, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States$12,298$13,027$13,871$15,022$15,473$16,029$16,655$17,322$17,710
Small (< 50 employees)$11,679$12,041$13,170$14,086$14,496$14,787$15,575$15,919$16,471
Medium (50-99 employees)$11,578$12,431$13,019$14,151$15,421$15,376$15,732$16,336$16,214
Large (100+ employees)$12,468$13,271$14,074$15,245$15,641$16,284$16,903$17,612$18,000
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

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Figure 9. Percentage change from previous year in total premiums per enrolled private-sector employee for single, employee-plus-one, and family coverage 2009-2016
20092010201120122013201420152016
Single6.5%5.8%5.7%3.1%3.5%4.7%2.2%2.3%
Emplyee-plus-one6.1%6.7%6.9%2.8%3.5%4.7%2.6%2.7%
Family5.9%6.5%8.3%3.0%3.6%3.9%4.0%2.2%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

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Figure 10. Average annual employee contribution (in dollars) for single coverage, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States$882$957$1,021$1,090$1,118$1,170$1,234$1,255$1,325
Small (< 50 employees)$794$834$907$960$979$1,045$1,035$1,065$1,216
Medium (50-99 employees)$861$896$1,035$1,101$1,096$1,145$1,220$1,230$1,393
Large (100+ employees)$912$1,000$1,054$1,127$1,159$1,209$1,287$1,307$1,343
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

Figure data for accessible table follows the image
Figure 11. Average annual employee contribution (in dollars) for employee-plus-one coverage, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States$2,303$2,363$2,498$2,736$2,824$2,940$3,097$3,220$3,376
Small (< 50 employees)$2,442$2,648$2,836$2,942$3,004$3,117$3,275$3,454$3,479
Medium (50-99 employees)$2,894$2,901$3,056$3,189$3,389$3,630$3,619$3,765$4,077
Large (100+ employees)$2,235$2,270$2,398$2,670$2,751$2,862$3,031$3,144$3,307
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

Figure data for accessible table follows the image
Figure 12. Average annual employee contribution (in dollars) for family coverage, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States$3,394$3,474$3,721$3,962$4,236$4,421$4,518$4,710$4,956
Small (< 50 employees)$3,458$3,630$4,117$4,144$4,366$4,228$4,426$4,587$4,510
Medium (50-99 employees)$3,852$4,102$4,455$4,669$4,866$5,360$5,206$5,502$5,821
Large (100+ employees)$3,348$3,393$3,588$3,882$4,169$4,387$4,483$4,671$4,971
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016

Figure data for accessible table follows the image
Figure 13. Percentage of private-sector enrolled employees in a health insurance plan with a deductible, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States70.7%73.8%77.5%77.8%79.6%81.3%83.9%85.4%84.5%
Small (< 50 employees)70.9%73.5%75.7%76.3%79.5%79.5%80.8%82.1%81.7%
Medium (50-99 employees)70.3%70.6%78.2%79.6%80.3%78.0%82.4%85.3%82.5%
Large (100+ employees)70.7%74.2%77.8%77.9%79.6%81.9%84.6%86.1%85.2%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016.

Figure data for accessible table follows the image
Figure 14. Average individual deductible (in dollars) per private-sector employee with single coverage in a health insurance plan with a deductible, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States$869$917$1,025$1,123$1,167$1,273$1,353$1,541$1,696
Small (< 50 employees)$1,177$1,283$1,447$1,561$1,628$1,695$1,777$1,964$2,105
Medium (50-99 employees)$1,149$1,249$1,522$1,543$1,622$1,755$1,744$2,008$2,173
Large (100+ employees)$740$774$852$951$989$1,106$1,205$1,383$1,558
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016.
Note: Due to refined data edits, the 2014 to 2015 increase is 4.8 percent higher than would have otherwise occurred.

Figure data for accessible table follows the image
Figure 15. Average family deductible (in dollars) per private-sector employee enrolled with family coverage in a health insurance plan with a deductible, overall and by firm size, 2008-2016
200820092010201120122013201420152016
United States$1,658$1,761$1,975$2,220$2,322$2,491$2,640$2,915$3,069
Small (< 50 employees)$2,389$2,652$2,857$3,329$3,515$3,761$3,810$4,090$3,940
Medium (50-99 employees)$2,173$2,362$3,040$3,349$3,523$3,634$3,404$3,875$3,840
Large (100+ employees)$1,488$1,552$1,734$1,954$2,038$2,215$2,408$2,676$2,887
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey Insurance Component, private-sector establishments, 2008-2016
Note: Due to refined data edits, the 2014 to 2015 increase is 2.4 percent higher than would have otherwise occurred.

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