SECTION3. EMPLOYEECOVERAGE,ELIGIBILITY,ANDPARTICIPATION Section3 EmployeeCoverage,Eligibility,and Participation EmployersaretheprincipalsourceofhealthinsuranceintheUnitedStates,providinghealthbenefitsforabout151million 1 non-elderlypeopleinAmerica. Mostworkersareofferedhealthcoverageatwork,andthemajorityofworkerswhoare offeredcoveragetakeit. Workersmaynotbecoveredbytheirownemployerforseveralreasons: theiremployermaynotoffer coverage,theymaynotbeeligibleforthebenefitsofferedbytheirfirm,theymayelecttoreceivecoveragethroughtheir spouse’semployer,ortheymayrefusecoveragefromtheirfirm. Beforeeligibleworkersmayenroll,aboutthree-quarters(76%) of coveredworkersfaceawaitingperiod. ELIGIBILITY • Notallworkersareeligibleforthehealthbenefitsofferedbytheirfirm,andnotalleligibleworkers“takeup”(i.e.,elect toparticipatein)theofferofcoverage. Theshareofworkerscoveredinafirmisaproductofboththepercentageof workerswhoareeligibleforthefirm’shealthinsuranceandthepercentagethatchoosetotakeupthebenefit. The percentageofworkerseligibleforhealthbenefitsatofferingfirmsin2017issimilartolastyearandtherecentpastfor bothsmallandlargefirms[Figure3.1]. – Seventy-ninepercentofworkersinfirmsofferinghealthbenefitsareeligibleforthecoverageofferedbytheir employer. Thepercentageofeligibleworkersishigherinsmallfirmswith3-24workers(84%)thanotherfirmsizes [Figure 3.2]. – Eligibility varies considerably by firm wage level. Workers in firms with a relatively large share of lower-wage workers(whereatleast35%ofworkersearn$24,000ayearorless)arelesslikelytobeeligibleforhealthbenefits thanworkersinfirmswithasmallershareoflower-wageworkers(68%vs.81%)[Figure3.3]. – Workersinfirmswitharelativelylargeshareofhigher-wageworkers(whereatleast35%earn$60,000or moreannually)aremorelikelytobeeligibleforhealthbenefitsthanworkersinfirmswithasmallershareof higher-wageworkers(88%vs.73%)[Figure3.3]. – Eligibility also varies by the age of the workforce. Those in firms with a relatively small share of younger workers (wherefewerthan35%oftheworkersareage26oryounger)aremorelikelytobeeligibleforhealthbenefitsthan thoseinfirmswithalargershareyoungerworkers(81%vs.64%)[Figure3.3]. – Theaverageeligibilityrateisparticularlylowinretailfirms(54%)[Figure3.2]. 1 Kaiser CommissiononMedicaidandtheUninsured. Theuninsured: Aprimer—Keyfactsabouthealthinsuranceandtheuninsuredinthewake of national health reform [Internet]. Washington (DC): The Commission;2016Nov[cited2016Aug1]. http://www.kff.org/uninsured/report/ the-uninsured-a-primer-key-facts-about-health-insurance-and-the-uninsured-in-the-wake-of-national-health-reform/. Seesupplementaltables-Table1: 270.2millionnon-elderlypeople,55.5%ofwhomarecoveredbyESI. The Kaiser Family Foundation and Health Research & Educational Trust / Page 56