Small and large firms vary substantially on health insurance offer rates and costs. Small firms are less likely to offer coverage, and there are important differences in the health benefits that they do offer. Workers at small firms are responsible for paying both a larger share of family premiums as well as higher cost sharing than workers in large firms. Small and large firms also face different regulatory requirements; for instance, small firms face different rules about ratings and benefits than larger firms, while firms with 50 or more full-time equivalents (FTEs) must offer affordable coverage or face a penalty. This brief expands on information presented in the 2015 Kaiser/HRET Survey of Employer-Sponsored Health Benefits to look exclusively at differences in offer rates, plan costs, and cost sharing between small firms and large firms. We define “small firms” as employers with 3 to 199 workers and “large firms” as employers with 200 or more workers. While the vast majority of businesses in the United States are small businesses, the majority of workers are employed at large firms. Of the over three million firms with 3 or more workers, 98% have between 3 and 199 employees. Small firms employ 38% of all workers and 30% of workers who receive health insurance through their own job. Information on the survey’s methodology can be found in the 2015 Kaiser/HRET Employer Health Benefits Survey full report.
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