The Associated Press-NORC Center for Public Affairs Research

The Intersection of Insight and Journalism

Employer Perspectives on the Health Insurance Market: A Survey of Businesses in the United States

With funding from the Robert Wood Johnson Foundation, the AP-NORC Center conducted a national survey of 1,061 private sector employers.
​A new, nationally representative survey of employers in the United States, conducted by the Associated Press-NORC Center for Public Affairs Research, with funding from the Robert Wood Johnson Foundation, shows that many employers that offer health insurance to employees are unfamiliar with objective metrics of health plan quality information, and most consider costs both to their organization and their employees as important factors when selecting plans. The survey also finds that employers are looking to the Affordable Care Act (ACA) as they make significant decisions on the benefits they offer, with the costs of health plans as a key consideration.

As employers change their purchasing behaviors to accommodate ACA requirements and as the health insurance marketplace evolves as a result of employers’ new purchasing decisions, this survey provides timely data on the quality information employers offering insurance do, or in many cases, do not, use when evaluating plans. The survey also provides insights into employers’ key considerations when choosing health insurance plans. Further, the survey shows how employers in general view the impact of the ACA as businesses consider changing employee benefits, and also provides data on employers’ wellness program offerings and promotion strategies.

The AP-NORC Center conducted interviews with representatives of 1,061 private sector employers with three or more employees, including 878 businesses that report offering health insurance benefits to employees and 181 businesses that report the company does not offer health insurance benefits to employees. The surveyed employers include 413 small businesses (3-49 employees), 353 medium businesses (50-499 employees), and 295 large businesses (500 or more employees). In the United States, a majority (96 percent) of employers are small businesses with fewer than 50 employees, although these organizations only employ 28 percent of workers. Medium- and large-sized businesses, with 50 or more employees, are 4 percent of the employer population, but they employ 72 percent of workers.

Five things you should know from the AP-NORC Center’s Employer Survey among private sector employers with at least three employees:
• Most employers think the ACA will have an impact on businesses’ decisions about the health benefits they offer, though some say it will make scaling benefits back easier and other say harder.
• One in 5 employers say their organization is examining the design of health insurance exchange plans as they work on updating or changing the insurance benefits they offer.
• Six in 10 employers offering insurance think plan quality ratings are important, but 9 in 10 are unfamiliar with objective quality metrics.
• When selecting health plans, employers’ top consideration is their own bottom line, but the cost to their employees is also important.
• Only 4 percent of companies offering insurance that employ 100 or more workers plan to change employee schedules to reduce the number of full-time employees to comply with the ACA.