Employee participation may increase as a result of additional support for dependent coverage as provided by small employers, including employer buy-in programs or other alternatives that lower the cost to employees. Employee participation may also be enhanced as a result of increased support for dependent coverage provided by small employers. Most insurance companies require a minimum level of employee participation in employer-sponsored plans in order to reduce the threat of adverse selection. It is often difficult for employers to obtain the required minimum level of participation for dependent health insurance programs due to the high cost of such plans. Therefore, assistance in lowering cost to employees may increase total participation in small employer health plans.