As hoped, the Business Register increased our ability to match health plans in the 5500 data back to specific employers, with a match rate of roughly 90 percent. Most of the remaining ten percent were sponsored by firms that were defunct or nonprivate, or that already had been identified as sponsors elsewhere in the data. Thus, for the purpose of identifying offering firms within the private sector, these nonmatches appear of limited consequence.
However, in spite of the high match rate, the data reflect lower rates of employer-offered health benefits compared to what we observe in the Medical Expenditure Survey (MEPS), even for large firms. MEPS indicates that, for workers in firms with over 1,000 employees, 97 percent have employers who offer health benefits, compared to 86 percent in the 5500 data. Thus, the data do not appear well suited to measuring the prevalence of employer offered health plans.
Nonetheless, patterns of health plan offerings appear similar to those seen in other data. Offer rates are higher among older and larger firms and within particular industries, consistent with other data. Also, there is encouraging concordance between employer health plans in the 5500 data and their workers’ reports of access to employer-provided health benefits in survey data. The graph to the right shows that, among large private firms, roughly 84 percent of SIPP workers who reported employer-provided health benefits worked for an employer with a health plan on file in the 5500. This varied by industry, with a low of around 70 percent for services and a high of 94 percent for manufacturing.
These findings provide preliminary evidence that the 5500 data are representative of firms that provide health plans, at least for large private firms. Additional analyses, proposed in the full report, could give a more definitive assessment, and seem merited based on these results. Given the data’s detail on firms, longitudinal tracking and employee links, they have the potential to answer questions about employer health benefits not before possible, including:
- Are changes in benefit offers by industry or market sector due primarily to new firms entering the market, existing firms dying, or continuing firms changing their offers?
- Do changes in worker reports of employer benefits seem to primarily reflect changes in access, eligibility, or take-up?
- When an employer’s cost of health plans rises, how much of the increase is passed along to workers, and how does this relate to worker participation?
- How much of a worker’s reported lack of coverage is due to their lack of awareness of employers’ benefit offers?
1. Firms are required to file Form 5500 for all benefit plans with 100 or more participants, and for a few smaller plans. The LEHD data contain a number of survey and administrative data files on workers and employers, including the Census Business Register. The Business Register pertains to all private sector firms. Thus, the scope of these linked data are limited to larger, private sector firms.
|Office of the Assistant Secretary for Planning and Evaluation
Office of Human Services Policy
U.S. Department of Health and Human Services
Washington, DC 20201
Michael J. O’Grady, Ph.D.
Barbara B. Broman