in the plans that they have purchased. The following section highlights some of this research to provide some insights into the level of coverage and services provided by the private insurance sector but does not provide information on how plans and employers address cost sharing, copayments, and coinsurance for these specific services.
Employer-Based Health Plans
The Bureau of Labor Statistics’ ongoing National Compensation Survey (DOL, 2011) surveyed approximately 3,900 employers with the aim of providing comprehensive data on employment-based health care benefits. A supplemental analysis of approximately 3,200 plan documents, including summary descriptions of the plans and other short summaries or comparison charts, was conducted to look at the extent of coverage of certain health benefits. When coverage or exclusion of a specific benefit by a plan is specifically mentioned, it is noted. For many of the benefits reviewed, coverage for particular services was mentioned one way or the other, but it is possible that the services would be covered for the workers.
The data on preventive care are limited but indicate that 56 percent of participants were in plans that identified coverage for adult immunizations and inoculations, 80 percent were in plans that covered adult physical examinations, and 77 percent were in plans that covered well-baby care. Gynecological examinations and services, such as pelvic examinations and Pap smears were covered for 60 percent of participants of employer-based health plans, usually under headings such as “well-woman exams.” However, these services were often subject to plan or separate limits, and copayments were commonly required. Plans often limited the number of examinations per year and the dollar amount on the services covered during examinations.
Sterilization was not mentioned in the coverage documents for the employer-based health plans of more than 70 percent of participants. However, when it was mentioned, approximately 90 percent of participants were in plans that cover sterilization. Coverage for maternity care was also not uniformly identified by the plans. Sixty-six percent of workers were in plans that explicitly covered maternity care, and only 6 percent of the workers in those plans had these benefits in full (virtually all of the remaining third of workers were in plans that did not specifically mention coverage for maternity care).
In 2001, Mercer Human Resource Consulting Inc. conducted the National Survey of Employer-Sponsored Health Plans, which had a special supplement on preventive care. More than 2,000 employers providing benefits to their employees completed the survey. The response rate was 21 percent. The survey uncovered significant differences in the preventive services covered. These differences were related to employer size, incentives, and extent of coverage (Bondi et al., 2006). Because only one-fifth of