Employer-based Health Coverage Remains Strong But Affordability A Major Concern 

7th Annual TCHS Employer Survey Key Findings

In September 2013, TCHS conducted the inaugural national survey of the U.S. General Adult Population and of Employers regarding their respective attitudes toward healthcare. The goals for the survey were to illuminate emerging healthcare trends, promote awareness, and help educate the public. The 7th Annual survey conducted in 2019 reports on the perspectives of U.S. businesses on current and future healthcare offerings, potential policy changes coming out of Washington, D.C., the actions employees were taking related to healthcare, the affordability of health insurance, and perceptions of mental health in the workplace.

Read the full report here 

The following are some key findings from the survey, with a focus on healthcare benefits, workplace wellness, cost, affordability, policy, and possible future changes. 

Healthcare Benefits 

More companies report providing benefits to part-time employees than ever before.
• One hundred percent of large employers and 98% of midsize companies offer healthcare benefits to full-time employees. (Q800)
• The proportion of employers offering healthcare benefits to part-time employees reaches a high (25%), while those reporting they do not offer benefits to any employees has continued to decrease each year.  (Q800)

A majority of companies that provide healthcare benefits (55%) offer at least three health plans, most commonly a PPO and increasingly an HMO. (Q815, Q820) 
 • Among those companies offering employee health insurance, Health Maintenance Organizations (HMOs)  (59%) and Preferred Provider Organizations (PPOs) (59%) are the most commonly offered health plans, followed by Health Savings Accounts (HSAs) (45%). (Q820)

More than three in four employers (76%) made no changes to healthcare benefits in the past 12 months.  (Q1010)

Three in five (62%) employers expect positive changes to health benefits in the next 1-2 years while only 27% expect negative changes. (Q1025)

Workplace Wellness

A majority of employers (63%) say they offer a workplace wellness program. (Q821)
• Among those not offering wellness benefits, two in five (40%) are not likely to offer a wellness program because the company is not big enough, while one-quarter (25%) say their employees are not interested. (Q1032)

Sixty eight percent of employers that offer a wellness program report high employee participation in their program. (Q822a)

Among those offering a wellness program, more than four in five employers say their wellness program positively impacts performance and productivity (84%), workers’ health (83%), and workers’ job satisfaction (81%). (Q824)

Almost all employers (96%) say improving mental health in the workplace is good for their business. (Q1)
 • Fewer than two in three (65%) believe their company provides adequate employee mental health resources, and 17% report their company does not provide any mental health resources. (Q2)
 • The most common mental health resources for employees, reported by nearly two in five employers, are stress management classes (39%) and mental health awareness training (39%). (Q3) 


A majority of employers (78%) report taking action to manage healthcare costs but are less frequently focusing on prescription drug savings. (Q826)

22% of employers report they are not taking any action to manage healthcare costs. (Q826)

When asked what their company is doing in order to manage healthcare costs, the most common response is offering an HMO plan (31%). (Q826)
• Fifteen percent of employers are even offering “medical tourism” trips for employees to travel to other states or countries for cheaper medical procedures. (Q826)

Almost nine in ten companies (88%) are in a good or excellent financial situation. (Q705)


The majority of employers that offer health insurance report keeping costs constant.
 • Around three in five employers are keeping costs constant for employees’ premium shares (61%), employees’ co-  pays (60%), and employees’ deductibles (63%). (Q919)

Over seven in 10 employers (71%) overall say their company is concerned about affordability of healthcare expenses. (Q923)

Nearly two in five employers (39%) are finding ways to reduce health insurance premiums, but slightly fewer are comparison shopping for the best options (37%) or talking to benefit advisors about how to reduce costs (37%). (Q925)

Almost eight in 10 employers (79%) want employees to take more action to minimize healthcare costs. (Q1120)

About three in five employers (58%) say student loan support benefits are important to attract and retain employees. (Q716)


Awareness of potential healthcare policy changes coming out of Washington, D.C. is similar to 2018.        
 • More than three in five employers (61%) say their company is aware of potential healthcare policy changes coming out of Washington, D.C., but 9% report they are not at all aware. (Q1370)
 • Midsize (76%) and large employers (80%) are nearly twice as likely as small employers (34%) to say their company is aware of potential healthcare policy changes. (Q1370)

An increasing percentage of employers do not want their company to make changes if the employer mandate is removed. 
 • Only four percent of employers say they would reduce coverage as much as possible. (Q1375) 

The most common employee fear regarding healthcare policy is losing health coverage because of a preexisting condition.

Future Changes

Employers believe that costs for companies and employees will increase.
Nearly half of employers (47%) say they expect the cost to the company for providing healthcare increase in the next 12 to 36 months. (Q1320)         

Employers are increasingly likely to say the quality of employee health insurance will improve.
 • Half of employers (50%) believe the quality of health insurance they offer to employees in the next 12 to 36 months will stay the same, while almost half believe this quality will improve. (Q1321)