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September 2003
 Private Health
Insurance: Federal and State Requirements Affecting Coverage
Offered by Small Businesses
Most employees in the U.S. have
health coverage through employers. Small businesses with fewer
than 50 employees, however, are less likely to offer coverage than
larger businesses. Many say they cannot afford it. When they do
provide coverage, small businesses typically purchase insurance
policies, while larger businesses are more likely to use their own
funds to pay for some of their employees' health care, a
practice known as self-funding.
One proposal to make health
coverage more affordable for small businesses would establish
Association Health Plans (AHP), which could offer coverage to
small businesses subject to different federal and state
requirements than currently exist. In light of this proposal, GAO
was asked to summarize current federal and state requirements for
health coverage offered by small businesses, including mandated
benefits, premium-setting requirements, and requirements regarding
availability of coverage.
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