Health Insurance: Frequently asked questions

No, there are no state or federal laws that require private U.S. employers to offer health insurance benefits to any employees at all. However, it is common practice, especially among larger employers, to offer health insurance benefits as a means to attract and retain workers.

Because private employers aren't required to offer health insurance, it is up to each company to decide which employees will be offered health coverage, as long as it is done equitably (for more, read our Health Insurance FAQ on deciding which employees receive benefits).

Many employers offer health benefits only to full-time employees. The number of hours an employee must work each week to qualify as a full-timer depends on the individual employer. In general, most have a cut-off in the 30- to 35-hour a week range. More generous employers might offer benefits to those working just 25 hours a week.

Among those most likely not to have health insurance are young adults in the 18- to 24-year-old age group, people with lower levels of education, people of Hispanic origin, those who work part time, and people born in another country, says a 1999 U.S. Census Bureau report.

It's interesting to note that although private employers are not required to offer health insurance initially, once they do offer such coverage, they become subject to a variety of state and federal laws that dictate such things as what kind of benefits to provide and continuation of coverage.

For instance, employers with more than 20 full-time workers that offer health insurance must offer continuation coverage called COBRA under certain circumstances. (For more, read Know your COBRA rights.) Another law, known as HIPAA, guarantees certain rights for people who have pre-existing medical conditions. (For more on that, read The HIPAA law: Your rights to health insurance portability.)

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