title: Implicit pooling of workers from large and small firms.
abstract: Risk pools for small employers have become an integral part of proposals for national health care reform and have been implemented by a number of states. These explicit attempts to pool small employers are occurring at the same time that many small-firm employees obtain health insurance through implicit pooling arrangements as the dependent of a policyholder insured by a large firm. We use data from the 1987 National Medical Expenditure Survey to document the extent of implicit pooling arrangements, to examine whether small-firm employees and their dependents are adverse health risks, and to assess the cost implications of pooling small- and large-firm employees and dependents.
authors.affiliation: Agency for Health Care Policy and Research, Center for General Health Services Intramural Research, Rockville, MD.
authors.forename: A C
authors.initials: AC
authors.lastname: Monheit
authors.forename: J P
authors.initials: JP
authors.lastname: Vistnes
mesh_terms: D003363:Cost Control / Q000331:legislation & jurisprudence; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D018166:Health Care Reform / Q000191:economics / Q000331:legislation & jurisprudence*; D006801:Humans; D015271:Insurance Pools / Q000191:economics / Q000331:legislation & jurisprudence*; D015273:Insurance Selection Bias; D009310:National Health Insurance, United States / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States