Most state and local government full-time workers are entitled to health benefits in Massachusetts with employee contributions often under 20%.
Private employers do not all provide health insurance and typically require a larger employee contribution. According to the Massachusetts Employer Health Insurance Survey, which surveyed private employers in 2005, 70% provide health insurance. The rate is close to 100% among larger employers, meaning that a more than 70% of all employees are covered. The median employer contribution in 2005 was 75% — meaning that half of private workers were contributing over 25% of the costs of their health insurance. Anecdotally, deductibles, copays and service networks are typically less generous in private sector plans than in state and local government plans.
The most dramatic differences occur after retirement. Public employees receive substantial health care benefits after retirement that supplement Medicare. For some, typically public safety employees, public retiree health insurances bridges the gap between retirement and Medicare eligibility. See generally the OPEB Valuation Report. However, only 10% of private employers offer health insurance to retirees under the age of 65, and only 9% offer health insurance to retirees over 65. See the Massachusetts Employer Health Insurance Survey.