While there is no federal law that requires employers to provide employees with healthcare insurance, historical factors, tax law incentives, and competitive requirements have resulted in an employment-based health insurance system in the United States. As a result, most employers (except for the smallest organizations) sponsor health benefit plans. Currently, employer-provided healthcare benefits are the major source of health insurance for most people in the United States. With the continuing rapid increase in the cost of health benefits, employers have implemented a variety of cost-cutting and cost-shifting strategies ranging from self-insurance and managed care to defined-contribution, or consumer-directed, health plans.

For information on other requirements relating to healthcare benefits, Please see the national Health Care Insurance, national Health Information Privacy, and national Health Insurance Continuation/COBRA. sections.