For most working Americans, health insurance comes through their employer, and that connection has practical consequences worth understanding.
The main route to health coverage for working-age adults. Larger employers face obligations under the Affordable Care Act, but for many employers health insurance is a benefit rather than a statutory requirement.
The cost split
Employers typically cover a share of the premium and employees pay the balance through payroll deduction, along with deductibles, copayments and coinsurance when care is used.
When evaluating an offer, the premium share matters as much as the salary.
COBRA
After separation, COBRA generally allows you to continue employer coverage for a limited period — but usually at the full cost, including the portion your employer was paying.
That often makes COBRA considerably more expensive than people expect. Marketplace plans may be a cheaper alternative, and losing job-based coverage triggers a special enrolment period.
Retirement
401(k) plans are the most common employer retirement vehicle. Employer matching, where offered, is effectively additional compensation.
Understand the vesting schedule: employer contributions may not be fully yours until you have been there a set period. Leaving before vesting means leaving money behind.
Social Security and Medicare
Funded through FICA. Employer FICA is 7.65% — 6.2% Social Security up to a wage base of $184,500 in 2026, plus 1.45% Medicare with no cap.
Employees over $200,000 pay an additional 0.9% Medicare tax with no employer match.
Unemployment insurance
A joint federal-state programme, administered by states with varying eligibility and benefit levels. Generally available to those who lose work through no fault of their own.
Apply promptly — benefits typically start from the application, not the separation date.
Workers' compensation
State-administered, covering work-related injury and illness. Report any workplace injury promptly and in writing.
What to ask at offer stage
The premium split, the deductible, whether there is a 401(k) match and its vesting schedule, and what paid leave the employer offers beyond any state requirement.