Almost no one gets "health insurance" through their employers. Most employees get health benefits. In the US, a majority of large employers don't buy insurance

Almost no one gets "health insurance" through their employers. Most employees get health benefits. In the US, a majority of large employers don't buy insurance in the strict actuarial sense. They self-fund health benefits under ERISA, paying claims directly and hiring insurers only as administrators (ASOs). The plan may contract with an insurer (e.g. UnitedHealthcare, Aetna, Cigna) to process claims and run the network, but for most employees at large firms, the insurer is not actually insuring anything. Self-funded ERISA plans are regulated by the US Department of Labor, not state insurance commissioners.