Large employers typically self-insure, including a large majority of companies with over 500 employees [1]. You might see, say, Blue Cross on your card, but they’re just administering - the actual payments to doctors, etc. are in fact coming from your company. Sometimes the company will still show a percentage of “premium” that they are covering; it’s not a real premium in that case, just a percentage of the average care covered per employee.

This means there could be a strictly financial incentive to dismiss a sick employee. This is of course entirely illegal if that were the purpose. [1] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pa...