The contracts with the insurance vendors are awarded and managed by OPM. When an employee of a private company selects an NHB plan, the private company must reimburse OPM for the total cost of the premium. The “employee’s share” will be deducted from employees pay check. The amount would be the same as a federal employee would have paid for the same plan. 

For large employers, there will be differences in the healthcare expense. The “employers share” of the premium selected by the employee will likely be different than the equivalent cost for the employer’s private plan. The differences should be small and should have minimal effect on the company bottom line. As is current practice, the subsidy expense would continue to be tax deductible.  Any cost difference, be they large or small, will be borne by the large employers not the taxpayer.

The Kaiser Foundation reports that, for firms with 200 or more employees, 98% offer health insurance to their employees. The NHB would require the remaining 2% to offer the NHB to their employees. It would be a significant change for those companies but the employees would directly benefit.