The bottom line: medical take rate is driven far more by service type than geography. Full-service associates enroll at ~29%; select-service at ~23%. Cost per enrollee rises with local cost of living, but only select-service hotels see take rate fall in expensive markets. Union hotels are a structurally different — and much costlier — cost pool, studied separately.
How participation varies. The dominant split is service type; within that, hotel scale matters (bigger hotels enroll slightly more) and — critically — select-service take rate collapses in high-cost markets while full-service stays flat.
Employer benefit cost three ways. Cost per enrolled associate is the cost of a covered life; cost per headcount blends across all staff (what a pro forma multiplies by projected headcount); cost per key reflects labor intensity per room.
Testing the hypothesis that associates in high-cost geographies take insurance less. Verdict: weakly true overall, sharply true for select-service only. Cost of living correlates with cost per enrollee (medical prices track local prices) but barely with take rate — and California, specifically, sits at the portfolio average.
Separate study — excluded from all benchmarks above. Seven union hotels carry a structurally different cost pool: multi-employer health & welfare fund contributions are paid per the CBA regardless of company-plan enrollment, so cost is decoupled from the take rate.
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Estimate a new hotel's annual employer group-insurance cost from its profile. Benchmarks are pooled from the core non-union portfolio and vary by service type and market cost tier. Two independent methods are shown — reconcile them for a defensible range.