[texasbigdata]

Correct. You'll have a employer and employee deduction per period to Blue Cross or your insurer of choice. Same for dental, workers comp, etc.

OP has an interesting point, but at the societal level it's not fair to do comparisons with an unpriced externality in one of the alternatives.

[syshum]

More and more companies are direct insurance, meaning even if they use an "insurance company" to manage the group, that is just for the administration of the group. The companies are paying the medical costs of the employee directly.