Although most private health insurance is obtained through the workplace, important gaps remain in the present system of employment-related coverage. National survey data reveal that more than 9 million persons with employment experience are uninsured, who, with their uninsured dependents, account for three-quarters of all persons who lack coverage. This paper examines the circumstances and characteristics of the employed uninsured, including their opportunity to secure health insurance fringe benefits, their medical care use and expenditures, and the benefits available in private insurance that is not work related. Alternative public policy responses to the problem of lack of health insurance coverage are also considered.