What risk? Market pay, many startups have decent health insurance, and even if it blows up, it actually looks good, not bad on the resume.
About what kind of startup are we talking here? When we discuss #1 engineer compensation we are most likely talking about a very early stage company that likely lacks a profound company structure and employee benefits program. So I would assume that #1 engineers will most likely not be greeted with a good health insurance on the employer side.