Medical/Rx Benefits

Financial Insurance Medical/Rx Benefits Benchmarks

Real plan data from verified employers in your industry

Verified Data
149Employers
430Plans
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Financial Insurance Employee Benefits Overview

Medical plan benchmarks from verified employer data

Verified Data

Medical benefits typically represent the largest share of employer benefit spending and are a key factor in employee recruitment and retention.

Our database includes 149 financial insurance employers offering 430 verified benefit plans. HDHP plans are the most common (43% of employers), followed by PPO (37%). Funding approaches are mixed, with self-insured (47%) and fully-insured (47%) both common. Most employers offer three or more plan options to employees (52%).

Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.

149 employers430 verified plansUpdated September 2026

Plan Type Mix

% of employers offering each

VERIFIED
HDHP43%
PPO37%
HMO11%
POS6%

Plan Funding

% of employers by funding

VERIFIED
Self-Insured47%
Fully-Insured47%
Level-Funded7%

Plans Offered

% of employers by plan count

VERIFIED
Three or More Plans52%
Two Plans36%
One Plan13%
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Financial Insurance plan design & cost benchmarks

In-Network Cost Sharing — sample layout
In-Network Benefits
LimitedBalancedRobust
Your Plan
Individual Deductible
$692
$1,489
$2,816
$1,48952Bal
Family Deductible
$1,224
$3,314
$5,352
$3,31452Bal
Individual OOP Max
$3,352
$4,419
$6,603
$4,41952Bal
Family OOP Max
$7,101
$10,451
$12,592
$10,45152Bal
Coinsurance
14%
19%
30%
19%52Bal
Primary Care
$24
$33
$49
$3352Bal
Specialist
$37
$57
$69
$5752Bal
Emergency Room
$159
$336
$461
$33652Bal
Urgent Care
$50
$71
$94
$7152Bal

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Real plan-design and cost benchmarks for financial insurance, with percentile rankings and exportable data.

What's inside the full report
In-Network Cost Sharing

Deductibles, copays, coinsurance & out-of-pocket maximums

Employee Contributions

Monthly employee premium contributions by tier

Gross Premium Rates

Total monthly premium costs by coverage tier

Prescription Drug Coverage

Rx copays, deductibles & mail-order options

Percentile rankings (25th / 50th / 75th)
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See What You'll Discover

Our reports reveal exactly where your plan stands, and why. Preview using sample financial insurance data.

72
Balanced
Sample Report
Sample PPO Gold 1500
Blue Cross Blue Shield · PPO

This plan aligns well with common market practices. Benefits and costs are competitive, providing reliable value that meets typical employer offerings in your segment.

Based on 847 comparable plans
Core Scoring Drivers
In-Network Cost Sharing78Robust

Deductibles and copays rank above market median, offering strong value to employees.

Employee Contributions65Balanced

Contribution levels are competitive with peer employers in your industry.

Premium Rates71Balanced

Gross premiums align with market expectations for comparable coverage.

Plan Types
PPO
42%
HDHP
31%
HMO
18%
POS
9%

% of employers

Plans Offered
2 Plans
38%
3 Plans
29%
1 Plan
22%
4+ Plans
11%

% of employers

Funding Types
Fully Insured: 58%
Self-Funded: 34%
Level-Funded: 8%
Top Performers

Features in top 25% of peers

Individual Deductible82Robust
In-Network Cost Sharing
Primary Care Copay79Robust
In-Network Cost Sharing
Generic Rx Copay77Robust
Prescription Drugs
Individual OOP Max76Robust
In-Network Cost Sharing
Under Performers

Features in bottom 25% of peers

Family Premium18Low
Gross Premium Rates
EE+Spouse Contribution21Low
Employee Contributions
Specialist Copay24Low
In-Network Cost Sharing
Actionable Insight

Family Premium ranks in the 18th percentile. Adjusting employer contribution strategy could improve retention without significant cost increases.

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Financial Insurance Benefits Landscape

Industry trends and benchmarking considerations

Insurance companies bring unique expertise to employee benefits as both providers and consumers of coverage. Our data shows insurance carriers typically self-fund their own employee plans and offer sophisticated plan designs. As employers who understand risk pooling intimately, their benefits strategies often serve as industry benchmarks.

Key Trends

Self-Funding Expertise

Insurance carriers in our database overwhelmingly self-fund, leveraging their actuarial expertise to optimize plan design and cost.

Comprehensive Ancillary Benefits

Life and disability coverage tends to be more generous at insurance companies, often exceeding benchmarks in other financial services segments.

Benchmarking Considerations

Insurance industry benchmarks should distinguish between carrier types. Life insurers, P&C carriers, and health insurers may show different benefits philosophies in our data.

Related Industries

Frequently Asked Questions

About financial insurance benefits benchmarking

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