Healthcare Ambulatory Services Medical/Rx Benefits Benchmarks
Real plan data from verified employers in your industry
Healthcare Ambulatory Services Employee Benefits Overview
Medical plan benchmarks from verified employer 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 309 healthcare ambulatory services employers offering 968 verified benefit plans. PPO plans are the most common (40% of employers), followed by HDHP (35%). Fully-Insured funding is the predominant model, used by 69% of industry employers. Most employers offer three or more plan options to employees (63%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
Plan Type Mix
% of employers offering each
Plan Funding
% of employers by funding
Plans Offered
% of employers by plan count
Healthcare Ambulatory Services plan design & cost benchmarks
| In-Network Benefits | LimitedBalancedRobust | Your Plan |
|---|---|---|
| Individual Deductible | $716 $1,825 $2,540 | $1,82552Bal |
| Family Deductible | $1,408 $4,202 $5,192 | $4,20252Bal |
| Individual OOP Max | $3,365 $5,235 $6,546 | $5,23552Bal |
| Family OOP Max | $7,434 $10,125 $12,886 | $10,12552Bal |
| Coinsurance | 13% 23% 27% | 23%52Bal |
| Primary Care | $25 $39 $45 | $3952Bal |
| Specialist | $38 $61 $75 | $6152Bal |
| Emergency Room | $168 $360 $489 | $36052Bal |
| Urgent Care | $58 $68 $91 | $6852Bal |
Unlock the full benchmarks
Real plan-design and cost benchmarks for healthcare ambulatory services, with percentile rankings and exportable data.
Deductibles, copays, coinsurance & out-of-pocket maximums
Monthly employee premium contributions by tier
Total monthly premium costs by coverage tier
Rx copays, deductibles & mail-order options
See What You'll Discover
Our reports reveal exactly where your plan stands, and why. Preview using sample healthcare ambulatory services data.
This plan aligns well with common market practices. Benefits and costs are competitive, providing reliable value that meets typical employer offerings in your segment.
Deductibles and copays rank above market median, offering strong value to employees.
Contribution levels are competitive with peer employers in your industry.
Gross premiums align with market expectations for comparable coverage.
% of employers
% of employers
Features in top 25% of peers
Features in bottom 25% of peers
Family Premium ranks in the 18th percentile. Adjusting employer contribution strategy could improve retention without significant cost increases.
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