Healthcare Ambulatory Services Medical/Rx Benefits Benchmarks
Real plan data from verified employers in your industry
Healthcare Ambulatory Services Employee Benefits Overview
Medical benefits typically represent the largest share of employer benefit spending and are a key factor in employee recruitment and retention.
Our database includes 313 healthcare ambulatory services employers offering 983 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 68% 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.
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
Plus full benchmarks for Life, Voluntary Life, Short- & Long-Term Disability, and Stop-Loss.
Plan Type Mix
% of employers offering each
Plan Funding
% of employers by funding
Plans Offered
% of employers by plan count
Frequently Asked Questions
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