Medical/Rx Benefits

Healthcare Hospitals Medical/Rx Benefits Benchmarks

Real plan data from verified employers in your industry

Verified Data
149Employers
439Plans
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Healthcare Hospitals 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 healthcare hospitals employers offering 439 verified benefit plans. PPO plans are the most common (47% of employers), followed by HDHP (38%). Funding approaches are mixed, with self-insured (55%) and fully-insured (42%) both common. Most employers offer three or more plan options to employees (51%).

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

149 employers439 verified plansUpdated September 2026

Plan Type Mix

% of employers offering each

VERIFIED
PPO47%
HDHP38%
EPO6%
HMO5%

Plan Funding

% of employers by funding

VERIFIED
Self-Insured55%
Fully-Insured42%
Level-Funded4%

Plans Offered

% of employers by plan count

VERIFIED
Three or More Plans51%
Two Plans34%
One Plan15%
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Healthcare Hospitals plan design & cost benchmarks

In-Network Cost Sharing — sample layout
In-Network Benefits
LimitedBalancedRobust
Your Plan
Individual Deductible
$648
$1,741
$2,928
$1,74152Bal
Family Deductible
$1,816
$3,326
$5,568
$3,32652Bal
Individual OOP Max
$3,032
$4,506
$6,686
$4,50652Bal
Family OOP Max
$6,627
$11,027
$13,296
$11,02752Bal
Coinsurance
11%
18%
30%
18%52Bal
Primary Care
$20
$34
$48
$3452Bal
Specialist
$42
$61
$74
$6152Bal
Emergency Room
$172
$372
$469
$37252Bal
Urgent Care
$55
$70
$92
$7052Bal

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Real plan-design and cost benchmarks for healthcare hospitals, 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)
Live, real-time data (this preview refreshes monthly)
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See What You'll Discover

Our reports reveal exactly where your plan stands, and why. Preview using sample healthcare hospitals 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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Healthcare Hospitals Benefits Landscape

Industry trends and benchmarking considerations

Hospital and health system employee benefits reflect the scale and complexity of healthcare delivery organizations. Our benchmarking data shows hospitals overwhelmingly self-fund their medical plans, giving them direct control over plan design. PPO plans remain dominant in this sector, and hospitals typically offer multiple plan options to accommodate diverse workforces spanning clinical, administrative, and support roles.

Key Trends

Self-Funding Dominance

Our data shows 75%+ of hospital systems self-fund their medical plans—significantly higher than the national average across all industries.

Multiple Plan Options

Most hospital employers in our database offer three or more medical plan options, providing choice across PPO, HDHP, and sometimes HMO designs.

Competitive Contribution Rates

Despite cost pressures, hospitals generally maintain competitive employer contribution rates to attract and retain clinical talent in tight labor markets.

Benchmarking Considerations

Hospital benefits benchmarks should account for system size and type. Large integrated health systems and academic medical centers typically show different patterns than community hospitals. Use state filters to compare against regional healthcare employers.

Frequently Asked Questions

About healthcare hospitals benefits benchmarking

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