Healthcare Hospitals Medical/Rx Benefits Benchmarks
Real plan data from verified employers in your industry
Healthcare Hospitals 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 146 healthcare hospitals employers offering 434 verified benefit plans. PPO plans are the most common (47% of employers), followed by HDHP (39%). Funding approaches are mixed, with self-insured (56%) and fully-insured (40%) both common. Most employers offer three or more plan options to employees (50%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
Healthcare Hospitals plan design & cost benchmarks
| 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 |
Unlock the full benchmarks
Real plan-design and cost benchmarks for healthcare hospitals, 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
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.
Related Industries
Frequently Asked Questions
About healthcare hospitals benefits benchmarking
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