Healthcare Hospitals Benefits Benchmarks
Real plan data from verified employers in your industry
117
Employers
324
Plans
Plan Type Mix
LivePPO48%
HDHP38%
HMO6%
EPO4%
Plan Funding
LiveFully-Insured49%
Self-Insured46%
Level-Funded5%
Plans Offered
LiveThree or More Plans46%
Two Plans39%
One Plan15%
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,928 | $1,741 | $648 |
| Family Deductible | $5,568 | $3,326 | $1,816 |
| Individual OOP Max | $6,686 | $4,506 | $3,032 |
| Family OOP Max | $13,296 | $11,027 | $6,627 |
| Coinsurance | 30% | 18% | 11% |
| Primary Care | $48 | $34 | $20 |
| Specialist | $74 | $61 | $42 |
| Emergency Room | $469 | $372 | $172 |
| Urgent Care | $92 | $70 | $55 |
| Inpatient Hospital | $704 | $496 | $349 |
| Outpatient Hospital | $315 | $198 | $138 |
| Lab & X-ray | $46 | $20 | $7 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $291 | $242 | $160 |
| Employee + Spouse | $672 | $538 | $447 |
| Employee + Child(ren) | $519 | $429 | $372 |
| Family | $912 | $778 | $565 |
Available in full report
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $881 | $750 | $634 |
| Employee + Spouse | $1,755 | $1,494 | $1,204 |
| Employee + Child(ren) | $1,476 | $1,272 | $1,028 |
| Family | $2,496 | $2,176 | $1,790 |
Available in full report
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $18 | $11 | $6 |
| Preferred Brand | $59 | $45 | $25 |
| Non-Preferred Brand | $96 | $69 | $53 |
| Specialty | $286 | $176 | $114 |
Available in full report
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Stoploss Plans and Strategues
HSA Accounts and Funding
Employer Contributions as a %
Out-of-Network Benefits
Surcharges and Opt-Outs
Rx-Carve Out Benefits