Healthcare Nursing Residential Care Benefits Benchmarks
Real plan data from verified employers in your industry
231
Employers
633
Plans
Plan Type Mix
LivePPO41%
HDHP32%
HMO14%
EPO7%
Plan Funding
LiveFully-Insured64%
Self-Insured34%
Level-Funded3%
Plans Offered
LiveThree or More Plans48%
Two Plans35%
One Plan18%
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,688 | $1,543 | $692 |
| Family Deductible | $5,032 | $3,386 | $1,232 |
| Individual OOP Max | $6,437 | $4,515 | $3,627 |
| Family OOP Max | $13,309 | $9,568 | $6,845 |
| Coinsurance | 29% | 18% | 11% |
| Primary Care | $47 | $36 | $25 |
| Specialist | $74 | $55 | $42 |
| Emergency Room | $478 | $375 | $151 |
| Urgent Care | $91 | $70 | $54 |
| Inpatient Hospital | $662 | $435 | $276 |
| Outpatient Hospital | $315 | $226 | $116 |
| Lab & X-ray | $49 | $28 | $2 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $281 | $215 | $154 |
| Employee + Spouse | $662 | $592 | $445 |
| Employee + Child(ren) | $547 | $460 | $389 |
| Family | $882 | $734 | $600 |
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| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $892 | $728 | $652 |
| Employee + Spouse | $1,710 | $1,481 | $1,208 |
| Employee + Child(ren) | $1,440 | $1,306 | $1,058 |
| Family | $2,366 | $2,011 | $1,850 |
Available in full report
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $18 | $12 | $6 |
| Preferred Brand | $60 | $41 | $30 |
| Non-Preferred Brand | $96 | $73 | $59 |
| Specialty | $296 | $186 | $124 |
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HSA Accounts and Funding
Employer Contributions as a %
Out-of-Network Benefits
Surcharges and Opt-Outs
Rx-Carve Out Benefits