Healthcare Physicians Practitioners Benefits Benchmarks
Real plan data from verified employers in your industry
486
Employers
1,310
Plans
Plan Type Mix
LivePPO42%
HDHP39%
HMO11%
EPO5%
Plan Funding
LiveFully-Insured70%
Self-Insured24%
Level-Funded6%
Plans Offered
LiveThree or More Plans50%
Two Plans29%
One Plan21%
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,788 | $1,897 | $956 |
| Family Deductible | $5,224 | $2,930 | $1,368 |
| Individual OOP Max | $6,430 | $4,640 | $3,762 |
| Family OOP Max | $13,066 | $9,626 | $7,165 |
| Coinsurance | 27% | 20% | 14% |
| Primary Care | $49 | $36 | $24 |
| Specialist | $71 | $53 | $35 |
| Emergency Room | $489 | $336 | $157 |
| Urgent Care | $92 | $79 | $56 |
| Inpatient Hospital | $732 | $521 | $265 |
| Outpatient Hospital | $306 | $201 | $142 |
| Lab & X-ray | $41 | $29 | $6 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $276 | $234 | $159 |
| Employee + Spouse | $673 | $585 | $408 |
| Employee + Child(ren) | $548 | $479 | $366 |
| Family | $935 | $721 | $578 |
Available in full report
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $847 | $758 | $604 |
| Employee + Spouse | $1,771 | $1,459 | $1,239 |
| Employee + Child(ren) | $1,427 | $1,318 | $1,062 |
| Family | $2,373 | $2,086 | $1,784 |
Available in full report
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $18 | $14 | $7 |
| Preferred Brand | $58 | $38 | $30 |
| Non-Preferred Brand | $94 | $74 | $56 |
| Specialty | $290 | $222 | $139 |
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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