Healthcare Social Services Benefits Benchmarks
Real plan data from verified employers in your industry
363
Employers
953
Plans
Plan Type Mix
LivePPO37%
HDHP26%
HMO21%
EPO10%
Plan Funding
LiveFully-Insured80%
Self-Insured16%
Level-Funded4%
Plans Offered
LiveThree or More Plans48%
Two Plans31%
One Plan21%
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,596 | $1,729 | $876 |
| Family Deductible | $5,328 | $4,034 | $1,360 |
| Individual OOP Max | $6,629 | $5,302 | $3,326 |
| Family OOP Max | $13,872 | $9,011 | $7,382 |
| Coinsurance | 27% | 21% | 12% |
| Primary Care | $46 | $35 | $24 |
| Specialist | $73 | $53 | $42 |
| Emergency Room | $434 | $352 | $190 |
| Urgent Care | $99 | $75 | $58 |
| Inpatient Hospital | $661 | $469 | $268 |
| Outpatient Hospital | $305 | $207 | $102 |
| Lab & X-ray | $46 | $18 | $4 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $297 | $212 | $169 |
| Employee + Spouse | $646 | $531 | $457 |
| Employee + Child(ren) | $537 | $479 | $375 |
| Family | $896 | $695 | $590 |
Available in full report
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $847 | $774 | $654 |
| Employee + Spouse | $1,772 | $1,433 | $1,212 |
| Employee + Child(ren) | $1,406 | $1,228 | $1,044 |
| Family | $2,467 | $2,026 | $1,779 |
Available in full report
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $19 | $14 | $6 |
| Preferred Brand | $60 | $40 | $31 |
| Non-Preferred Brand | $94 | $76 | $52 |
| Specialty | $270 | $179 | $140 |
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Out-of-Network Benefits
Surcharges and Opt-Outs
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