Services Repair Maintenance Benefits Benchmarks

Real plan data from verified employers in your industry

95
Employers
247
Plans
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Plan Type Mix

Live
PPO39%
HDHP35%
HMO15%
EPO6%

Plan Funding

Live
Fully-Insured70%
Self-Insured21%
Level-Funded8%

Plans Offered

Live
Three or More Plans41%
Two Plans34%
One Plan25%
In-Network BenefitsLimitedBalancedRobust
Individual Deductible
$2,696
$1,987
$776
Family Deductible
$5,672
$3,206
$1,256
Individual OOP Max
$6,354
$4,458
$3,275
Family OOP Max
$12,413
$8,915
$6,973
Coinsurance
29%
21%
12%
Primary Care
$50
$32
$25
Specialist
$72
$58
$37
Emergency Room
$442
$372
$162
Urgent Care
$96
$81
$52
Inpatient Hospital
$678
$503
$285
Outpatient Hospital
$322
$233
$143
Lab & X-ray
$41
$29
$9

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Employee ContributionsLimitedBalancedRobust
Employee Only
$295
$242
$152
Employee + Spouse
$670
$563
$451
Employee + Child(ren)
$534
$458
$370
Family
$938
$804
$572
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Gross Premium RatesLimitedBalancedRobust
Employee Only
$864
$713
$601
Employee + Spouse
$1,767
$1,524
$1,276
Employee + Child(ren)
$1,403
$1,224
$1,082
Family
$2,382
$2,205
$1,731
Available in full report
PrescriptionsLimitedBalancedRobust
Generic
$19
$11
$6
Preferred Brand
$55
$46
$27
Non-Preferred Brand
$93
$76
$53
Specialty
$290
$174
$108
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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