California Benefits Benchmarks
Real plan data from verified employers in your state
Employee Benefits in California
Medical plan benchmarks from verified employer data
Medical benefits typically represent the largest share of employer benefit spending and are a key factor in employee recruitment and retention.
Our database includes 1,742 employers in California offering 6,367 verified benefit plans. PPO plans are the most common (38% of employers), followed by HDHP (29%). Fully-Insured funding is the predominant model, used by 76% of state employers. Most employers offer three or more plan options to employees (70%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,608 | $2,017 | $872 |
| Family Deductible | $5,144 | $4,094 | $1,728 |
| Individual OOP Max | $6,603 | $4,563 | $3,301 |
| Family OOP Max | $13,040 | $10,394 | $6,384 |
| Coinsurance | 27% | 21% | 12% |
| Primary Care | $45 | $38 | $22 |
| Specialist | $68 | $58 | $41 |
| Emergency Room | $465 | $338 | $219 |
| Urgent Care | $95 | $68 | $56 |
| Inpatient Hospital | $722 | $535 | $252 |
| Outpatient Hospital | $306 | $243 | $136 |
| Lab & X-ray | $48 | $21 | $5 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $294 | $238 | $159 |
| Employee + Spouse | $651 | $553 | $412 |
| Employee + Child(ren) | $538 | $472 | $363 |
| Family | $909 | $691 | $563 |
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $868 | $741 | $603 |
| Employee + Spouse | $1,720 | $1,571 | $1,222 |
| Employee + Child(ren) | $1,404 | $1,324 | $1,074 |
| Family | $2,346 | $2,153 | $1,802 |
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $17 | $14 | $8 |
| Preferred Brand | $57 | $39 | $25 |
| Non-Preferred Brand | $91 | $74 | $56 |
| Specialty | $293 | $214 | $134 |
Plan Type Mix
LivePlan Funding
LivePlans Offered
LiveCalifornia Benefits Landscape
Regional trends and benchmarking considerations
California employers navigate one of the nation's most regulated benefits environments and highest cost-of-living markets. Our benchmarking data shows California employers typically offer richer plan designs with lower deductibles and out-of-pocket maximums compared to national averages. The competitive talent market drives above-average employer contribution rates across industries.
Key Highlights
Lower Employee Cost-Sharing
California employers in our database typically show lower deductibles and OOP maximums than the national median, reflecting both regulatory environment and talent competition.
HMO Prevalence
Unlike many states, California shows higher HMO adoption in our data, driven by established regional health plans like Kaiser Permanente.
Higher Premium Costs
Gross premium rates in California consistently exceed national averages in our benchmarks, reflecting higher healthcare costs in the state.
Benchmarking Considerations
California benefits vary by industry. Technology and healthcare employers typically offer richer plans than retail or hospitality. Use industry filters to find the most relevant comparison set for your organization.
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