California Benefits Benchmarks

Real plan data from verified employers in your state

Live Data
1,786Employers
6,515Plans
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Employee Benefits in California

Medical plan benchmarks from verified employer data

Live 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 1,786 employers in California offering 6,515 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 75% of state employers. Most employers offer three or more plan options to employees (71%).

Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.

1,786 employers6,515 verified plansUpdated February 2026
In-Network Benefits
LimitedBalancedRobust
Your Plan
Individual Deductible
$872
$2,017
$2,608
$2,01752Bal
Family Deductible
$1,728
$4,094
$5,144
$4,09452Bal
Individual OOP Max
$3,301
$4,563
$6,603
$4,56352Bal
Family OOP Max
$6,384
$10,394
$13,040
$10,39452Bal
Coinsurance
12%
21%
27%
21%52Bal
Primary Care
$22
$38
$45
$3852Bal
Specialist
$41
$58
$68
$5852Bal
Emergency Room
$219
$338
$465
$33852Bal
Urgent Care
$56
$68
$95
$6852Bal

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Also Included in Report
Employee Contributions
Monthly employee premium contributions by tier
Gross Premium Rates
Total monthly premium costs by coverage tier
Prescription Drug Coverage
Rx copays, deductibles, and mail-order options
Full report includes percentile rankings for all metrics

Plan Type Mix

LIVE
PPO38%
HDHP29%
HMO24%
EPO6%

Plan Funding

LIVE
Fully-Insured75%
Self-Insured20%
Level-Funded5%

Plans Offered

LIVE
Three or More Plans71%
Two Plans19%
One Plan10%
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See What You'll Discover

Our reports reveal exactly where your plan stands—and why. Preview using sample California data.

72
Balanced
Sample Report
Sample PPO Gold 1500
Blue Cross Blue Shield · PPO

This plan aligns well with common market practices. Benefits and costs are competitive, providing reliable value that meets typical employer offerings in your segment.

Based on 847 comparable plans
Core Scoring Drivers
In-Network Cost Sharing78Robust

Deductibles and copays rank above market median, offering strong value to employees.

Employee Contributions65Balanced

Contribution levels are competitive with peer employers in your industry.

Premium Rates71Balanced

Gross premiums align with market expectations for comparable coverage.

Plan Types
PPO
42%
HDHP
31%
HMO
18%
POS
9%

% of employers

Plans Offered
2 Plans
38%
3 Plans
29%
1 Plan
22%
4+ Plans
11%

% of employers

Funding Types
Fully Insured: 58%
Self-Funded: 34%
Level-Funded: 8%
Top Performers

Features in top 25% of peers

Individual Deductible82Robust
In-Network Cost Sharing
Primary Care Copay79Robust
In-Network Cost Sharing
Generic Rx Copay77Robust
Prescription Drugs
Individual OOP Max76Robust
In-Network Cost Sharing
Under Performers

Features in bottom 25% of peers

Family Premium18Low
Gross Premium Rates
EE+Spouse Contribution21Low
Employee Contributions
Specialist Copay24Low
In-Network Cost Sharing
Actionable Insight

Family Premium ranks in the 18th percentile. Adjusting employer contribution strategy could improve retention without significant cost increases.

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California 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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Detailed benchmarks, industry breakdowns, and exportable data

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Employer Contributions as a %
Out-of-Network Benefits
Surcharges and Opt-Outs
Rx-Carve Out Benefits
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