District of Columbia Benefits Benchmarks
Real plan data from verified employers in your state
311
Employers
940
Plans
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,660 | $1,453 | $764 |
| Family Deductible | $5,840 | $3,098 | $1,856 |
| Individual OOP Max | $6,808 | $4,544 | $3,422 |
| Family OOP Max | $12,822 | $9,318 | $6,704 |
| Coinsurance | 29% | 20% | 11% |
| Primary Care | $47 | $31 | $22 |
| Specialist | $70 | $55 | $39 |
| Emergency Room | $498 | $357 | $191 |
| Urgent Care | $96 | $76 | $54 |
| Inpatient Hospital | $656 | $555 | $326 |
| Outpatient Hospital | $310 | $248 | $147 |
| Lab & X-ray | $50 | $24 | $1 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $299 | $225 | $167 |
| Employee + Spouse | $693 | $506 | $443 |
| Employee + Child(ren) | $541 | $430 | $376 |
| Family | $924 | $709 | $595 |
Available in full report
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $875 | $752 | $640 |
| Employee + Spouse | $1,729 | $1,555 | $1,284 |
| Employee + Child(ren) | $1,453 | $1,307 | $1,073 |
| Family | $2,352 | $1,986 | $1,756 |
Available in full report
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $19 | $12 | $7 |
| Preferred Brand | $57 | $39 | $30 |
| Non-Preferred Brand | $94 | $70 | $54 |
| Specialty | $274 | $179 | $121 |
Available in full report
Plan Type Mix
LiveHDHP36%
PPO35%
HMO12%
POS10%
Plan Funding
LiveFully-Insured65%
Self-Insured27%
Level-Funded8%
Plans Offered
LiveThree or More Plans60%
Two Plans27%
One Plan13%
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Detailed benchmarks, industry breakdowns, and exportable data
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HSA Accounts and Funding
Employer Contributions as a %
Out-of-Network Benefits
Surcharges and Opt-Outs
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