Massachusetts Benefits Benchmarks
Real plan data from verified employers in your state
Employee Benefits in Massachusetts
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 557 employers in Massachusetts offering 1,659 verified benefit plans. PPO plans are the most common (38% of employers), followed by HDHP (33%). Fully-Insured funding is the predominant model, used by 63% of state employers. Most employers offer three or more plan options to employees (57%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,776 | $1,417 | $996 |
| Family Deductible | $5,704 | $4,022 | $1,592 |
| Individual OOP Max | $6,955 | $4,986 | $3,787 |
| Family OOP Max | $13,078 | $9,568 | $6,371 |
| Coinsurance | 28% | 18% | 13% |
| Primary Care | $46 | $38 | $23 |
| Specialist | $71 | $58 | $42 |
| Emergency Room | $473 | $284 | $183 |
| Urgent Care | $94 | $75 | $58 |
| Inpatient Hospital | $724 | $507 | $344 |
| Outpatient Hospital | $306 | $261 | $132 |
| Lab & X-ray | $48 | $26 | $7 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $279 | $243 | $158 |
| Employee + Spouse | $667 | $530 | $443 |
| Employee + Child(ren) | $549 | $451 | $369 |
| Family | $888 | $746 | $573 |
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $880 | $710 | $627 |
| Employee + Spouse | $1,763 | $1,481 | $1,236 |
| Employee + Child(ren) | $1,439 | $1,228 | $1,006 |
| Family | $2,487 | $2,155 | $1,722 |
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $18 | $10 | $7 |
| Preferred Brand | $59 | $47 | $26 |
| Non-Preferred Brand | $96 | $77 | $53 |
| Specialty | $267 | $225 | $107 |
Plan Type Mix
LivePlan Funding
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LiveMassachusetts Benefits Landscape
Regional trends and benchmarking considerations
Massachusetts employers operate under one of the nation's first comprehensive healthcare reform frameworks, with mandatory coverage requirements predating the ACA. Our benchmarking data shows Massachusetts employers offering competitive benefits with higher coverage rates than most states. The strong healthcare and biotech sectors drive benefits expectations.
Key Highlights
Healthcare Industry Hub
Massachusetts' concentration of hospitals, biotech, and life sciences creates competitive benefits expectations in our data.
High Coverage Rates
State requirements contribute to higher employer coverage rates and broader benefits offerings in our benchmarks.
Benchmarking Considerations
Massachusetts benefits reflect the state's healthcare and technology concentration. These sectors typically offer richer benefits than other industries. Use industry filters for relevant comparisons.
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