Massachusetts Medical/Rx 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 715 employers in Massachusetts offering 2,091 verified benefit plans. PPO plans are the most common (38% of employers), followed by HDHP (34%). Fully-Insured funding is the predominant model, used by 60% of state employers. Most employers offer three or more plan options to employees (55%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
Massachusetts plan design & cost benchmarks
| In-Network Benefits | LimitedBalancedRobust | Your Plan |
|---|---|---|
| Individual Deductible | $996 $1,417 $2,776 | $1,41752Bal |
| Family Deductible | $1,592 $4,022 $5,704 | $4,02252Bal |
| Individual OOP Max | $3,787 $4,986 $6,955 | $4,98652Bal |
| Family OOP Max | $6,371 $9,568 $13,078 | $9,56852Bal |
| Coinsurance | 13% 18% 28% | 18%52Bal |
| Primary Care | $23 $38 $46 | $3852Bal |
| Specialist | $42 $58 $71 | $5852Bal |
| Emergency Room | $183 $284 $473 | $28452Bal |
| Urgent Care | $58 $75 $94 | $7552Bal |
Unlock the full benchmarks
Real plan-design and cost benchmarks for massachusetts, with percentile rankings and exportable data.
Deductibles, copays, coinsurance & out-of-pocket maximums
Monthly employee premium contributions by tier
Total monthly premium costs by coverage tier
Rx copays, deductibles & mail-order options
Plan Type Mix
% of employers offering each
Plan Funding
% of employers by funding
Plans Offered
% of employers by plan count
See What You'll Discover
Our reports reveal exactly where your plan stands, and why. Preview using sample Massachusetts data.
This plan aligns well with common market practices. Benefits and costs are competitive, providing reliable value that meets typical employer offerings in your segment.
Deductibles and copays rank above market median, offering strong value to employees.
Contribution levels are competitive with peer employers in your industry.
Gross premiums align with market expectations for comparable coverage.
% of employers
% of employers
Features in top 25% of peers
Features in bottom 25% of peers
Family Premium ranks in the 18th percentile. Adjusting employer contribution strategy could improve retention without significant cost increases.
This is sample data. Get real insights for your plans.
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Massachusetts 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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Frequently Asked Questions
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