Medical/Rx Benefits

New Jersey Medical/Rx Benefits Benchmarks

Real plan data from verified employers in your state

Verified Data
731Employers
2,289Plans
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Source-verified plan dataReal plans, not surveysRefreshed monthly
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Employee Benefits in New Jersey

Medical plan benchmarks from verified employer data

Verified 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 731 employers in New Jersey offering 2,289 verified benefit plans. PPO plans are the most common (36% of employers), followed by HDHP (36%). Funding approaches are mixed, with fully-insured (51%) and self-insured (39%) both common. Most employers offer three or more plan options to employees (61%).

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

731 employers2,289 verified plansUpdated October 2026
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New Jersey plan design & cost benchmarks

In-Network Cost Sharing — sample layout
In-Network Benefits
LimitedBalancedRobust
Your Plan
Individual Deductible
$676
$2,017
$2,976
$2,01752Bal
Family Deductible
$1,776
$3,926
$5,192
$3,92652Bal
Individual OOP Max
$3,134
$5,293
$6,373
$5,29352Bal
Family OOP Max
$7,280
$10,682
$12,656
$10,68252Bal
Coinsurance
10%
18%
29%
18%52Bal
Primary Care
$25
$32
$46
$3252Bal
Specialist
$42
$50
$68
$5052Bal
Emergency Room
$188
$319
$438
$31952Bal
Urgent Care
$57
$80
$98
$8052Bal

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Real plan-design and cost benchmarks for new jersey, with percentile rankings and exportable data.

What's inside the full report
In-Network Cost Sharing

Deductibles, copays, coinsurance & out-of-pocket maximums

Employee Contributions

Monthly employee premium contributions by tier

Gross Premium Rates

Total monthly premium costs by coverage tier

Prescription Drug Coverage

Rx copays, deductibles & mail-order options

Percentile rankings (25th / 50th / 75th)
Live, real-time data (this preview refreshes monthly)
Exportable to PDF & CSV

Plan Type Mix

% of employers offering each

VERIFIED
PPO36%
HDHP36%
EPO14%
POS7%

Plan Funding

% of employers by funding

VERIFIED
Fully-Insured51%
Self-Insured39%
Level-Funded10%

Plans Offered

% of employers by plan count

VERIFIED
Three or More Plans61%
Two Plans27%
One Plan11%
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See What You'll Discover

Our reports reveal exactly where your plan stands, and why. Preview using sample New Jersey 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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New Jersey Benefits Landscape

Regional trends and benchmarking considerations

New Jersey employers face high healthcare costs similar to neighboring New York, but with somewhat more flexibility in plan design. Our benchmarking data shows New Jersey employers offering competitive benefits to attract talent, driving above-average contribution strategies across industries.

Key Highlights

High Premium Environment

New Jersey premium rates rank among the highest in our national database, second only to New York in many categories.

Pharmaceutical Industry

New Jersey's concentration of pharmaceutical companies influences benefits expectations, with pharma typically offering richer plans.

Benchmarking Considerations

New Jersey employers compete for talent regionally. The pharmaceutical and financial services sectors typically show richer plans than other industries in our data.

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Frequently Asked Questions

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