New York Medical/Rx Benefits Benchmarks
Real plan data from verified employers in your state
Employee Benefits in New York
Medical benefits typically represent the largest share of employer benefit spending and are a key factor in employee recruitment and retention.
Our database includes 1,144 employers in New York offering 3,754 verified benefit plans. PPO plans are the most common (37% of employers), followed by HDHP (35%). Funding approaches are mixed, with fully-insured (59%) and self-insured (31%) both common. Most employers offer three or more plan options to employees (66%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
New York plan design & cost benchmarks
| In-Network Benefits | LimitedBalancedRobust | Your Plan |
|---|---|---|
| Individual Deductible | $584 $1,501 $2,880 | $1,50152Bal |
| Family Deductible | $1,000 $2,786 $5,552 | $2,78652Bal |
| Individual OOP Max | $3,582 $4,496 $6,245 | $4,49652Bal |
| Family OOP Max | $6,192 $10,394 $12,605 | $10,39452Bal |
| Coinsurance | 12% 18% 28% | 18%52Bal |
| Primary Care | $25 $37 $48 | $3752Bal |
| Specialist | $35 $60 $70 | $6052Bal |
| Emergency Room | $205 $329 $456 | $32952Bal |
| Urgent Care | $52 $71 $91 | $7152Bal |
Unlock the full benchmarks
Real plan-design and cost benchmarks for new york, 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
Plus full benchmarks for Life, Voluntary Life, Short- & Long-Term Disability, and Stop-Loss.
Plan Type Mix
% of employers offering each
Plan Funding
% of employers by funding
Plans Offered
% of employers by plan count
New York Benefits Landscape
Regional trends and benchmarking considerations
New York employers operate in one of the most heavily regulated state insurance markets, with community rating requirements and mandated benefits that influence plan design. Our benchmarking data shows New York employers face significantly higher premium costs than national averages. Employer contribution strategies often absorb more of this cost to remain competitive for talent.
Key Highlights
Highest Premium Costs
New York consistently shows the highest or near-highest gross premium rates in our national database, driven by state regulations and healthcare market dynamics.
Generous Employer Contributions
To offset high premiums, New York employers typically contribute above-average percentages, particularly for employee-only coverage.
Regulatory Complexity
State-mandated benefits and community rating rules limit plan design flexibility, resulting in more standardized offerings across employers.
Benchmarking Considerations
New York benefits reflect the state's unique regulatory environment. Financial services and healthcare employers typically offer richer plans than other sectors. Use industry filters to find relevant comparisons.
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The complete New York benchmark
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