Pennsylvania Medical/Rx Benefits Benchmarks
Real plan data from verified employers in your state
Employee Benefits in Pennsylvania
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 1,198 employers in Pennsylvania offering 3,418 verified benefit plans. PPO plans are the most common (42% of employers), followed by HDHP (36%). Funding approaches are mixed, with fully-insured (54%) and self-insured (38%) both common. Most employers offer three or more plan options to employees (54%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
Pennsylvania plan design & cost benchmarks
| In-Network Benefits | LimitedBalancedRobust | Your Plan |
|---|---|---|
| Individual Deductible | $576 $1,585 $2,836 | $1,58552Bal |
| Family Deductible | $1,096 $3,278 $5,416 | $3,27852Bal |
| Individual OOP Max | $3,621 $5,312 $6,878 | $5,31252Bal |
| Family OOP Max | $6,205 $10,336 $13,296 | $10,33652Bal |
| Coinsurance | 12% 21% 27% | 21%52Bal |
| Primary Care | $25 $33 $49 | $3352Bal |
| Specialist | $43 $53 $73 | $5352Bal |
| Emergency Room | $178 $342 $471 | $34252Bal |
| Urgent Care | $50 $80 $91 | $8052Bal |
Unlock the full benchmarks
Real plan-design and cost benchmarks for pennsylvania, 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 Pennsylvania 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.
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Pennsylvania Benefits Landscape
Regional trends and benchmarking considerations
Pennsylvania employers operate in a diverse market with moderate premium costs compared to neighboring New York and New Jersey. Our benchmarking data shows a mix of traditional PPO and growing HDHP adoption, with funding strategies varying by employer size and industry.
Key Highlights
Moderate Costs
Pennsylvania premium rates fall below neighboring New York and New Jersey in our database, offering relative cost advantages.
Manufacturing Influence
Pennsylvania's manufacturing sector influences benefits patterns, often setting competitive standards for the state.
Benchmarking Considerations
Pennsylvania benefits vary by industry. Healthcare and manufacturing employers typically show different patterns than professional services. Use industry filters for relevant comparisons.
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