Pennsylvania 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 1,058 employers in Pennsylvania offering 2,959 verified benefit plans. PPO plans are the most common (42% of employers), followed by HDHP (35%). Fully-Insured funding is the predominant model, used by 60% of state employers. Most employers offer three or more plan options to employees (51%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,836 | $1,585 | $576 |
| Family Deductible | $5,416 | $3,278 | $1,096 |
| Individual OOP Max | $6,878 | $5,312 | $3,621 |
| Family OOP Max | $13,296 | $10,336 | $6,205 |
| Coinsurance | 27% | 21% | 12% |
| Primary Care | $49 | $33 | $25 |
| Specialist | $73 | $53 | $43 |
| Emergency Room | $471 | $342 | $178 |
| Urgent Care | $91 | $80 | $50 |
| Inpatient Hospital | $731 | $503 | $272 |
| Outpatient Hospital | $308 | $257 | $127 |
| Lab & X-ray | $47 | $21 | $3 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $299 | $222 | $166 |
| Employee + Spouse | $698 | $586 | $424 |
| Employee + Child(ren) | $546 | $423 | $352 |
| Family | $902 | $697 | $594 |
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $888 | $792 | $639 |
| Employee + Spouse | $1,691 | $1,455 | $1,252 |
| Employee + Child(ren) | $1,403 | $1,235 | $1,055 |
| Family | $2,353 | $2,189 | $1,809 |
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $18 | $14 | $7 |
| Preferred Brand | $58 | $45 | $30 |
| Non-Preferred Brand | $96 | $74 | $58 |
| Specialty | $263 | $184 | $110 |
Plan Type Mix
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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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