Pennsylvania Benefits Benchmarks

Real plan data from verified employers in your state

1,058
Employers
2,959
Plans
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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.

1,058 employers2,959 verified plansUpdated January 2026
In-Network BenefitsLimitedBalancedRobust
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 ContributionsLimitedBalancedRobust
Employee Only
$299
$222
$166
Employee + Spouse
$698
$586
$424
Employee + Child(ren)
$546
$423
$352
Family
$902
$697
$594
Available in full report
Gross Premium RatesLimitedBalancedRobust
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
Available in full report
PrescriptionsLimitedBalancedRobust
Generic
$18
$14
$7
Preferred Brand
$58
$45
$30
Non-Preferred Brand
$96
$74
$58
Specialty
$263
$184
$110
Available in full report

Plan Type Mix

Live
PPO42%
HDHP35%
EPO9%
HMO8%

Plan Funding

Live
Fully-Insured60%
Self-Insured34%
Level-Funded6%

Plans Offered

Live
Three or More Plans51%
Two Plans28%
One Plan21%

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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Frequently Asked Questions

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