Texas Benefits Benchmarks
Real plan data from verified employers in your state
Employee Benefits in Texas
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 1,959 employers in Texas offering 5,838 verified benefit plans. PPO plans are the most common (44% of employers), followed by HDHP (36%). Fully-Insured funding is the predominant model, used by 64% of state employers. Most employers offer three or more plan options to employees (57%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,916 | $1,813 | $800 |
| Family Deductible | $5,552 | $3,962 | $1,664 |
| Individual OOP Max | $6,238 | $5,130 | $3,288 |
| Family OOP Max | $13,130 | $9,434 | $7,114 |
| Coinsurance | 28% | 18% | 11% |
| Primary Care | $49 | $33 | $22 |
| Specialist | $75 | $50 | $39 |
| Emergency Room | $464 | $332 | $211 |
| Urgent Care | $98 | $73 | $54 |
| Inpatient Hospital | $658 | $543 | $336 |
| Outpatient Hospital | $322 | $250 | $147 |
| Lab & X-ray | $46 | $24 | $8 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $275 | $244 | $158 |
| Employee + Spouse | $643 | $540 | $400 |
| Employee + Child(ren) | $547 | $432 | $353 |
| Family | $930 | $772 | $593 |
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $887 | $717 | $609 |
| Employee + Spouse | $1,760 | $1,540 | $1,292 |
| Employee + Child(ren) | $1,486 | $1,313 | $1,046 |
| Family | $2,392 | $2,091 | $1,745 |
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $19 | $12 | $6 |
| Preferred Brand | $58 | $40 | $29 |
| Non-Preferred Brand | $98 | $72 | $60 |
| Specialty | $294 | $216 | $114 |
Plan Type Mix
LivePlan Funding
LivePlans Offered
LiveTexas Benefits Landscape
Regional trends and benchmarking considerations
Texas employers benefit from a business-friendly regulatory environment and lower healthcare costs compared to coastal states. Our benchmarking data shows a diverse mix of plan types and funding arrangements, with self-funding more common among larger employers. The state's industry diversity—from energy to technology to healthcare—creates varied benefits patterns across sectors.
Key Highlights
Cost Advantage
Texas employers in our database typically show lower gross premium rates than national averages, reflecting the state's lower healthcare costs.
Self-Funding Growth
Our data shows increasing self-funded plan adoption among mid-sized Texas employers, taking advantage of the state's regulatory flexibility.
PPO Dominance
PPO plans strongly dominate in Texas, with HMO penetration well below national averages in our benchmarks.
Benchmarking Considerations
Texas benefits vary significantly by industry. Energy sector employers often show different patterns than technology or healthcare. Use industry filters to benchmark against your specific sector.
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