Virginia Benefits Benchmarks
Real plan data from verified employers in your state
Employee Benefits in Virginia
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 717 employers in Virginia offering 2,126 verified benefit plans. PPO plans are the most common (38% of employers), followed by HDHP (37%). Funding approaches are mixed, with fully-insured (59%) and self-insured (31%) both common. Most employers offer three or more plan options to employees (58%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,884 | $1,861 | $712 |
| Family Deductible | $5,504 | $3,998 | $1,680 |
| Individual OOP Max | $6,885 | $5,571 | $3,435 |
| Family OOP Max | $13,104 | $10,797 | $6,602 |
| Coinsurance | 29% | 18% | 13% |
| Primary Care | $49 | $39 | $21 |
| Specialist | $74 | $61 | $38 |
| Emergency Room | $478 | $340 | $202 |
| Urgent Care | $92 | $79 | $52 |
| Inpatient Hospital | $729 | $466 | $314 |
| Outpatient Hospital | $306 | $244 | $140 |
| Lab & X-ray | $47 | $23 | $6 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $282 | $209 | $160 |
| Employee + Spouse | $692 | $543 | $430 |
| Employee + Child(ren) | $540 | $440 | $374 |
| Family | $884 | $783 | $583 |
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $869 | $761 | $659 |
| Employee + Spouse | $1,784 | $1,488 | $1,301 |
| Employee + Child(ren) | $1,411 | $1,198 | $1,091 |
| Family | $2,371 | $2,078 | $1,810 |
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $18 | $11 | $8 |
| Preferred Brand | $57 | $39 | $30 |
| Non-Preferred Brand | $99 | $75 | $54 |
| Specialty | $274 | $227 | $124 |
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