Wisconsin Benefits Benchmarks
Real plan data from verified employers in your state
Employee Benefits in Wisconsin
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 673 employers in Wisconsin offering 1,918 verified benefit plans. HDHP plans are the most common (43% of employers), followed by PPO (34%). Fully-Insured funding is the predominant model, used by 61% of state employers. Most employers offer three or more plan options to employees (47%).
Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.
| In-Network Benefits | Limited | Balanced | Robust |
|---|---|---|---|
| Individual Deductible | $2,540 | $1,477 | $520 |
| Family Deductible | $5,664 | $3,950 | $1,408 |
| Individual OOP Max | $6,373 | $5,197 | $3,230 |
| Family OOP Max | $12,451 | $9,338 | $6,051 |
| Coinsurance | 26% | 18% | 11% |
| Primary Care | $46 | $31 | $22 |
| Specialist | $70 | $60 | $39 |
| Emergency Room | $460 | $363 | $161 |
| Urgent Care | $99 | $75 | $51 |
| Inpatient Hospital | $674 | $485 | $262 |
| Outpatient Hospital | $332 | $198 | $120 |
| Lab & X-ray | $45 | $28 | $6 |
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| Employee Contributions | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $285 | $210 | $152 |
| Employee + Spouse | $667 | $557 | $415 |
| Employee + Child(ren) | $518 | $436 | $366 |
| Family | $876 | $690 | $580 |
| Gross Premium Rates | Limited | Balanced | Robust |
|---|---|---|---|
| Employee Only | $888 | $759 | $646 |
| Employee + Spouse | $1,751 | $1,465 | $1,317 |
| Employee + Child(ren) | $1,432 | $1,251 | $1,074 |
| Family | $2,482 | $2,139 | $1,804 |
| Prescriptions | Limited | Balanced | Robust |
|---|---|---|---|
| Generic | $19 | $11 | $5 |
| Preferred Brand | $58 | $46 | $25 |
| Non-Preferred Brand | $96 | $79 | $51 |
| Specialty | $273 | $192 | $128 |
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