Higginbotham Sample Benchmarking Report

Sample Employee Benefits Benchmarking Analysis Run Date: 12/13/2023

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 1 of 11

Benefit Plans Included in Report

1. Medical/Rx PPO Plan - PPO 750 - Included

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 2 of 11

Medical/Rx PPO Benchmarking Analysis

Plan: PPO 750

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 3 of 11

Medical/Rx Plans: PPO/POS/EPO

In-Network Cost Share (PPO 750) Benefit

Low (25th)

Median (50th)

High (75th)

Your Plan

Rank

Deductible - Single 1

$1,500

$800

$450

$750

56 th

Deductible - Family

$3,000

$2,000

$1,000

$1,500

60 th

Maximum - Single

$5,000

$3,150

$2,000

$5,000

27 th

Maximum - Family

$10,000

$7,000

$4,500

$10,000

29 th

20%

20%

10%

20%

60 th

Coinsurance

Fig.1: Single INN Deductible $2,400 $2,200 $2,000 $1,800 $1,600 $1,400 $1,200 $1,000 $800 $600 $400 $200

10th Percentile: $2,500

25th Percentile: $1,500

Your Plan: $750 75th Percentile: $450 90th Percentile: $0

Medical/Rx Plans: PPO/POS/EPO

Out-of-Network Cost Share (PPO 750) Benefit

Low (25th)

Median (50th)

High (75th)

Your Plan

Rank

Deductible - Single 2

$3,500

$2,000

$1,000

$5,000

17 th

Deductible - Family

$8,000

$4,000

$2,000

$10,000

18 th

Maximum - Single

$10,000

$7,000

$4,000

-

-

$4,000

Maximum - Family

$22,500

$14,400

$8,000

-

-

$3,500

50%

th

$3,000

Coinsurance

50%

40%

30%

25

Fig.2: Single OON Deductible $5,000

Your Plan: $5,000

$4,500

25th Percentile: $3,500

$2,500 $2,000

50th Percentile: $2,000

$1,500

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

$1,000

75th Percentile: $1,000

$500

90th Percentile: $500

Page 4 of 11

Medical/Rx Plans: PPO/POS/EPO

Services & Prescriptions (PPO 750) Services Primary Care

Specialist

Median (50th)

Your Plan

No Ded.

No Ded.

$25 Copay

$30 Copay

No Ded.

No Ded.

$40 Copay

$60 Copay

$250 Ded. Emergency Room

0% Coin. $75 Copay

Urgent Care

Inpatient

Outpatient

Lab-Xray

$750 Ded. 20% Coin.

No Ded.

No Ded.

$50 Copay

$75 Copay

$1000 Ded.

$750 Ded. 20% Coin.

$800 Ded.

$750 Ded.

10% Coin.

20% Coin.

No Ded.

$750 Ded.

50% Coin.

20% Coin.

Rank

Prescriptions

35 th

Generic

24 th

Preferred

20 th

Non-Preferred

Specialty 34 th Generic (Mail) 56 th Preferred (Mail) 53 rd Non-Preferred (Mail) 31 st Specialty (Mail)

Figures based on In-Network benefits, unless otherwise noted.

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Median (50th)

Your Plan

No Ded.

No Ded.

$10 Copay

$10 Copay

No Ded.

No Ded.

$35 Copay

$45 Copay

No Ded.

No Ded.

$60 Copay

$90 Copay

No Ded.

No Ded.

$100 Copay

$150 Copay

No Ded. $20 Copay No Ded. $75 Copay No Ded. $140 Copay No Ded. $150 Copay

Rank 76 th 25 th 19 th 39 th

-

-

-

-

-

-

-

-

Page 5 of 11

Medical/Rx Plans: PPO/POS/EPO

Employee Contributions (PPO 750) Enrollment Tier

Low (25th)

Median (50th)

High (75th)

Your Plan

Rank

EE Only 3

$1,765

$1,112

$607

$0

100 th

EE & Spouse

$6,188

$3,913

$2,315

$8,024

17 th

EE & Children

$5,782

$3,282

$1,942

$5,921

21 st

Family

$9,375

$5,266

$3,091

$15,191

8 th

Fig.3: Employee Only Contributions $2,500

10th Percentile: $2,604

$2,000 25th Percentile: $1,765 $1,500

Figures shown on an annual basis. $1,000 $500

50th Percentile: $1,112 75th Percentile: $607

Your Plan: $0

Medical/Rx Plans: PPO/POS/EPO

Gross Premium Rates (PPO 750) Enrollment Tier

Low (25th)

Median (50th)

High (75th)

Your Plan

Rank

EE Only 4

$10,623

$9,164

$7,641

$7,790

71 st

EE & Spouse

$22,984

$19,717

$16,701

$15,814

84 th

EE & Children

$21,732

$17,725

$14,904

$13,711

82 nd

Family

$31,128

$25,851

$22,390

$22,981

69 th

Figures shown on an annual basis.

4% of plans are based on age-banded rates.

Fig.4:Employee Only Premium Rates 10th Percentile: $12,564 $12,000 $11,000 $10,000 $9,000 $8,000 $7,000

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

25th Percentile: $10,623

50th Percentile: $9,164

Your Plan: $7,790 90th Percentile: $6,882

Page 6 of 11

Medical/Rx Plans: PPO/POS/EPO

Rx-Only Cost Share (PPO 750) Enrollment Tier

Low (25th)

Median (50th)

High (75th)

Your Plan

Rank

Deductible - Single

$1,000

$250

$150

-

-

Deductible - Family

$2,700

$500

$300

-

-

Maximum - Single

$4,500

$3,350

$2,000

-

-

5%

8%

Maximum - Family

$9,000

$6,700

$4,000

-

-

separate Ded.

separate Max.

30%

20%

20%

-

-

Coinsurance

5% / 8% plans require separate deductibles / maximums for Rx. These figures represent only those plans.

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 7 of 11

Employer Comparison Set

Benchmarking Filters Breakdown

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 8 of 11

Comparison Set

Employer Breakdown Industry Public Administration & Government

Employers 100%

Size

Employers

Under 100

36%

100 to 250

24%

250 to 500

17%

500 to 1000

10%

1000 to 5000

14%

Figures denote what percent of employers qualify for each individual filter option.

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 9 of 11

Total Benefits Benchmarking Analysis

Plan Prevalence

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 10 of 11

Medical/Rx

Plan Prevalence Plan Counts

Employers

Plan Types

Employers

One Plan

40%

PPO

59%

Two Plans

36%

POS

8%

Three or More Plans

25%

EPO

4%

None/Not Provided

0%

HMO

19%

HDHP

57%

None/Not Provided

0%

2023 Employee Benefits Benchmarking Analysis. Datasource: https://www.bnchmrk.com

Page 11 of 11