Employee Benefits Survey

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Medical care benefits: Plan type
Table includes percent of workers enrolled in medical plans by plan type.

Fee-for-service plans: Summary of selected features
Table includes percent of workers enrolled in fee-for-service plans with an annual deductible, coinsurance, and an annual out-of-pocket maximum.

Fee-for-service plans: Type and amount of annual individual deductible
Table includes percent of workers enrolled in fee-for-service individual medical plans with: fixed, variable, other, and no annual deductible; and the median deductible amount for in-network, out-of-network, and point-of-service variable plans.

Fee-for-service plans: Type and amount of annual family deductible
Table includes percent of workers enrolled in fee-for-service family medical plans with fixed, variable, other, and no annual deductibles; and the median deductible amount for in-network, out-of-network, and point-of-service variable plans.

Fee-for-service plans: Amount of annual individual deductible
Table includes percent of workers enrolled in fee-for-service individual medical plans that require an annual deductible and the annual deductible amount by percentile.

Fee-for-service plans: Amount of annual family deductible
Table includes percent of workers enrolled in fee-for-service family medical plans that require an annual deductible and the annual deductible amount by percentile.

Fee-for-service plans: Amount of coinsurance
Table includes percent of workers enrolled in fee-for-service medical plans that require fixed and variable coinsurance; and the median coinsurance amount for in-network, out-of-network, and point-of-service plans.

Fee-for-service plans: Amount of annual individual out-of-pocket maximum
Table includes percent of workers enrolled in fee-for-service medical plans that limit the annual amount of individual out-of-pocket expenses the enrollee must pay.

Fee-for-service plans: Amount of annual family out-of-pocket maximum
Table includes percent of workers enrolled in fee-for-service medical plans that limit the annual amount of family out-of-pocket expenses the enrollee must pay.

Health maintenance organizations: Summary of selected features
Table includes percent of workers enrolled in health maintenance organizations with an annual deductible, coinsurance, and an annual out-of-pocket maximum.

Outpatient prescription drug benefits: Type of coverage
Table includes percent of workers enrolled in outpatient prescription drug plans that provide coverage for brand-name drugs, generic drugs, mail order drugs, and higher reimbursement for formulary drugs. Formulary drugs are drugs approved by the healthcare provider. Drugs not approved by the healthcare provider are nonformulary drugs, for which enrollees receive less generous benefits, such as a higher per-prescription copayment.

Outpatient prescription drug benefits: Copayment provisions
Table includes percent of workers enrolled in outpatient prescription drug plans that require a copayment for generic drugs and brand-name drugs, and the median copayment amount per prescription.

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Medical care benefits: Eligibility requirements
Table includes percent of workers in medical plans with and without a service requirement; and, for plans with the requirement, the percent by the length of service required and the median number of required months.

Medical care benefits: Coverage for selected services
Table includes percent of workers in medical plans with coverage for hospital room and board, inpatient surgery, outpatient surgery, physician office visits, skilled nursing facilities, home health care, and hospice care.

Medical care benefits: Median copayment per visit for selected services by type of plan
Table includes median copayment per visit for hospital room and board, physician office visit, and outpatient surgery, by type of plan.

Medical care benefits: Median number of days or visits covered per year for selected services by type of plan
Table includes median number of days covered for skilled nursing facility and the median number of home health care visits covered, by type of plan.

Fee-for-service plans: Coverage for selected services
Table includes percent of workers enrolled in fee-for-service medical plans with coverage for hospital room and board, inpatient surgery, outpatient surgery, physician office visits, skilled nursing facilities, home health care, and hospice care.

Fee-for-service plans: Coverage for mental health care and substance abuse treatment
Table includes percent of workers enrolled in fee-for-service medical plans with coverage for inpatient mental health care, outpatient mental health care, inpatient alcohol detoxification, inpatient alcohol rehabilitation, outpatient alcohol rehabilitation, inpatient drug detoxification, inpatient drug rehabilitation, and outpatient drug rehabilitation.

Health maintenance organizations: Coverage for selected services
Table includes percent of workers enrolled in health maintenance organizations with coverage for hospital room and board, inpatient surgery, outpatient surgery, physician office visits, skilled nursing facilities, home health care, and hospice care.

Health maintenance organizations: Coverage for mental health care and substance abuse treatment
Table includes percent of workers enrolled in health maintenance organizations with coverage for inpatient mental health care, outpatient mental health care, inpatient alcohol detoxification, inpatient alcohol rehabilitation, outpatient alcohol rehabilitation, inpatient drug detoxification, inpatient drug rehabilitation, and outpatient drug rehabilitation.

Medical care benefits: Coverage for selected services by type of plan
Table includes percent of workers enrolled in medical plans with coverage for hearing care, adult physical exams, well baby care, and adult immunization and inoculation, by type of plan.

Hospital room and board benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for hospital room and board by type of plan.

Inpatient surgery benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for inpatient surgery, by type of plan.

Outpatient surgery benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for outpatient surgery, by type of plan.

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Physician office visit benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for physician office visits, by type of plan.

Mental health care and substance abuse treatment benefits: Coverage for selected services
Table includes percent of workers enrolled in medical plans with coverage for the following types of care: inpatient mental health, outpatient mental health, inpatient alcohol detoxification, inpatient alcohol rehabilitation, outpatient alcohol rehabilitation, inpatient drub detoxification, inpatient drug rehabilitation, and outpatient drug rehabilitation.

Inpatient mental health care benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for inpatient mental health care, by type of plan.

Outpatient mental health care benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for outpatient mental health care, by type of plan.

Inpatient alcohol detoxification benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for inpatient alcohol detoxification, by type of plan.

Inpatient alcohol rehabilitation benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for inpatient alcohol rehabilitation, by type of plan.

Outpatient alcohol rehabilitation benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for outpatient alcohol rehabilitation, by type of plan.

Inpatient drug detoxification benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for inpatient drug detoxification, by type of plan.

Inpatient drug rehabilitation benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for inpatient drug rehabilitation, by type of plan.

Outpatient drug rehabilitation benefits: Extent of coverage by type of plan
Table includes percent of workers enrolled in medical plans with full coverage, limited coverage, and no coverage for outpatient drug rehabilitation, by type of plan.

Mental health care benefits: Median days or visits covered per year for selected services by type of plan
Table includes median number of days or visits for inpatient care and outpatient care, by type of plan.

Substance abuse treatment benefits: Median days covered per year for selected services by type of plan
Table includes median number of days covered for inpatient care and outpatient care, by type of plan. Substance abuse includes drug and alcohol abuse.

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Alcohol abuse treatment benefits: Median days covered per year for selected services by type of plan
Table includes median number of days covered for inpatient detoxification, inpatient rehabilitation, and outpatient rehabilitation, by type of plan.

Drug abuse treatment benefits: Median days covered per year for selected services by type of plan
Table includes median number of days covered for inpatient detoxification, inpatient rehabilitation, and outpatient rehabilitation, by type of plan.

Dental care benefits: Coverage for selected services
Table includes percent of workers enrolled in dental plans with coverage for preventive, basic, and major dental services; orthodontia for employee and dependents; and orthodontia for dependents only.

Dental care benefits: Extent of coverage for selected services
Table includes percent of workers enrolled in dental plan with full coverage, limited coverage, and no coverage; for preventive, basic, and major dental services.

Dental care benefits: Coverage for orthodontia
Table includes percent of workers enrolled in dental plans with full coverage, limited coverage, and no coverage; the median percent of covered charges; and the median lifetime maximum amount of insurance coverage for employee and dependent or dependent only.

Dental care benefits: Median percent of covered charges paid by plan for selected services
Table includes percent of covered charges paid by the plan for preventive, basic, and major dental services.

Dental care benefits: Amount of annual individual deductible
Table includes percent of workers enrolled in individual dental plans that specify an annual deductible and the annual amount of the deductible by percentile.

Dental care benefits: Amount of annual family deductible
Table includes percent of workers enrolled in family dental plans that specify an annual deductible and the annual amount of the deductible by percentile.

Dental care benefits: Amount of annual plan maximum
Table includes percent of workers enrolled in dental plans that specify an annual maximum and the annual plan maximum amount by percentile.

Vision care benefits: Coverage for selected services
Table includes percent of workers enrolled in vision plans with coverage for eye exams, glasses, and contact lenses.

Vision care benefits: Extent of coverage for selected services
Table includes percent of workers enrolled in vision plans with full coverage, limited coverage, and no coverage, for eye exams, glasses, and contact lenses.

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Last Modified Date: July 9, 2009

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