Source: Segal, 2012
From the abstract:
The following are among the key findings of The Segal Company’s 2011 Study of State Employee Health Benefits:
• Almost all states offer either preferred provider organizations (PPOs) or point-of-service (POS) plans. Moreover, that is the predominant type of medical coverage offered in each region.
• The vast majority of states offer four or fewer family coverage tiers.
• For all medical plan types, the employee cost sharing percentage is greater for family coverage than for employee-only coverage.
• The most common deductible amount was $500 (median $350), with nearly 40 percent of PPOs/POS plans having annual per-person deductibles of at least $500.
• The most prevalent copayment range for primary care visits was $20-$24 for PPOs/POS plans. Just under half of those plans require copayments of at least $30 for specialist office visits.
• Just over half of medical plans require a copayment of less than $10 for retail generic drugs. The most prevalent copayment for retail generic drugs was $5 (median $8.50). More than half of plans require a copayment of $20 or more for retail preferred brand-name drugs and a copayment of $40 or more for retail non-preferred brand-name drugs.
The report of results from the 2011 Study of State Employee Health Benefits, which covers all states and the District of Columbia and reflects benefits offered to active, full-time employees of these jurisdictions in 2011, provides details about these and other findings. Examining what other states are offering can be helpful in making tough decisions about potential changes in coverage, including types of coverage offered, the number of plans of each type offered, the number of coverage tiers offered and how costs are shared with employees.