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Employee Benefits Survey
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Table 6. Medical care benefits: Amount of annual individual out-of-pocket maximum, private industry workers, 2017
(All workers participating in medical care plans = 100 percent)
Characteristics With out-of- pocket maximum Amount of out-of-pocket maximum(1) With no out-of- pocket maximum Not determinable
10th percentile 25th percentile 50th percentile (median) 75th percentile 90th percentile

Worker characteristics

All workers

94 $1,000 $1,500 - $3,500 $5,000 5 (2)

Management, professional, and related

95 $1,000 $1,500 $2,300 $3,250 $4,950 5 (2)

Management, business, and financial

96 $1,000 $1,500 $2,100 $3,250 $4,650 - -

Professional and related

94 $1,000 $1,500 $2,500 $3,250 $5,000 5 (2)

Service: Protective service

100 - $1,350 - $5,150 $5,150 - -

Sales and office

95 $1,000 $1,500 $2,300 $3,500 $4,650 4 1

Sales and related

98 $1,100 $1,700 $2,950 $4,100 $5,000 - -

Office and administrative support

93 $1,000 $1,400 $2,000 $3,000 $4,100 6 1

Natural resources, construction, and maintenance: Construction, extraction, farming, fishing, and forestry

96 $1,000 $1,500 $2,500 $4,000 $5,650 - -

Production, transportation, and material moving

- - - - - - 6 -

Production

93 $1,000 $1,600 $2,500 $3,250 $4,900 - -

Transportation and material moving

94 $1,000 $1,350 $2,200 $3,500 $4,650 6 1

Full time

95 $1,000 $1,500 - $3,500 $5,000 5 (2)

Part time

90 $1,000 $1,500 $2,200 $4,000 $5,100 - -

Union

91 $1,000 $1,000 $2,000 $3,500 $5,150 8 (2)

Nonunion

95 $1,000 $1,500 $2,500 $3,500 $5,000 5 (2)

Average wage within the following categories(3):

Second 25 percent

96 $1,000 $1,500 $2,500 $3,500 $5,000 4 (2)

Third 25 percent

94 $1,000 $1,500 $2,300 $3,250 $4,900 6 1

Highest 25 percent

95 $1,000 $1,500 $2,200 $3,250 $5,000 5 (2)

Highest 10 percent

93 $1,000 $1,500 $2,000 $3,000 $4,900 - -

Establishment characteristics

Goods-producing industries

95 $1,000 $1,550 $2,500 $3,500 $5,000 - -

Construction

97 $1,000 $1,500 $2,500 $3,500 $4,800 - -

Service-providing industries

94 $1,000 $1,500 $2,300 $3,500 $5,000 5 (2)

Trade, transportation, and utilities

95 $1,000 $1,500 $2,600 $3,850 $4,650 5 1

Retail trade

96 $1,400 $2,000 $3,000 $4,100 $5,000 3 (2)

Transportation and warehousing

94 $1,000 $1,000 $2,000 $2,600 $4,100 - -

Information

98 $1,000 $1,250 $2,000 $2,650 $3,500 - -

Financial activities

95 $1,000 $1,550 $2,000 $3,000 $4,600 4 1

Finance and insurance

96 $1,000 $1,550 $2,000 $2,650 $4,000 - -

Credit intermediation and related activities

97 $1,000 $1,500 $2,000 $2,500 $3,800 - -

Insurance carriers and related activities

93 $1,000 $1,800 $2,200 $2,850 $4,000 - -

Education and health services

89 $1,000 $1,500 $2,500 $3,200 $5,000 10 1

Educational services

95 $1,000 $1,500 $2,000 $3,600 $5,650 - -

Junior colleges, colleges, and universities

93 $1,000 $1,500 $2,000 $3,500 $5,650 - -

100 workers or more

95 $1,000 $1,500 $2,250 $3,500 $5,100 5 (2)

100 to 499 workers

96 $1,000 $1,500 $2,500 $3,750 $5,100 - -

500 workers or more

93 $1,000 $1,500 $2,000 $3,050 $5,000 - -

Geographic areas

Northeast

91 $1,000 $1,500 $2,500 $4,100 $5,150 8 1

New England

88 $1,000 $1,500 $2,500 $3,500 $5,450 - -

Middle Atlantic

93 $1,000 $1,400 $2,500 $4,100 $5,150 7 1

South

92 $1,000 $1,600 $2,500 $3,500 $5,000 7 (2)

West South Central

89 - - $2,500 $3,500 $4,650 - -

Midwest

97 $1,000 $1,450 $2,000 $3,000 $4,100 - -

East North Central

96 $1,000 $1,350 $2,000 $3,000 $4,100 4 (2)

West

97 $1,000 $1,500 $2,200 $3,250 $5,000 - -

Mountain

99 $1,000 $1,500 $2,500 $3,500 - - -

Pacific

97 $1,000 $1,500 $2,000 $3,150 $5,000 - -

Footnotes:
(1) The out-of-pocket maximum is the annual limit on the amount of covered expenses that a participant or a family must pay after the deductible has been satisfied. Once reached, covered expenses are fully reimbursed for the rest of the year.
(2) Less than 0.5.
(3) Surveyed occupations are classified into wage categories based on the average wage for the occupation, which may include workers with earnings both above and below the threshold. The categories were formed using percentile estimates generated using data from the National Compensation Survey publication, "Employer Costs for Employee Compensation - March 2017."

Note: Because of rounding, sums of individual items may not equal totals. Dashes indicate that no data were reported or that data do not meet publication criteria. For definitions of major plans, key provisions, and related terms, see the "Glossary of Employee Benefit Terms" at www.bls.gov/ncs/ebs/glossary20162017.htm.
Source: U.S. Bureau of Labor Statistics, National Compensation Survey.

 

Last Modified Date: May 15, 2018