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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