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Employee Benefits Survey
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Table 9. Medical care benefits: Amount of annual individual out-of-pocket maximum,(1) private industry workers, 2018
(All workers participating in medical care plans = 100 percent)
Characteristics With out-of-pocket maximum Amount of out-of-pocket maximum With no out-of-pocket maximum Not determinable
10th percentile 25th percentile 50th percentile (median) 75th percentile 90th percentile

Worker characteristics

All workers

97 $1,000 $1,500 $2,500 $3,500 $4,850 2 (2)

Management, professional, and related

98 $1,200 $1,500 $2,500 $3,450 $4,850 1 (2)

Management, business, and financial

98 $1,200 $1,500 $2,500 $3,400 $4,850 1 (2)

Professional and related

99 $1,100 $1,500 $2,400 $3,500 $4,850 - -

Sales and office

98 $1,000 $1,500 $2,500 $3,500 $4,500 - -

Sales and related

100 $1,000 $2,000 $3,000 $4,100 $4,500 - -

Office and administrative support

97 $1,000 $1,500 $2,500 $3,300 $4,500 - -

Full time

98 $1,000 $1,500 $2,400 $3,450 $4,700 2 (2)

Part time

96 $1,000 $2,000 $2,900 $4,300 - - -

Establishment characteristics

Service-providing industries

98 $1,000 $1,500 $2,500 $3,500 $4,850 - -

Trade, transportation, and utilities

100 $1,000 $1,600 $2,500 $3,650 $4,300 - -

Information

100 $1,000 $1,350 $2,300 $3,500 $4,000 - -

Financial activities

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

Education and health services

99 $1,000 $1,600 $2,400 $3,500 $6,350 1 1

Educational services

95 $1,000 $1,400 $2,000 $3,000 $4,450 4 (2)

Health care and social assistance

99 - $1,600 $2,500 $3,750 $6,350 - -

Geographic areas

Northeast

96 $1,000 $1,600 $2,500 $3,700 $6,600 - -

New England

94 $1,000 - $2,500 $3,450 $4,200 - -

Middle Atlantic

96 $1,000 $1,500 $2,500 $4,050 $6,850 - -

South

98 $1,000 $1,650 $2,500 $3,500 $4,500 - -

South Atlantic

98 $1,000 $1,750 $2,500 $3,450 $4,300 - -

West South Central

99 $1,000 - - $3,500 $4,500 - -

Midwest

98 $1,000 $1,500 $2,250 $3,200 $4,550 2 (2)

East North Central

97 $1,000 $1,500 - $3,400 $4,550 3 (2)

West North Central

99 $1,000 $1,500 $2,000 $3,000 $4,100 - -

West: Mountain

98 - $1,250 $2,000 $3,500 $5,450 - -

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.

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/detailedprovisions/2018/ownership/private/glossary.htm.
Source: U.S. Bureau of Labor Statistics, National Compensation Survey.

 

Last Modified Date: April 18, 2019