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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