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Employee Benefits Survey
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Table 21. Outpatient prescription drug benefits: Brand-name drugs on formulary limits, private industry workers, 2018
(All workers participating in outpatient prescription drug plans with brand-name drug on formulary coverage = 100 percent)
Characteristics Copayment Median copayment per prescription Coinsurance Median coinsurance per prescription Coinsurance exists and a minimum or maximum dollar amount applies Combination of copayment and coinsurance or another limit No cost per fill or refill Not determinable

Worker characteristics (1)

All workers

 58 35 36 75 22 - 4 -

Management, professional, and related

 56 35 37 80 22 - 5 -

Management, business, and financial

 54 35 41 75 25 - 3 -

Professional and related

 58 40 35 80 20 - 6 -

Sales and office

 54 35 41 75 28 1 3 1

Sales and related

 46 30 49 75 37 - - 1

Office and administrative support

 57 35 38 75 24 1 3 1

Full time

 58 35 36 75 21 - 3 -

Part time

 48 30 38 75 31 - - (2)

Establishment characteristics

Service-providing industries

 56 35 36 75 23 - - 1

Trade, transportation, and utilities

 47 30 49 75 35 2 - -

Information

 48 35 50 80 29 - - (2)

Financial activities

 40 35 55 70 31 - 2 -

Education and health services

 59 30 23 80 14 - - 2

Educational services

 76 30 11 80 7 2 - -

Health care and social assistance

 56 30 25 80 16 - - 2

Geographic areas

Northeast

 59 35 33 75 20 - - 1

New England

 68 30 29 80 21 - - (2)

Middle Atlantic

 56 35 35 75 20 1 - -

South

 52 35 41 80 26 - - 1

South Atlantic

 58 35 38 80 26 - - 1

West South Central

 46 35 46 80 27 - - (2)

Midwest

 56 35 39 75 23 2 3 1

East North Central

 54 30 40 75 24 1 - -

West North Central

 59 35 36 80 19 - 3 -

West: Mountain

 43 30 39 75 20 - - 1

Footnotes:
(1) Outpatient prescription drug benefits include both stand-alone drug plans and prescription drug benefits included as part of a medical plan.
(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