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Employee Benefits Survey
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Table 22. Outpatient prescription drug benefits: Brand-name drugs not on formulary limits, private industry workers, 2018
(All workers participating in outpatient prescription drug plans with brand-name drug not 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

 55 60 38 60 22 - 2 -

Management, professional, and related

 52 60 42 60 25 1 4 1

Management, business, and financial

 52 60 43 60 27 - 3 -

Professional and related

 52 60 41 60 24 2 5 1

Sales and office

 54 50 40 60 26 2 - -

Sales and related

 53 60 42 60 24 - - 1

Office and administrative support

 55 50 39 60 26 2 - -

Full time

 56 60 37 60 22 - 3 -

Part time

 41 50 42 60 29 - - (2)

Establishment characteristics

Service-providing industries

 54 60 38 60 24 - 3 -

Trade, transportation, and utilities

 53 60 43 60 26 3 - -

Information

 53 60 44 60 25 - - (2)

Financial activities

 38 60 57 55 36 - - 2

Education and health services

 52 50 28 60 16 - - 2

Educational services

 76 50 15 65 7 - - (2)

Health care and social assistance

 48 50 30 60 17 - - 2

Geographic areas

Northeast

 55 50 37 60 21 - - 1

New England

 64 50 - - - - - (2)

Middle Atlantic

 51 50 38 55 22 - - 1

South

 52 60 41 65 26 - - 1

South Atlantic

 58 60 38 65 26 - - 1

West South Central

 46 60 44 65 24 - - (2)

Midwest

 54 60 40 60 24 - - 1

East North Central

 51 60 42 60 26 3 - -

West North Central

 58 60 38 65 19 - - (2)

West: Mountain

 39 50 41 60 20 - - 2

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