Medical Benefits

Employee Medical Benefits Summary Pennsylvania

Providing high-quality, cost-effective medical benefits for employees is a crucial element of any total compensation package. There are roughly 5,900,000 people covered by healthcare in Pennsylvania, whether you work for Comcast or Steelworkers Union.

The Affordable Care Act (ACA) stipulates that if you have more than 50 workers in the state of Pennsylvania, you must provide health insurance to them. Because this may be accomplished in a variety of ways, we've broken down how it works for both small businesses (1-50 employees) and big businesses (51 or more employees).


Small Employer Guide to Medical Benefits

Cost & Coverage

Among the 222,000 small employers in Pennsylvania representing over 937,000 employees, 66% provide access to medical benefits, while 66% of employees take advantage of the benefit. On average, if you’re a small employer in Pennsylvania, the employer covers an average of 79% for single employees and 73% for families, which costs the small employer approximately $478 each month for individuals and $1273 for families. The employee also has to pay a monthly amount which totals out to $126 for a single employee and $464 for a family on average. A family individual component can range from $307 at the 25th percentile to $684 at the 75th percentile.

Plan Design

For small employers, 21% pick a high deductible health plan, 18% choose an HMO, and 38% select a PPO. These various plan types provide a wide range of coverage depending on the network, which may include one or more PCPs, specialists, and hospitals.

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Tax Advantaged Accounts

In Pennsylvania, 29% of employers offer a Health Savings Account (HSA), and 44% offer a healthcare Flexible Spending Account (FSA) to assist employees in managing their costs and pay effectively. Either option is an excellent method to help workers save money on medical expenditures while lowering the employer's costs.

Dental and Vision

When deciding whether or not to join your company's comprehensive employee benefits package, be sure to evaluate any dental or vision perks. Dental benefits are available from 43% of small employers, whereas only 32% offer vision. This is considerably lower than the 77% that take advantage of dental coverage and the 75% that take advantage of vision coverage among big businesses.

Large Employer Guide to Medical Benefits

Cost & Coverage

The 116,000 large employers in Pennsylvania provide medical coverage to over 5,043,000 individuals across the state. Larger employers, in general, are able to provide most comprehensive medical coverage for their employees. The percentage of employees at large employers in Pennsylvania that take advantage of this benefit is 73%. Large Pennsylvania employers cover an average of 81% of the monthly premium for single employees and 81% of the premium for families. This equates to an employer cost of $542 per month for a single person and $1572 for a family. For the employees, this equates to an average of $123 per month for single employees and $361 for families, with costs ranging from $88 each month for a family at the 25th percentile and $176 for a family at the 75th percentile. If you are lucky, 14.5% of large Pennsylvania employers cover all medical expenses for single individuals and 11.4% for families.

Plan Design & Cost

Depending on the characteristics of your staff, you may choose from a variety of plan types. 43% of Pennsylvanian employees chose to participate in PPO plans, 19% opted for an HMO, and 35% picked a High Deductible Health Plan (HDHP). The difference in plan type determines the extent of insurance coverage available at medical offices and clinics. It also has an impact on copays, deductibles, and other elements.

Tax Advantaged Accounts

Providing employees with tax-advantaged methods to manage their medical expenses is an important aspect of a well-rounded comprehensive benefits package. How can you accomplish this? Flexible Spending Accounts (FSA), also known as Caboodle Accounts, and Health Savings Accounts (HSA) are popular options. An HSA is available in 49% of big businesses in Pennsylvania, while an FSA may be found in 68% of employers.

Dental & Vision

Larger organizations have a greater offering rate than small companies when it comes to dental and vision plans. In the state of Pennsylvania, 67% of large employers provide dental coverage and 82% make use of the benefit, whereas 48% offer vision insurance and 75% utilize the benefit.

Medical Benefits Considerations

Choosing a broker to design health insurance benefits for your plan type is an important decision, whether you're a small or large business in Pennsylvania. If you want a list of businesses in your area that specialize in medical benefits, contact Mployer Advisor now.


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