By Tanya L. Burns, LUTCF, RHU, LTCP
Tanya L. Burns and Associates, Inc.

Tanya L. Burns, LUTCF, RHU, LTCP

Tanya L. Burns, LUTCF, RHU, LTCP

Article submitted by Tanya L. Burns, LUTCF, RHU, LTCP, to share a health insurance update. If you’d like to submit an article, email Kelly Sawyer at

Since the cost of employee benefits continue to increase for the small employer (under 100 employees), I am often asked: “What are other small employers doing for their employees?”   

The following information shown below is comprised of approximately 10,000 small employers from the Southeastern Region of the United States:

  • Types of Medical Plans Offered:
    • PPO/POS Plans: 43%
    • HMO Plans: 19%
  • Average Deductible:
    • Individual: $1,800
    • National Average:  $1,600
  • Average Deductible:
    • Family: $3,800
    • National Average:  $3,500
  • Average Out Of Pocket Maximum:
    • Individual: $4,500
    • National Average:  $4,800
  • Average Out of Pocket Maximum:
    • Family: $9,000
    • National Average: $8,800
  • Average Employer Contribution:
    • 73% Employee Cost
    • 30% Dependent Cost
  • Average In-Network Copay:
    • PCP: $25
    • Specialist: $40
    • Emergency Room: $250
    • Urgent Care: $55
  • Average RX Copays:
    • Generic: $12
    • Brand (Formulary): $40
    • Brand (Non-Formulary): $70

As of this writing, The American Healthcare Act is on its way to the Senate for review, discussion, and modification. This review process will take some time – possibly through most of the summer. I promise to keep you updated in the next issue of where things stand. Right now, it’s too early to summarize any specifics.



Tanya L. Burns, LUTCF, RHU, LTCP