Benchmark Health Insurance Benefits in Your Industry

You can only tell whether your benefits are competitive by comparing them with something. For a Texas employer with 50 or more employees, that means specific numbers: what comparable employers pay, how much of the premium they cover, and what deductible their employees actually face. This page sets out where Texas employers currently stand, the four comparisons worth making, and the US sources to take your figures from.

Where Texas Employers Actually Stand

Start with the comparison most employers never make: how your contribution split compares with other Texas employers, and with the country as a whole. The federal MEPS-IC survey gives both.

Average annual premium per enrolled employee, 2025. Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey – Insurance Component (MEPS-IC), via KFF State Health Facts.

Family coverage	Total premium	Employee pays	Employer pays	Employer share
Texas	$25,053	$7,913	$17,140	68.4%
United States	$26,281	$7,314	$18,967	72.2%
Employee-only coverage	Total premium	Employee pays	Employer pays	Employer share
Texas	$8,543	$1,638	$6,905	80.8%
United States	$9,025	$1,817	$7,208	79.9%

Read the two halves of that table together, because they say different things. On employee-only coverage, Texas employers are competitive — they cover 80.8% of the premium against a national average of 79.9%, and a Texas employee pays $179 a year less than the national average for their own coverage.

On family coverage, Texas employers are behind. The total premium is lower than the national average — $25,053 against $26,281 — but the Texas employee absorbs more of it: $7,913 a year against $7,314 nationally, which is $599 more out of pocket. The employer share drops to 68.4% against 72.2% nationally.

That gap is the single most useful benchmark on this page. If you are losing candidates or seeing low dependent enrollment, the dependent tier is the first place to look — not the medical plan itself. It is also a comparatively cheap thing to fix, because you are adjusting a contribution strategy rather than buying a richer plan.

The Four Comparisons That Matter

Benchmarking goes wrong when it turns into a list of everything that could be compared. For an employer with 50 or more employees, four comparisons carry nearly all the signal.

1. Your contribution split, by tier

Employer versus employee share, looked at separately for employee-only and family coverage. As the table above shows, an employer can be generous on one tier and well below market on the other without realizing it. This is the comparison most likely to change a hiring outcome.

2. Deductible and out-of-pocket maximum

Nationally, the average general annual deductible for single coverage is $1,886. The size gap is wide: employers with 200 or more workers average $1,670, while employers with 3 to 199 workers average $2,631 (KFF, 2025). Out-of-pocket maximums matter as much — 72% of covered workers face a maximum above $3,000, and 21% face one above $6,000.

If you are above 50 employees and your deductible looks like the small-employer average rather than the large-employer average, you are not getting the benefit of your own size.

3. The plan types you offer

Whether you offer a choice at all, and what kind. About 29% of covered workers are enrolled in an HSA-qualified plan (KFF, 2025). Offering a single option is not automatically wrong, but it is a decision worth making deliberately rather than inheriting.

4. Ancillary and voluntary lines

Dental, vision, life, disability and voluntary benefits are where benchmarking most often finds an easy gap, because these lines get renewed for years without review. Employers frequently discover competitors offer a line they do not — or that they are paying for one almost nobody has enrolled in.

Where the Real Numbers Come From

Benchmarking is only as good as its source. Use primary, US data, and note the year — benefits figures move every year, and a number without a date is not a benchmark.

• KFF Employer Health Benefits Survey — the standard annual reference for premiums, contributions, deductibles and plan design, broken out by firm size. The 2025 edition is its 27th, covering more than 1,800 employers.
• AHRQ Medical Expenditure Panel Survey, Insurance Component (MEPS-IC) — the source of the state-level figures above, and the only way to get a reliable Texas cut of premiums and contributions.
• Bureau of Labor Statistics, Employer Costs for Employee Compensation (ECEC) — benefits as a share of total compensation, useful for sanity-checking your overall benefits spend rather than the plan itself.
• Texas Department of Insurance — for anything state-regulated, including small-group rules and carrier filings in Texas.

Two cautions. First, these surveys use different methods, so do not mix a KFF national figure and a MEPS-IC state figure inside the same comparison and treat the difference as meaningful. Second, industry-association salary and benefits surveys can be useful for your specific sector, but check the sample size and the region before you rely on them.

Benchmark by Size and Region, Not Just Industry

Industry comparisons get the most attention and are usually the least actionable. Two comparisons do more work:

Size

Carrier pricing, plan options, claims data access and funding structures all change with group size, and the largest single break is around the 50-employee mark. A 60-employee employer benchmarked against 15-employee employers will look generous while leaving real money on the table. Compare yourself to the size band you are actually in.

Region

Medical cost varies widely across Texas. The Dallas-Fort Worth, Houston, Austin and border markets do not price alike, and neither do their networks. A statewide average is a starting point, not an answer — which is why the local market matters more than a national percentile.

Industry

Worth checking where your industry genuinely differs — construction, healthcare and manufacturing carry different risk classifications and different workforce profiles. Beyond that, industry benchmarks tend to confirm what size and region already told you.

What Benchmarking Will Not Tell You

This is the honest limit, and it matters if you are trying to decide what to do next.

Benchmarking compares plans. It cannot tell you why your renewal came in where it did, because it does not see your claims. Two employers with identical plan designs and identical contribution splits can get very different renewals, and the difference is in their claims experience — utilization patterns, a handful of large claims, specialty pharmacy trend.

So benchmarking answers “is our plan competitive?” It does not answer “is our cost manageable?” Once you are above 50 employees you can usually get claims reporting from your carrier, and that is the more powerful document. Use benchmarking to check your market position, and your own claims data to manage your cost. You need both.

How Often, and When in the Renewal Cycle

Once a year, and early enough to act on what you find. Benchmarking three weeks before open enrollment is an interesting report; benchmarking four to six months before renewal is a plan.

The practical trigger is your renewal timeline. If your renewal reaches you 60 days ahead, you have time to take a benchmark, model a change and communicate it — we explain why that lead time matters in why your benefits renewal should arrive 60 days early. Benchmark outside that window as well if you cross an employee-count threshold, change carriers, acquire another business, or lose candidates over benefits.

If a benchmark shows you are behind and your broker has not raised it with you, that is worth noting. Working out what actually drives your premium is covered in what actually lowers group health insurance costs, and if you conclude you need different representation, the timing options are in the best time to change an employee benefits broker.

FAQs

What is benefits benchmarking?

Comparing your health and ancillary benefits — premium, contribution split, deductible, out-of-pocket maximum and the lines you offer — against employers of similar size and region, using published survey data rather than anecdote.

How often should we benchmark?

Once a year, four to six months before renewal so there is time to act. Also benchmark if you cross an employee-count threshold, change carriers, or start losing candidates over benefits.

Where do reliable benchmarking numbers come from?

The KFF Employer Health Benefits Survey for national plan-design and contribution figures, and the AHRQ MEPS-IC for state-level Texas figures. BLS ECEC helps sanity-check total benefits spend, and the Texas Department of Insurance covers state-regulated questions. Always note the data year.

Can we do it in-house?

Yes. The main sources are public. The work is in matching the comparison group to your actual size and market, and in reading your own plan documents accurately — contribution splits by tier are where in-house benchmarks most often go wrong.

We benchmarked and we are competitive. Why is our renewal still rising?

Because benchmarking compares plans, not claims. A competitive plan can still carry a difficult renewal if your claims experience is running above the pool you are rated against. At your size the next step is claims reporting from your carrier, not more benchmarking.

The Bottom Line

Benchmarking is worth doing because it replaces a feeling with a number. For Texas employers the most common finding is the one in the table at the top of this page: competitive on employee-only coverage, behind the national average on family coverage. That is a specific, fixable gap.

Take one benchmark a year, use US sources and note the year, compare against your own size band and your own region, and then look at your claims data to understand the cost behind the plan.