I just got a job offer in NYC where the cost of living is crazy high, as you probably know. This is my first corporate job and I need advice/feedback on is this pricing structure for insurance is the norm.
I know you can’t believe everything you read on the internet but I’ve read that the general norm is for the employer to cover 80-85% of the monthly premium.
I would be earning less than 75k and only covering myself but the price still seems quite high? I’ve never paid more than $118 bi-weekly.
I think that’s normal for most companies. They get other benefits like stock, but because the health plan is a pooled resource they tend to have higher earners subsidize lower paid employees
It’s definitely not close to being a fortune500/100 and the place I worked before had moneymoney so I was only paying $35 a month for a PPO plan. I need a gauge on working for a regular corporate office.
OP I am a health insurance broker although I work in the Midwest.
I've never seen a company charge different amounts based on employee earnings. However, I think its excellent they're paying a greater amount for employees who earn less. I am not sure the accounting or legal structure behind this.
The normal/standard amount for an employer to cover here in the Midwest is 50%. I do not know your industry or if New York has a different benefits culture, but here we would not expect more than 50% EE (employee only) coverage.
I love that they pay for a portion of dependent's coverage. It may not mean anything to you if you do not have a family, but thats a generous investment from the company. Coverage of dependent's premiums can quickly inflate the cost.
Those prices aren't unreasonable if the benefits are incredibly high - Say a $1500 or lower deductible with less than a $3,000 MOOP.
If you're young and healthy and the savings of $100-150/mo makes a large difference to you, you might be able to find a lesser priced plan with significantly weaker benefits. However, if this is a strong policy, knowing the cost of everything is generally higher in NYC, I would take it.
Those premiums look insanely high to me. I pay $160 for employee + family coverage but I have far less covered and my individual deductible (6850) and max OOP are much higher. I also don’t have copays for various services they just all count towards the deductible so it’s functionally much less coverage.
Honestly, I’d be okay with that and less coverage as I never hit the deductible. The HDHP/HSA option they have is not an option for me as it does not cover any mental health services until after the 6k deductible.
But what is the premium on the HDHP? Because you’d be spending $4728 on premiums with the PPO before any co-pays.
Does the employer contribute any to the HSA?
How much do you spend on mental health each year? Is it more than 5)3 total of premiums for the PPO?
My HDHP has zero premium to employee and they give $1000 into the HSA each year. I have $6000 deductible. Even with monthly or twice monthly therapy, I still come out ahead versus my PPO option.
ETA: people who haven’t been on HDHP before often feel uncomfortable with the setup at the start. It feels like you’re spending more, but it’s just spending it differently. And with how most places have jacked up PPO premiums and OOP max, it rarely makes sense to select the PPO anymore, regardless of medical situation.
When ever I want to complain about my job, I think about my benefits. I pay $45 a paycheck for family coverage and my husband pays $0 for family coverage. My plan is a $1250/per person or 2500/family deductible and 80%/20%. My husband’s is a $2000 per person deductible or 4000% family and 70%/30%. Out of pocket for family is around 6k for both plans. I know we are both extremely lucky with our insurance.
Without knowing what the benefits are in your plan, it is impossible to say.
What is your deductible? What are co-payments? What is your co-insurance. What is your maximum out of pocket?
However $400 for health insurance is not that high - especially in an extremely high cost of living area. Medical costs in New York are extremely high - on the other hand you have access to the best care in the country versus being in a medical desert.
Okay it won’t let me edit the original post. I’m truly at a loss because it’s so much higher than what I’m used to and I’m taking a massive pay cut as I try to switch industries.
Those are actually quite good benefits. The deductible is not bad at all. The out of pocket max is pretty high, but a lot of the items are a copay and deductible does not apply. I mean, ER and hospital is covered, no deductible, all preventative is covered, no deductible. It's actually pretty great.
This is really good and explains the premiums. Like I’d trade my $45 premium for this —- the diagnostic testing coverage (mri, ct,labs) being 100% covered is amazing
This looks like my coverage for Cigna in FL. Except ours is just you + spouse which is around $400ish a month, and whole family which is closer to $600 I think.
I don’t know where you work but remind me to never work there.
I’m the insurance carrier for my family and holy shit… 928.18/pay on this plan for full family? That’s like easily 45% of pay at 75K
This plan is shit.
My family plan through my employer is 212/pay.. that your employee only plan is almost that.. this is a shit plan.
It costs your employer approximately $1500 to insure a spouse and they do subsidize a portion of that.
A company only has a certain amount of money which is can use for workers in the form of salary and benefits. The employer is already subsidizing a huge amount for spouses and children
If you aren't insuring your spouse and/or children would you want to have your salary reduced or your vacation accrual or other benefits?
I think that’s a broader topic, but I see your point. I really was just hoping to learn what was average percentage that employees are paying in relation to their premium and coverage so I can figure out if this works for me.
Jeez, I am paying $7500/year for my insurance and it's just me, nobody else on the plan. It IS good insurance, though. No referrals needed for anything and I can see whatever doc I want whenever. $2k deductible, $4k max OOP. Man, healthcare is expensive in the US.
I wasn't responding to you directly since you are insuring only yourself but to people who thought the premiums for spouse and child were "outrageous".
As health insurance becomes increasingly expensive employers are faced with difficult choices - do they want to charge more/reduce benefits for actual employees.
Employers with better benefits wind up essentially giving other companies a free ride since spouses choose the "better" more generous plan which creates the kind of pricing/
Spousal exclusions are a thing in plans. My employer won't allow spouses to be covered if they are employed and have access to their own health insurance benefits.
I get you, and you make a fair point and it would be an interesting discussion. I think this thread is just having me realize my own ignorance and naivety about insurance and pricing as a whole.
Employer here. The rates are going up astronomically in New York. I pay $1500 per employee of mine not counting spouses to insure them with a reasonable EPO plan with similar numbers to yours.
I used to work an office job not a Fortune 500 but was corporate and those rates aren’t horrendous for a PPO but they also aren’t the $35 a month you’re used to. NYC is high cost so costs are gonna be up for you every which way
i’m a broker in nyc those total premium rates aren’t far off from the norm. health care in nyc is the most expensive in the country. The amount they charge to employees is definitely on the high side though. hopefully they make it up to you in salary.
This would be super high for me. Based on pay bands it would cost me $2200 more per month to insure my family and it would be crappier coverage than I have today. It really depends on the industry and the companies financial position. I work in healthcare.
My guess is either the benefits (like the maximum out of pocket) are incredibly rich.
Another possibility is their rates are inflated by really bad experience (in the case of a large employer) or having a really skewed population (for a small employer), like if the workers already on the plan are quite old (I’ve seen plans where the only people who enroll are the higher age range, which drives rates up, causing the young employees to balk)
The average employer subsidy these days is roughly 70- 75% of the total premium. While many companies don't tier contributions based on salary, I have seen this at other companies. I like the idea, but can be complicated to administer, which is one reason why this doesn't get embraced more.
I pay $280 biweekly for my insurance with Aetna. It's just for me, no spouse or independents. I have a $2k deductible and $4k out of pocket max. Those prices look standard to me.
Paying $4700/year for a $2000 ded copay only Cigna oapin plan is great. Your employer pays 73% of the premium. In 2025 that is generous. See if you can avoid copays when seeing primary care and specialists by using telemedicine. Make sure you do your preventative care too, because it’s free. All in all, this plan and your contribution to it are significantly better than what most Americans have access to.
From my perspective, it’s expensive. I’ve never paid anything for employee-only coverage at any job I’ve had. Most heavily subsidized (like $100/mo for family) or fully covered dependents at no cost too.
It is for many companies. However, I pay a tiny fraction of that. I don't remember the employee+spouse or family costs, but I pay about $20 a week for really good medical care. This is the benefit of being in a **UNION**.
My last full time job (large multinational) I had similar fees and structured the same - loaded so the lower paid staff paid significantly more proportionally. And the Cigna plan was a crock of shit, I put off surgery while I worked there because I could not afford it, which not only resulted in significant degredation of my quality of life but delaying caused other health issues.
What was really upsetting was directors and above got a way better plan and paid little more. Apparently the workers didn't deserve as good a healthcare.
I had to quit that job because one of my children's medications was costing over $4K/month so we slid backwards heavily every month. Now self employed and my marketplace plan costs less and heaps better.
Personally if you are going to pay that much for healthcare, earn $75K or less and in NYC then I'd keep looking for another offer if you can afford to because that's just crap.
So I know a lot of people will say it's not the norm but for a HCOL area, this is about right. It has been quite a frustrating thing for me because I have a family and it's close to $1k/month for coverage but it highly depends on the OOPM I pick.
I’ve never seen the premium based on income for an employer sponsored plan. Do you know what the deductible and out of pocket max is for this plan? I’ve definitely seen plans around this biweekly but without knowing anything about this plan it’s hard to say.
Is the PPO the only option? These costs look similar to my workplace PPO and I only make 60k. But we also have a HDHP where the employer covers employee only and also gives $1000 toward the HSA.
More and more where I live, they make the PPO costs so high that the only logical choice is the HDHP. And once you get used to it, the high deductible isn’t as scary as it was when they first came in the market.
This is exactly what I was thinking. A close to $1500/mo full cost plan sounds high but what does it buy and what is it being compared to?
PPO (referring to a copay and/or "low" deductible plan since PPO is technically a network term) premium + PPO out of pocket max is so often greater than HDHP premium + HDHP out of pocket max - employer HSA contribution, if any, that I do a double-take and double-check my math when it's not. Also, there is a certain irony in that 1k would pass for a low deductible these days but was the "normal" HDHP early on.
This is terrible. I’ve never paid that much, ever. Been doing this paying for insurance at work thing 15 years. Barf. But I expect this to happen come next year tbh. I hate it
Every workplace is different. My last 2 jobs also had premium difference based on salary, so I would say that is not unusual. I don’t know how good your coverage is to know if those rates are good. My employer has 2 plans to choose from and our premiums are way less than that for the employee contribution.
I pay 325 for Family coverage. 75 of that is a penalty for opting to cover a spouse who has access to health insurance through their employer. Deductible is 1000 per year for the family. Spouses company reimburses 300 as a premium cash option.
For comparison check out single premium on heakth care dot gov without subsidy. In my much lower COL area the premium is much higher than your employee part of $393 per month.
I know quite a few here paying similar or more as yours for employer provided. But I cant answer specific to nyc.
80% is probably on the high side of normal. You’ll usually see anywhere from 50%-100%, and it’s hard to predict what any particular employer will offer. They also may be structuring it to ensure they meet the affordability metrics.
This is the first time I’ve seen insurance premiums differ by pay scale. Where I worked previously, the longer you stayed, the more they covered each year for all coverage options (w/ spouse, etc).
It was great. By year ten, it was $0 for the employee but only if insuring yourself. I don’t remember the other shares but I definitely did not make it to ten years, lol.
They changed the percentages for new hires starting in 2021 but it was still the same idea of the employees paying less over time. I don’t think it gets down to zero at year ten anymore.
Where do you live cuz I’ve never paid more than $80 per month for low deductible health insurance in any job. Right now my health insurance through my employer is $8 per paycheck. Is it really this bad for other companies? If so I’m never leaving 😭
I work in banking in WA. My full coverage cost for myself and my children is around 250-300 a month. I pay $70/month for just me. 1500 deductible (it's 4500 but my employer reimburses you once you pay 1500 out of pocket for the remainder). I'd need to pull up specifics but my coverage after deductible for most things is 80-90%. There's a higher cost plan they offer but I'm pretty healthy and dont have children yet.
Edit: everyone at my job is offered the same plans regardless of income level, if you work full time
No, nothing like NYC. But employers here usually pay 1/2 to 3/4 of the single premium. This is for a low ded , low copay type plan vs the high deductible hsa plans.
Could certainly be regional. Banking is the prevalent industry in NC? Right? Maybe more common in certain industries / regions?
I have the HSA plan right now and deductible and OOP max are $1500 with $15/mo in premiums. But last year I was on the HMO plan which was $75/mo.
Idk about banking, this I the first I’m hearing that NC has banking jobs lol. I’m I RTP which is a biotech hub and my industry is pharma development. I’ve been I this industry for a decade and it’s pretty much been around $70-80 per month in every company I’ve worked for (for the PPO or HMO plan)
Lol this thread must be filled with spoiled mag 7 workers or something. This is literally like 1/4 my premium and thats for the highest deductible plan available
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u/DufflesBNA Jul 04 '25
No. I work for a fortune 100 company and everybody pays the same for healthcare. (In fact they have subsidies for those who’s earn below a threshold)