How can I find out what % of the health insurance premium my employer pays?

Let's say I pay $600/month (deducted from my paycheck) for the premiums in my PPO plan. Is there a public place to check how much of the premium my employer pay (without needing to ask them of course)?

31.7k 17 17 gold badges 102 102 silver badges 190 190 bronze badges asked Sep 20, 2023 at 14:18 Henley Wing Chiu Henley Wing Chiu 301 3 3 silver badges 7 7 bronze badges Why not ask them? The employer has no reason to hide this information. Commented Sep 20, 2023 at 14:20 That doesn't answer my question. If I wanted to ask them, I wouldn't be asking here Commented Sep 20, 2023 at 14:25

I'd still like to understand why not ask. It sounds like what you're really trying to get an answer to may not be the question you have asked us

Commented Sep 20, 2023 at 14:44

Our company makes a big deal about telling us how much they pay towards the plan. it is an employee benefit. Why WOULDN'T they want to tell you how much they are benefitting you?

Commented Sep 20, 2023 at 14:58 @MonkeyZeus That's for some other company. The OP is talking about their current employer. Commented Sep 22, 2023 at 14:41

6 Answers 6

You haven't told us why you can't ask. But lets make the assumption that you have asked and they haven't provided the information.

There are some additional ways to determine this number:

find somebody who recently quit or was let go. They will receive the COBRA paperwork which will tell them what they need to pay out of their pocket to keep they insurance benefits. This only works if they are willing to show you, and if they have the same plan option as you do. I have worked for companies that have had 3 or 4 policies to pick from so that might be hard to find a match, but it would give you an idea.
If the company gives an extra benefit if you decline the insurance because you have coverage from another family member, or from some other source, the value of the benefit may help determine how much they are saving when you decline the insurance.

There is another official source, but the information lags. For the last few years it has been included on the W-2:

It goes in Box-12 Code DD.

Reporting on the Form W-2

Employers that are subject to this requirement should report the value of the health care coverage in Box 12 of the Form W-2PDF, with Code DD to identify the amount. There is no reporting on the Form W-3 of the total of these amounts for all the employer’s employees.

In general, the amount reported should include both the portion paid by the employer and the portion paid by the employee. See the chart, below, and the questions and answers for more information.

You might have to wait until early 2024 for the 2023 info, or use the W-2 for 2022.

answered Sep 20, 2023 at 16:43 mhoran_psprep mhoran_psprep 143k 15 15 gold badges 197 197 silver badges 403 403 bronze badges

Unless they include that information on your pay stub (like mine does), the only way to know is to ask them. Even if you know the specific plan you have I don't know of a way to find the total cost for your exact employer. Total cost can vary based on location and the number of employees even for the same plan.

answered Sep 20, 2023 at 14:36 9,744 1 1 gold badge 25 25 silver badges 52 52 bronze badges

In most employers, you can easily find your actual cost to them: add up the claims your insurance paid on your behalf and subtract your paycheck deduction.

Nearly all medium-to-large companies' health plans are self-insured. That is when a claim is made, the company pays that out of its pockets. The "insurance company" is really a plan administrator that contracts providers, validates claims, adds a markup, and sends the bill to your employer. Note the words that are actually used, your employer provides a health plan, not health insurance.

The result of this system is that benefits vary widely by employer, even though they're under the same insurance brand. Employers can select different drug formularies and different provider networks, which would not otherwise be available on the open insurance market.

The employer may give you a "premium" as in the amount they budget for you: they take the claims over the group, perhaps adjust allocation for risk/demographics, and divide by the number of participants.

Roughly, in the US, 70-80% of costs are borne by the employer, and the remainder is equally split between paycheck deductions and point-of-service payments.