How do other employers in our industry structure their plans, and how do ours compare?

Across industries, most employers focus on three goals: ACA compliance, employee affordability, and predictable costs. The most competitive plans center around accessible primary care, offer a few clear options, and control spending through smarter design rather than higher deductibles.

Common plan structures by industry

Retail, hospitality, staffing, and logistics:

• MEC for compliance plus $0 primary care.
• Optional buy-up to an HDHP or PPO.
• Voluntary add-ons such as accident, hospital indemnity, vision, or dental coverage.

Manufacturing and distribution:

• Curated PPO or EPO networks with moderate deductibles.
• On-site or near-site clinics for concentrated worksites.
• Voluntary financial protection benefits to round out coverage.

Professional services and technology:

• PPO and HDHP options with HSA funding.
• Built-in telehealth or virtual primary care.
• Strong mental health and family benefits to support retention.

Healthcare and education:

• Broad networks or multi-tier plan structures.
• Emphasis on preventive, mental health, and chronic condition management.
• Lower out-of-pocket costs to increase engagement.

How to compare your plan in five quick checks

1. Compliance: Full-time employees receive MEC and Minimum Value coverage with affordable employee-only premiums. Part-time or variable-hour employees have a compliance pathway.
2. Access to everyday care: Primary care, preventive services, labs, mental health, and prescriptions are available at $0 or low cost, with virtual or in-home options.
3. Total cost balance: Premiums are competitive, and out-of-pocket costs do not discourage care.
4. Choice without confusion: Offer two or three clear options, such as a core plan, a buy-up plan, or an ICHRA.
5. Support and navigation: Provide clear guidance to help employees choose care appropriately and avoid unnecessary ER visits.

Where primary-care-first models stand out

• $0 access to primary and preventive care that employees actually use.
• Simple, digital access including virtual visits and mental health support.
• Predictable employer costs through prepaid or capitated care rather than fee-for-service models.

Potential gaps to monitor when benchmarking

• Employee-only premiums that no longer meet ACA affordability standards for lower-wage roles.
• Too many similar plan options that create confusion.
• High deductibles without a $0 primary care layer, which discourage early care and increase long-term claims.
• Limited access for remote or multi-state employees if the network is local only.

Ways to close gaps and stay competitive

• Keep primary care, preventive care, and mental health visits at $0.
• Pair HDHP savings with a primary care layer so employees can access care before meeting the deductible.
• Use curated networks and virtual care to expand access without broad-network pricing.
• Add voluntary benefits such as accident or hospital indemnity coverage to enhance protection without raising employer costs.

For multi-state or diverse teams, use an ICHRA with defined contributions and consistent primary care access.

Vitable’s primary-care-first model is built on value-based care principles. Every member receives $0 primary care, mental health, and prescription access, all coordinated through one seamless platform. Providers are incentivized to focus on outcomes, not volume.
By combining capitated primary care with proactive care navigation, Vitable helps employers:

• Improve utilization and engagement.
• Reduce ER and hospital use.
• Maintain predictable, transparent costs.

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Across industries, the most competitive benefit designs share the same foundation: free and simple access to everyday care, limited but meaningful plan choice, and cost control through value-based, primary-care-first design.

If your plan includes $0 primary care and clear navigation, it will stand out in both employee satisfaction and long-term cost management.

If you need a detailed benchmark against peers, Vitable can map your premiums, out-of-pocket costs, and utilization features into a short scorecard by role and location.

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