National Compensation Survey:

Employee Benefits in Private Industry

in the United States, 2003

U.S. Department of Labor

Elaine L. Chao, Secretary

U.S. Bureau of Labor Statistics

Kathleen P. Utgoff, Commissioner

October 2005

Bulletin 2577
iii

Preface

This bulletin presents findings of the 2003 National

Compensation Survey (NCS) conducted by the Bureau of Labor Statistics (BLS). The survey provides

data on detailed provisions of healthcare and retirement plans

in private industry. Data on incidence and provisions of

selected benefit plans have been published separately; the

latest release, March 2005, can be found at the BLS World

Wide Web site at www.bls.gov/ncs/ebs/sp/ebsm0003.pdf.

The public may access other NCS benefit incidence and

provisions data through the Web site at www.bls.gov/ncs/

ebs/home.htm. Questions on the data in this publication

should be referred to the staff of the NCS at (202) 606-6199 or

via E-mail: OCLTINFO@bls.gov. Sensory-impaired individuals may obtain information in this publication upon request.

Voice telephone: (202) 691-5200; Federal Relay Service: 1-

800-877-8339.
v

Contents

Introduction ............................................................................................................................................................... 1

Chapter 1. Health Benefits ....................................................................................................................................... 3

Medical Care ......................................................................................................................................................... 3

Healthcare plans and systems....................................................................................................................... 3

Limitations on coverage ................................................................................................................................ 3

Alternatives to hospitalization ...................................................................................................................... 4

Mental health and substance abuse treatment ............................................................................................. 4

Related terms ................................................................................................................................................. 4

Prescription Drugs ................................................................................................................................................ 4

Dental Care ........................................................................................................................................................... 5

Vision Care ............................................................................................................................................................ 5

Tables:

Medical care:

1. Medical care benefits: Fee arrangement and financial intermediary............................................................. 6

2. Medical care benefits: Coverage for selected services by type of plan ....................................................... 8

3. Indemnity plans: Coverage for selected services......................................................................................... 10

 4. Indemnity plans in and out of network: Summary of selected features ....................................................... 11

 5. Indemnity plans with overall limits: Average dollar limits ............................................................................ 12

 6. Indemnity plans with overall limits: Amount of individual deductible ......................................................... 13

7. Indemnity plans with overall limits: Individual deductible difference between

 in-network and outside of network coverage .............................................................................................. 15

8. Indemnity plans with overall limits: Relationship between individual and family deductible ...................... 16

9. Indemnity plans with overall limits: Coinsurance rates ................................................................................ 17

10. Indemnity plans with overall limits: Coinsurance rate difference between in-network

 and outside of network coverage ................................................................................................................ 18

11 Indemnity plans with overall limits: Maximum out-of-pocket expense provisions ...................................... 19

12. Traditional indemnity plans with overall limits: Maximum out-of-pocket expense provisions .................... 20

13. Indemnity plans in and outside of network with overall limits: Maximum out-of-pocket

 expense provisions ...................................................................................................................................... 21

14. Indemnity plans with overall limits: Maximum benefit provisions ............................................................... 22

15. Indemnity plans: Coverage for alternatives to hospital care ........................................................................ 23

16. Copayment provisions for hospital room and board by plan type ............................................................... 24

17. Prepaid plans: Coverage for selected services and alternatives to hospital care ........................................ 25

18. Prepaid plans: Summary of selected features ............................................................................................... 26

19. Prepaid plans: Extent of coverage for extended care facilities ...................................................................... 27

20. Outpatient prescription drug benefits: Summary of coverage ..................................................................... 28

Mental healthcare and substance abuse treatment:

21. Mental healthcare and substance abuse treatment benefits: Comparison with coverage for

 other illnesses .............................................................................................................................................. 29

22. Mental healthcare and substance abuse treatment benefits: Coverage in prepaid plans ............................ 30

23. Mental healthcare benefits: Separate limits on coverage in indemnity and prepaid plans ........................... 31

24. Alcohol and drug abuse treatment benefits: Relationship between provisions in indemnity and

 prepaid plans ............................................................................................................................................... 32

25. Alcohol abuse treatment benefits: Separate limits on coverage in indemnity plans..................................... 33

26. Alcohol abuse treatment benefits: Separate limits on coverage in prepaid plans ........................................ 34

27. Drug abuse treatment benefits: Separate limits on coverage in indemnity plans ......................................... 35

28. Drug abuse treatment benefits: Separate limits on coverage in prepaid plans ............................................. 36

 Page
vi

29. Mental healthcare and substance abuse treatment benefits: Application to out-of-pocket

 expense provisions in indemnity plans ....................................................................................................... 37

Dental care:

30. Dental care benefits: Coverage for selected procedures and average percentage of

 usual, customary, and reasonable charge.................................................................................................... 39

31. Dental care benefits: Amount of individual deductible ................................................................................ 42

32. Dental care benefits: Relationship of yearly family deductibles to yearly individual deductibles .............. 43

33. Dental care benefits: Maximum benefit provision ........................................................................................ 44

34. Orthodontia care benefits: Maximum benefit provision ............................................................................... 45

35. Orthodontia care benefits: Percent of participants in plans with orthodontic benefits by

 type of individuals covered ......................................................................................................................... 46

Vision care:

36. Vision care benefits: Coverage for selected procedures .............................................................................. 47

Chapter 2. Retirement Income Benefits................................................................................................................... 49

Defined Benefit Plans............................................................................................................................................ 49

Traditional ........................................................................................................................................................ 49

Other types ...................................................................................................................................................... 49

Normal retirement ............................................................................................................................................. 49

Early retirement ................................................................................................................................................ 49

Benefit payment methods ................................................................................................................................ 49

Vesting ............................................................................................................................................................. 49

Integration with Social Security ....................................................................................................................... 50

Portability ......................................................................................................................................................... 50

Disability retirement ......................................................................................................................................... 50

Defined Contribution Plans .................................................................................................................................. 50

Plan types ........................................................................................................................................................ 50

Investment choices .......................................................................................................................................... 50

Withdrawals and loans..................................................................................................................................... 51

Vesting ............................................................................................................................................................. 51

Employer contribution methods ...................................................................................................................... 51

Related plans and terms ................................................................................................................................... 51

Tables:

Defined benefit plans:

37. Defined benefit plans: Summary of plan provisions..................................................................................... 52

38. Defined benefit plans: Eligibility requirements ............................................................................................. 53

39. Defined benefit plans: Plan sponsor............................................................................................................. 54

40. Defined benefit plans: Primary formula ......................................................................................................... 55

41. Defined benefit plans: Integration with Social Security ............................................................................... 56

42. Defined benefit plans: Terminal earnings formulas ...................................................................................... 57

43. Defined benefit plans: Definitions of terminal earnings ............................................................................... 58

44. Defined benefit plans: Dollar amount formulas ............................................................................................ 59

45. Defined benefit plans: Maximum benefit provisions .................................................................................... 60

46. Defined benefit plans: Selected age and service requirements for normal retirement .................................. 61

47. Defined benefit plans: Availability of lump-sum benefits at retirement ....................................................... 62

48. Defined benefit plans: Selected age and service requirements for early retirement ..................................... 63

49. Traditional defined benefit plans: Selected age and service requirements for early retirement ................... 64

Contents—Continued

Page

Chapter 1. Tables—Continued
vii

50. Defined benefit plans: Early retirement reductions ...................................................................................... 65

51. Traditional defined benefit plans: Early retirement reductions ..................................................................... 66

52. Defined benefit plans: Initiation of disability retirement benefits ................................................................ 67

53. Defined benefit plans: Postretirement survivor benefits.............................................................................. 68

54. Defined benefit plans: Preretirement survivor benefits ................................................................................ 69

55. Defined benefit plans: Vesting requirements................................................................................................ 70

56. Defined benefit plans: Provisions for early receipt of deferred vested benefits .......................................... 71

57. Traditional defined benefit plans: Provisions for early receipt of deferred vested benefits ......................... 72

58. Cash balance plans: Percentage basis of employer and interest rate contributions .................................... 73

Defined contribution plans:

59. Defined contribution plans: Participation in types of plans with employer contributions .......................... 74

Savings and thrift plans:

60. Savings and thrift plans: Summary of provisions ........................................................................................ 75

61. Savings and thrift plans: Plan sponsor......................................................................................................... 76

62. Savings and thrift plans: Transfer and rollover provisions ......................................................................... 77

63. Savings and thrift plans: Maximum employee contributions ....................................................................... 78

64. Savings and thrift plans: Method of determining employee pretax contribution ........................................ 79

65. Savings and thrift plans: Maximum pretax employee contributions............................................................. 80

66. Savings and thrift plans: Method of employer matching contributions ...................................................... 81

67. Savings and thrift plans: Employee contributions by employer specified matching percentage ................ 82

68. Savings and thrift plans: Investment choices .............................................................................................. 83

69. Savings and thrift plans: Eligibility requirements......................................................................................... 84

70. Savings and thrift plans: Automatic enrollment requirements ..................................................................... 85

71. Savings and thrift plans: Vesting provisions ............................................................................................... 86

Deferred profit-sharing plans:

72. Deferred profit-sharing plans: Employer contribution .................................................................................. 87

73. Deferred profit-sharing plans: Allocation of employer contributions to individual employee accounts ..... 88

74. Deferred profit-sharing plans: Eligibility requirements ................................................................................ 89

Money purchase pension plans:

75. Money purchase pension plans: Employer contributions ........................................................................... 90

Appendix A. Technical Note

Scope of survey ............................................................................................................................................. 91

Industry groups............................................................................................................................................. 91

Occupational groups ..................................................................................................................................... 91

Definition of terms ......................................................................................................................................... 91

Calculation details ......................................................................................................................................... 91

Benefit areas .................................................................................................................................................. 92

Sample design and data collection ................................................................................................................ 92

Data calculation ............................................................................................................................................. 92

Survey estimation methods ........................................................................................................................... 92

Reliability of estimates................................................................................................................................... 93

Table A-1. Number of establishments and occupational observations studied and estimated number of

 workers within the scope of the survey, 2003 ........................................................................................... 94

Appendix B. Survey Response .................................................................................................................................. 95

Contents—Continued

Page

Chapter 2. Tables—Continued
1

A note on the tables

Introduction

This bulletin includes data on detailed provisions of

healthcare and retirement plans offered as employee

benefits in private industry. The period for compiling

these data was December 2002 through April 2004; thus,

they have a 2003 reference date. Chapter 1 presents information on healthcare benefits, and chapter 2, on defined benefit

and defined contribution retirement plans.

Interpreting the tables in terms of the group of employees described is the key to understanding and correctly

using the data. In most cases, the tables in this bulletin refer to the percentage of all employees who receive

specified benefits, as well as the provisions of many of these benefits. For provision data, tabulations generally

indicate the percentage of all employees receiving a benefit (that is, participants) who are covered by specified

features.

Most tables in the bulletin exhibit the percentage of all employees with access to, or participating in, a particular

benefit plan or the percentage covered by a specific provision. For example, table 1 indicates the percentage of all

workers participating in a medical plan by the type of fee arrangement and financial intermediary. Indemnity or feefor-service plans account for 76 percent of participants, and prepaid or HMO plans account for 24 percent of

participants. Other tables provide information on workers participating in a plan, along with information on

particular features of the plan. For example, table 17 indicates that 79 percent of workers in prepaid plans have

inpatient surgery costs covered in full, while 21 percent are subject to limits. In this case, the title reads “Prepaid

plans.” The “total” line in table 17 (100 percent) represents all workers in prepaid plans. All other figures shown

in this table are percentages of this subset of workers.

Another type of table contains data on average values—for example, an average annual deductible or a lifetime

maximum. In these tables, the average value shown is based only on those who were affected by the provision;

employees without such coverage were not included in the calculation of an average value. In table 5, for example,

the calculation of the average deductible is based on workers required to pay a deductible. A careful reading of the

title, column, and row headings of each table will help clarify its content. More detail on the calculation of benefit

participation percentages and benefit provision averages is given in appendix A.
3

Chapter 1. Health Benefits

The National Compensation Survey collects information on a variety of health benefits, including medical,prescription drug, dental, and vision care. Definitions

of major types of plans, key provisions, and related terms

follow.

Medical Care

Medical care plans provide or pay for services rendered in

the hospital or by a qualified medical care provider. Plans

that provide only dental, vision, or prescription drug coverage are tabulated separately and described in their own sections below.

Healthcare plans and systems

Indemnity plan. This type of medical plan reimburses the

patient or the provider as expenses are incurred.

Traditional indemnity plan. A traditional indemnity medical

plan allows the participant the choice of any provider, without affecting reimbursement. This type of plan reimburses

the patient or the provider as expenses are incurred.

Indemnity inside and outside of network plan (formerly

called a preferred provider organization or PPO plan). This

kind of indemnity plan provides coverage to participants

through a network of selected healthcare providers. Enrollees may receive services outside the network, but at higher

costs. The additional costs may be in the form of higher

deductibles or coinsurance rates (or both), or of nondiscounted charges from providers. Under this type of plan,

there may be a requirement to obtain a primary care

physician’s referral before obtaining medical care from a

specialist. If this requirement is not met, benefits may be

reduced.

Prepaid plan, or a health maintenance organization (HMO).

A prepaid or HMO healthcare plan assumes both the financial risks associated with providing comprehensive medical

services and the responsibility for healthcare delivery in a

particular geographic area, usually in return for a fixed, prepaid fee from members.

Prepaid in network (traditional HMO). This kind of plan

provides no benefits for services obtained outside the network.

Prepaid in and out of network (point of service or POS

HMO). A POS plan is an HMO/PPO hybrid. POS plans

resemble HMOs for in-network services. Services received

outside the network are usually reimbursed in a manner similar to traditional indemnity plans (e.g., provider reimbursement based on a fee schedule or on what the insurer considers “usual, customary, and reasonable” charges).

Mixed-model HMO. An HMO initially adopts one type of

model, such as a group/staff model, then expands its capacity or its geographic region by adding another type of model,

such as an independent practice association (IPA) HMO.

Network model HMO. An HMO contracts with multiple physician groups to provide services to its members. The physician groups may involve large single- and multispecialty

groups and may provide services to both HMO and nonHMO plan participants.

Group/staff HMO. This is a type of closed-panel HMO, meaning patients can receive services only through a limited number of providers. Under this type of plan, physicians are

employees of the HMO, and they see patients in the HMO’s

own facilities.

Individual practice association (IPA) HMO. An IPA is composed of independent practicing physicians who maintain

their own offices and band together to contract their services to HMOs. An IPA may contract with and provide services to both HMO and non-HMO plan participants.

Limitations on coverage

Maximum dollar limit. This refers to the maximum amount

payable by the insurer for covered expenses for the enrollee

and each covered dependent while enrolled in the health

plan. Plans can have a yearly or a lifetime maximum dollar

limit. The typical limit is a lifetime maximum of $1 million per

individual.

Maximum out-of-pocket expense. This is a limit on the dollar

amount a group member is required to pay out of pocket

during the benefit period. Until this maximum is met, the plan

and the member share in the cost of covered expenses. After

the maximum is reached, the insurance carrier pays all covered expenses, often up to a lifetime maximum.

Deductible. The deductible is a fixed dollar amount that the

enrollee pays during the benefit period—usually a year—
4

before the insurer starts to make payments for covered medical services. Plans may have both individual and family

deductibles. Some plans have separate deductibles for specific services. For example, a plan may have a hospitalization

deductible per admission. Deductibles may differ between

services received from an approved provider—that is, a provider with whom the insurer has a contract or an agreement

specifying payment levels and other requirements—and

those received from providers not on the approved list.

Coinsurance. This form of medical cost sharing requires an

enrollee to pay a stated percentage of medical expenses after

the deductible amount, if any, is paid. After any deductible

amount and coinsurance are paid, the insurer is responsible

for the rest of the reimbursement for covered benefits, up to

the maximum allowed charges. The individual is responsible

for any charges in excess of what the insurer determines to

be “usual, customary, and reasonable.” Coinsurance rates

may differ between services received from an approved provider and those received from providers not on the approved

list.

Overall limits. These are restrictions that apply to all or

most benefits under the plan, as opposed to selected benefits—for example, a $300 per year deductible that must be

paid before medical expenses become eligible for reimbursement. Another example would be an 80-percent coinsurance

that applies to all categories of care except outpatient surgery.

Internal limits. An internal limit applies to individual categories of care—for example, a $250 per procedure deductible

for inpatient surgery.

Alternatives to hospitalization

Alternatives to hospitalization are offered as a means of reducing costs.

Extended-care facilities. These facilities provide skilled nursing care, rehabilitation, and convalescent services to patients

who require less intensive treatment than that provided in a

hospital.

Home healthcare. These services provide skilled nursing

and related care to patients in their own homes.

Hospice care. These programs provide nursing care and

psychological support to terminally ill patients and their families, either on an inpatient basis or in the patient’s home.

Mental health and substance abuse treatment

These services include inpatient and outpatient care for psychiatric conditions and alcohol or drug dependency. The

coverage is generally more restrictive than that for general

medical conditions.

Detoxification. This treatment involves supervised care by

medical personnel that is designed to reduce or eliminate the

symptoms of chemical dependency. Treatment can occur on

an inpatient or an outpatient basis.

Rehabilitation. These services are intended to alter the behavior of substance abusers and usually are provided after

detoxification is complete. Services can be provided on an

inpatient or an outpatient basis.

Related terms

Premium. A premium is the fee paid for coverage of medical

benefits for a defined period. Premiums can be paid by employers, unions, or employees or can be shared by the enrollee and the plan sponsor.

Self-insured plan. Under this type of plan, employers directly assume the major cost of health insurance for their

employees. Some self-insured plans bear the entire risk. Other

self-insured employers insure against large claims by purchasing stop-loss coverage. Some self-insured employers

contract with insurance carriers or third-party administrators

for claims processing and other administrative services; other

self-insured plans are self-administered.

Stop-loss coverage. Stop-loss coverage is a form of reinsurance for self-insured employers that limits the amount the

employer will have to pay for each employee’s healthcare

(individual limit) or for the total expenses of the employer

(group limit).

Insured plan. The employer contracts with another organization to assume financial responsibility for the costs of enrollees’ medical claims.

Prescription Drugs

Prescription drug plans provide coverage for outpatient prescription drugs. Prescription drugs dispensed during a hospital stay are covered as miscellaneous hospital charges.

Name-brand drugs. These are drugs that once were, or still

are, under patents.

Generic drugs. These are drugs that are not under patents.

Once a drug’s patent has expired, some plans provide more

generous coverage for same-formula generic drugs than for

name-brand drugs; the practice is adopted as a cost containment measure.

Mail-order drugs. These are drugs that can be ordered

through the mail. As a cost containment measure, some plans

use mail-order pharmacies that typically provide 3-month

supplies of maintenance drugs.

Formulary drugs. These are drugs approved by the healthcare provider. Drugs not approved by the healthcare pro-
5

vider are nonformulary drugs, for which enrollees receive

less generous benefits, such as a higher per prescription

copayment.

Copayment. A copayment is the amount the employee must

pay each time a specific service is received.

Dental Care

Dental care plans provide services or payments for preventive and restorative care and related dental services.

Preventive services. Such services include routine exams

and x rays.

Restorative services. These services include fillings, dental

surgery, endodontics (root canal therapy), periodontics (treatment for gum disease), crowns, and prosthetics (replacement of missing teeth with bridgework or dentures).

Orthodontic services. These are services for the correction

of malpositioned teeth.

Vision Care

Vision care plans provide coverage for eyeglasses, eye examinations, and contact lenses. Coverage is typically limited

and is subject to applicable copayments or scheduled cash

allowances.
Table 1. Medical care benefits: Fee arrangement and financial intermediary, all private industry workers, National Compensation Survey, 2003

Fee arrangement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity

Total ...................................................... 76 77 77 67 79 75 76 76 71 77

Self insured ....................................... 31 30 32 29 31 30 23 37 30 31

With administrative services only

contract ........................................ 20 19 23 18 23 19 13 26 19 20

Without administrative services

only contract ................................ 7 7 6 8 5 8 6 8 9 7

Not determinable ........................... 4 4 3 3 3 4 4 3 3 4

Insured .............................................. 46 47 46 38 48 45 53 40 40 47

Traditional indemnity

Total ...................................................... 7 7 9 - 8 7 7 8 13 6

Self insured ....................................... 4 4 5 - 3 4 3 4 9 3

With administrative services only

contract ........................................ 2 2 2 - 2 1 1 2 3 1

Without administrative services

only contract ................................ 2 2 3 - 1 2 2 2 5 1

Not determinable ........................... 1 ( ) 1 ( ) 1 () - 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 ( ) 1 ( )

Insured .............................................. 4 3 5 - 5 3 4 4 4 3

Indemnity in and out of network

Total ...................................................... 67 68 67 61 70 66 68 67 57 69

Self insured ....................................... 26 26 27 26 27 26 19 32 22 27

With administrative services only

contract ........................................ 18 16 21 18 21 17 12 23 15 19

Without administrative services

only contract ................................ 5 6 3 6 4 5 4 6 4 5

Not determinable ........................... 3 4 2 2 3 3 4 3 3 3

Insured .............................................. 41 42 40 35 43 40 48 35 35 42

Indemnity in and out of network

without primary care physician

Total ...................................................... 54 54 55 52 57 53 55 53 45 56

Self insured ....................................... 22 21 24 24 23 22 16 27 19 23

With administrative services only

contract ........................................ 15 13 19 16 18 14 10 20 13 16

Without administrative services

only contract ................................ 5 5 3 6 3 5 4 5 4 5

Not determinable ........................... 2 2 2 2 3 2 2 2 2 2

Insured .............................................. 32 33 31 28 34 31 39 25 25 33

See footnotes at end of table.

6
Table 1. Medical care benefits: Fee arrangement and financial intermediary, all private industry workers, National Compensation Survey, 2003

— Continued

Fee arrangement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity in and out of network with

primary care physician

Total ...................................................... 13 14 12 9 13 13 12 14 12 13

Self insured ....................................... 4 5 3 2 4 4 3 5 3 4

With administrative services only

contract ........................................ 3 3 2 2 3 3 2 3 2 3

Without administrative services

only contract ................................ 1 ( ) 1 () 1 1 () 1 1 () - 1 1 () 1

Not determinable ........................... 1 1 1 ( ) 1 () - 1 1 1 ( ) 1 () 1

Insured .............................................. 9 9 9 7 9 9 9 9 10 9

Other2

Total ...................................................... 2 2 1 1 1 2 2 2 1 2

Prepaid

Total ...................................................... 24 23 23 33 21 25 24 24 29 23

Self insured ....................................... 2 2 1 1 1 2 1 2 1 2

Insured .............................................. 22 21 22 32 20 23 23 22 28 21

Prepaid in network only

Total ...................................................... 20 19 19 28 18 21 20 20 24 19

Self insured ....................................... 1 2 1 1 1 2 1 () 2 1 1

Insured .............................................. 19 17 18 28 17 19 20 18 24 18

Prepaid in and out of network

Total ...................................................... 4 4 - - - 4 - 4 - 4

Self insured ....................................... 1 ( ) 1 () - - - 1 () - 1 () - 1 ( )

Insured .............................................. 4 4 - - - 4 - 4 - 3

1 Less than 0.5 percent. 2 Includes exclusive provider organizations, which are groups of hospitals and

physicians that contract to provide comprehensive medical services. Participants

are required to obtain services from members of the organization in order to receive

plan benefits.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

7
Table 2. Medical care benefits: Coverage for selected services by type of plan, all private industry workers, National Compensation Survey,

2003

Type of plan and service All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

All plans

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Hospital room and board ................... 99 99 99 99 100 98 98 99 99 99

Inpatient surgery ................................ 96 97 96 96 98 96 96 97 97 96

Outpatient surgery1 ........................... 96 97 95 93 98 95 96 96 97 96

Office physician visit .......................... 99 100 99 96 99 99 99 99 99 99

Extended care2 .................................. 79 80 79 72 77 80 78 80 77 79

Home health care2 ............................ 85 84 87 82 87 84 85 85 87 84

Inpatient hospice ............................... 71 71 72 64 74 70 67 74 72 71

Home hospice ................................... 15 16 14 15 14 16 10 19 17 15

Inpatient mental ................................. 92 92 93 92 94 92 92 93 94 92

Outpatient mental ............................. 93 93 92 91 94 92 92 93 96 92

Inpatient alcohol detoxification3 ......... 94 94 94 94 95 93 93 94 95 93

Inpatient alcohol rehabilitation4 ......... 85 85 84 81 86 84 83 86 83 85

Outpatient alcohol rehabilitation4 ...... 88 88 87 86 88 88 88 87 89 88

Inpatient drug detoxification3 ............. 94 94 94 95 95 93 93 94 95 94

Inpatient drug rehabilitation3 ............. 85 85 84 82 86 84 82 86 83 85

Outpatient drug rehabilitation4 ........... 88 88 86 88 88 87 87 88 88 87

Hearing care5 .................................... 25 25 23 32 25 25 23 26 30 24

Adult physical exams ......................... 69 69 68 70 74 66 67 69 66 69

Well baby care ................................... 77 77 77 79 80 76 76 78 77 77

Adult immunization and inoculation ... 50 49 52 52 58 47 50 51 50 50

Indemnity plans

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Hospital room and board ................... 99 98 99 98 100 98 98 99 99 99

Inpatient surgery ................................ 97 96 98 96 99 96 96 98 98 97

Outpatient surgery1 ........................... 97 97 98 97 99 97 97 98 98 97

Office physician visit .......................... 99 100 98 100 99 99 99 99 98 99

Extended care2 .................................. 81 82 81 78 79 83 79 84 79 82

Home health care2 ............................ 85 83 89 80 87 84 84 85 88 84

Inpatient hospice ............................... 76 75 78 71 81 74 73 78 78 76

Home hospice ................................... 16 16 15 19 15 16 11 20 17 16

Inpatient mental ................................. 93 93 94 89 94 92 92 94 96 92

Outpatient mental ............................. 92 92 94 87 94 92 92 93 96 92

Inpatient alcohol detoxification3 ......... 93 93 93 92 94 92 91 94 94 93

Inpatient alcohol rehabilitation4 ......... 89 89 89 83 89 88 88 89 89 88

Outpatient alcohol rehabilitation4 ...... 89 89 89 83 89 89 89 89 90 89

Inpatient drug detoxification3 ............. 93 93 93 93 94 92 91 94 94 93

Inpatient drug rehabilitation3 ............. 88 89 88 84 89 88 87 89 89 88

Outpatient drug rehabilitation4 ........... 89 89 89 85 89 89 88 89 90 89

Hearing care5 .................................... 15 16 14 21 16 15 12 18 19 15

Adult physical exams ......................... 65 64 66 60 70 62 63 66 60 65

Well baby care ................................... 76 75 77 72 77 75 75 76 75 76

Adult immunization and inoculation ... 46 44 49 48 53 43 46 46 45 46

See footnotes at end of table.

8
Table 2. Medical care benefits: Coverage for selected services by type of plan, all private industry workers, National Compensation Survey,

2003 — Continued

Type of plan and service All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Prepaid plans

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Hospital room and board ................... 99 100 97 100 100 98 100 98 100 98

Inpatient surgery ................................ 95 98 88 97 96 95 96 94 95 95

Outpatient surgery1 ........................... 91 95 85 85 96 89 93 89 94 90

Office physician visit .......................... 99 100 100 89 100 98 100 97 100 98

Extended care2 .................................. 72 73 73 60 69 73 75 69 74 71

Home health care2 ............................ 86 88 82 87 85 86 89 83 86 86

Inpatient hospice ............................... 55 59 51 48 47 58 48 60 58 54

Home hospice ................................... 13 14 12 7 11 13 8 16 15 12

Inpatient mental ................................. 90 89 90 98 93 90 93 88 89 91

Outpatient mental ............................. 93 95 86 100 95 92 95 91 96 92

Inpatient alcohol detoxification3 ......... 97 98 95 98 99 96 98 95 99 96

Inpatient alcohol rehabilitation4 ......... 72 73 69 77 75 71 67 76 68 73

Outpatient alcohol rehabilitation4 ...... 84 85 79 93 85 84 85 83 85 84

Inpatient drug detoxification3 ............. 97 98 95 98 99 96 98 95 99 96

Inpatient drug rehabilitation3 ............. 72 73 69 77 75 71 67 76 68 73

Outpatient drug rehabilitation4 ........... 84 85 79 93 85 84 85 83 85 84

Hearing care5 .................................... 54 55 52 55 56 54 60 49 56 54

Adult physical exams ......................... 81 84 73 91 87 79 82 80 81 81

Well baby care ................................... 83 85 76 93 89 81 81 84 83 83

Adult immunization and inoculation ... 65 68 62 60 74 62 65 65 62 66

1 Charges incurred in the outpatient department of a hospital and outside the

hospital. 2 Some plans provide this care only to a patient who was previously

hospitalized and is recovering without need of the extensive care provided by a

general hospital. 3 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse.

4 Rehabilitation is designed to alter abusive behavior in patients once they are

free of acute physical and mental complications. 5 Plans provide, at a minimum, coverage for hearing examination expenses.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

9
Table 3. Indemnity plans: Coverage for selected sevices, all private industry workers, National Compensation Survey, 2003

Category of care and extent of coverage All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Hospital room and board

Total ................................................................ 100 100 100 100 100 100 100 100 100 100

Covered in full .............................................. 10 9 11 5 9 10 10 9 15 9

Subject to internal limits only1 ...................... 8 8 9 7 9 8 8 9 10 8

Subject to internal and overall limits ............ 13 12 12 17 13 12 9 15 12 13

Subject to overall limits only2 ....................... 70 70 68 71 69 70 73 67 63 71

Internal limits

Dollar deductible .......................................... 16 17 15 21 16 17 13 19 14 17

Dollar limits .................................................. 1 3 () 2 2 2 3 ( ) 3 () 1 2 1

Separate coinsurance .................................. 2 2 3 3 4 2 2 3 3 2

Other limit .................................................... 1 1 2 3 () 1 1 1 1 4 1

Limits not determinable ................................ 3 ( ) 3 () 1 - - 3 () 1 - - 3 ( )

Inpatient surgery

Total ................................................................ 100 100 100 100 100 100 100 100 100 100

Covered in full .............................................. 15 14 19 7 17 14 15 15 28 12

Subject to internal limits only1 ...................... 4 3 4 4 5 3 4 4 1 4

Subject to internal and overall limits ............ 3 3 5 2 4 3 2 4 6 3

Subject to overall limits only2 ....................... 78 80 73 86 73 80 79 78 65 81

Internal limits

Dollar limits .................................................. 1 1 2 3 () 2 1 3 () 1 1 1

Separate coinsurance .................................. 3 2 3 4 3 2 2 3 2 3

Other limit .................................................... 3 3 3 2 4 3 2 4 3 3

Limits not determinable ................................ 3 ( ) 3 ( ) 3 ( ) 3 () 1 3 () 1 - - 3 ( )

Outpatient surgery4

Total ................................................................ 100 100 100 100 100 100 100 100 100 100

Covered in full .............................................. 12 11 16 2 17 10 11 12 23 10

Subject to internal limits only1 ...................... 7 7 8 4 7 7 10 5 4 8

Subject to internal and overall limits ............ 8 8 8 12 8 9 9 8 8 8

Subject to overall limits only2 ....................... 73 74 69 82 68 75 70 75 65 74

Internal limits

Dollar limits .................................................. 1 1 2 3 () 2 1 3 () 1 2 1

Separate coinsurance .................................. 3 2 4 2 4 2 2 3 4 3

Deductible per surgery ................................. 9 10 7 10 5 11 13 6 4 10

Other limit .................................................... 3 3 3 3 4 2 2 3 3 3

Limits not determinable ................................ 3 ( ) 3 ( ) 3 ( ) 3 () 1 3 ( ) 3 () - - 3 ( )

Office physician visits

Total ................................................................ 100 100 100 100 100 100 100 100 100 100

Covered in full .............................................. 1 1 1 2 1 1 1 1 2 1

Subject to internal limits only1 ...................... 46 49 44 42 45 47 52 42 38 48

Subject to internal limits plus overall limits .. 31 31 30 33 31 31 28 33 21 33

Subject to overall limits only2 ....................... 22 19 25 23 23 21 19 24 38 19

1 Internal limits apply to individual categories of care; for example, internal

limits or benefits for hospitalization. Limits may be set in terms of dollar or day

ceilings on benefits, a requirement that the participant pay a percentage of costs

(coinsurance), or a requirement that the participant pay a specific amount

(deductible or copayment) before reimbursement begins or services are rendered. 2 Overall limits apply to all benefits under the plan, not selected individual

benefits. Overall limits are (1) deductibles and coinsurance percentages that must

be paid by the participant before any plan benefits begin, and (2) overall limits on

plan benefits that can be paid. 3 Less than 0.5 percent. 4 Charges incurred in the outpatient department of a hospital and outside the

hospital.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category or data do not

meet publication criteria.

10
Table 4. Indemnity plans in and out of network: Summary of selected features, all private industry workers, National Compensation Survey,

2003

In-network incentives All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Service subject to in-network incentive

Hospital room and board ................ 94 94 93 94 92 95 92 95 90 94

Surgery ........................................... 94 94 92 95 92 94 93 94 91 94

Office visit ....................................... 92 93 90 94 89 93 91 93 89 93

Outpatient prescription drugs .......... 24 26 20 20 20 26 19 28 23 24

Not determinable ............................ 4 3 5 1 5 3 4 4 5 4

Type of in-network incentive

Coinsurance rate differs1 ................ 85 86 83 86 88 84 84 86 81 86

Lower annual deductible2 ............... 35 37 31 33 35 34 32 37 29 35

1 The coinsurance rate is higher if services are received from an approved

provider. For example, in-network physician office visits had a 90-percent

coinsurance payment, while out-of-network visits had an 80-percent payment. 2 The deductible is lower if services are received from an approved provider. 

For example, the individual in-network annual deductible requirement is $100, while

the out-of-network requirement is $500.

NOTE: Sum of individual items is greater than total because some participants were

in plans with more than one type of limit. Where applicable, dash indicates no

employees in this category or data do not meet publication criteria.

11
Table 5. Indemnity plans with overall limits: Average dollar limits, all private industry workers, National

Compensation Survey, 2003

Characteristics

Annual deductible1 Annual out-of-pocket

expense maximum2 Lifetime

maximum3

Individual Family Individual Family

All workers ............................................. $430 $1,080 $1,962 $3,908 $1,887,453

Worker characteristics

White collar ............................................ 430 1,041 1,885 3,536 1,965,777

Blue collar .............................................. 411 1,084 2,020 4,441 1,742,310

Service .................................................. 511 1,337 2,299 4,522 2,018,060

Full time ................................................. 435 1,094 1,935 3,895 1,903,004

Part time ................................................ 338 858 2,510 4,168 1,605,403

Union ..................................................... 284 755 2,061 4,047 1,515,785

Nonunion ............................................... 455 1,136 1,949 3,892 1,954,958

Average wage less than $15 per hour ... 441 1,122 2,109 4,025 1,863,314

Average wage $15 per hour or higher ... 418 1,039 1,820 3,800 1,912,828

Establishment characteristics

Goods producing ................................... 413 1,117 1,885 4,103 1,883,516

Service producing .................................. 437 1,065 1,993 3,827 1,889,305

1 to 99 workers ...................................... 496 1,270 2,122 3,915 2,227,580

100 workers or more ............................. 369 917 1,819 3,903 1,608,797

Geographic areas4

Metropolitan areas ................................. 444 1,132 1,948 3,906 1,898,957

Nonmetropolitan areas .......................... 376 876 2,018 3,917 1,844,452

New England ......................................... 447 1,141 1,839 3,599 1,753,884

Middle Atlantic ....................................... 400 1,038 1,737 3,677 1,703,049

East North Central ................................. 386 971 1,557 3,131 2,255,687

West North Central ................................ 373 824 1,429 3,100 1,845,256

South Atlantic ........................................ 468 1,155 1,933 4,064 1,947,022

East South Central ................................ 470 1,334 2,307 4,840 1,673,892

West South Central ............................... 516 1,290 1,999 4,291 1,831,795

Mountain ................................................ 442 1,120 2,409 4,205 1,750,121

Pacific .................................................... 380 1,009 2,697 4,794 1,729,878

1 The deductible is the amount of covered expenses that

an individual or family must pay before any charges are paid

by the medical care plan. Deductibles that apply separately

to a specific category of expense, such as a deductible for

each hospital admission, were excluded from this tabulation. 2 The out-of-pocket expense maximum is the amount an

individual or a family must pay before the plan will pay 100

percent of additional charges. Deductible amounts were

excluded from computation of the out-of-pocket dollar limits.

Usually, out-of-pocket limits were specified on an annual

basis. Charges for certain services, such as mental health

care, may not be counted toward the out-of-pocket

maximum. 3 The maximum is the total amount of expenses that the

plan will pay. Maximum described is for each insured

person. Where the maximum differed for employees and

dependents, the employee maximum was tabulated.

4 The nine census divisions are defined as follows: New

England: Connecticut, Maine, Massachusetts, New

Hampshire, Rhode Island, and Vermont; Middle Atlantic:

New Jersey, New York, and Pennsylvania; East North

Central: Illinois, Indiana, Michigan, Ohio, and Wisconsin;

West North Central: Iowa, Kansas, Minnesota, Missouri,

Nebraska, North Dakota, and South Dakota; South Atlantic:

Delaware, District of Columbia, Florida, Georgia, Maryland,

North Carolina, South Carolina, Virginia, and West Virginia;

East South Central: Alabama, Kentucky, Mississippi, and

Tennessee; West South Central: Arkansas, Louisiana,

Oklahoma, and Texas; Mountain: Arizona, Colorado, Idaho,

Montana, Nevada, New Mexico, Utah, and Wyoming; and

Pacific: Alaska, California, Hawaii, Oregon, and Washington.

NOTE: Where applicable, dash indicates no employees in

this category or data do not meet publication criteria.

12
Table 6. Indemnity plans with overall limits: Amount of individual deductible,1 all private industry workers, National Compensation Survey,

2003

Fee arrangement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Deductible specified ........................... 73 70 76 81 73 73 77 70 71 73

Flat dollar amount ........................... 73 70 75 80 72 73 76 69 71 73

Less than $200 ............................ 12 10 17 10 16 10 11 13 30 9

$200 ............................................. 11 11 10 8 11 10 9 12 11 11

$201–249 ..................................... 2 ( ) 2 ( ) 2 () - 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( )

$250 ............................................. 12 11 15 10 14 12 11 14 13 12

$251–299 ..................................... - - - - - - - - - -

$300 ............................................. 8 8 9 6 8 9 8 9 7 9

Greater than $300 ....................... 29 29 24 47 23 31 37 22 10 32

Other ............................................... 1 2 () 1 1 1 1 2 () 1 1 1

No deductible ..................................... 25 28 22 18 26 25 21 28 27 25

Not determinable ................................ 2 2 2 1 1 2 2 1 2 2

Average annual deductible individual .... $430 $430 $411 $511 $413 $437 $496 $369 $284 $455

Average annual deductible family ......... 1,080 1,041 1,084 1,337 1,117 1,065 1,270 917 755 1,136

Traditional Indemnity

Total ...................................................... 100 100 100 - 100 100 100 100 100 100

Deductible specified ........................... 86 85 88 - 93 82 85 87 96 82

Flat dollar amount ........................... 84 84 85 - 90 82 82 86 93 81

Less than $200 ............................ 41 31 53 - 49 38 34 47 72 30

$200 ............................................. 10 17 2 - 5 12 10 9 2 ( ) 13

$201–249 ..................................... 1 1 - - 2 - 2 - - 1

$250 ............................................. 5 7 4 - 6 5 3 8 6 5

$251–299 ..................................... - - - - - - - - - -

$300 ............................................. 7 7 8 - 15 4 7 7 7 7

Greater than $300 ....................... 20 21 19 - 14 23 27 15 7 25

Other ............................................... 1 2 () 3 - 3 1 2 1 4 1

No deductible ..................................... 12 12 11 - 6 15 13 11 3 16

Not determinable ................................ 2 3 1 - 1 3 2 2 1 3

Average annual deductible individual .... $374 $341 $423 - $364 $379 $549 $242 $186 $450

Average annual deductible family ......... 792 712 881 - 816 779 1,154 525 428 959

See footnotes at end of table.

13
Table 6. Indemnity plans with overall limits: Amount of individual deductible,1 all private industry workers, National Compensation Survey,

2003 — Continued

Fee arrangement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity in and outside of network

without primary care physician

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Deductible specified ........................... 78 75 83 82 79 78 82 74 78 78

Flat dollar amount ........................... 78 74 82 82 78 77 82 74 78 78

Less than $200 ............................ 11 9 15 6 15 9 10 12 26 9

$200 ............................................. 12 12 13 10 13 12 9 14 16 12

$201–249 ..................................... 2 ( ) 2 ( ) 2 () - - 2 () - 2 ( ) 2 ( ) 2 ( )

$250 ............................................. 14 13 17 8 16 13 13 14 14 14

$251–299 ..................................... - - - - - - - - - -

$300 ............................................. 9 9 11 7 9 10 9 9 9 9

Greater than $300 ....................... 31 31 27 51 26 34 40 24 12 34

Other ............................................... 2 ( ) 2 () 1 2 ( ) 2 ( ) 2 ( ) 2 () 1 2 ( ) 2 ( )

No deductible ..................................... 21 25 16 17 20 21 17 24 20 21

Not determinable ................................ 1 1 2 1 1 1 2 () 2 3 1

Average annual deductible individual .... $431 $432 $408 $516 $414 $438 $472 $391 $312 $449

Average annual deductible family ......... 1,124 1,073 1,144 1,378 1,174 1,102 1,251 1,010 874 1,161

Indemnity in and outside of network

with primary care physician3

Total ...................................................... 100 100 100 - 100 100 100 100 100 100

Deductible specified ........................... 40 42 29 - 23 47 38 41 24 43

Flat dollar amount ........................... 39 41 29 - 23 46 38 39 24 41

Less than $200 ............................ 2 2 1 - - 2 2 () 3 2 1

$200 ............................................. 4 5 1 - 3 4 2 5 3 4

$201–249 ..................................... - - - - - - - - - -

$250 ............................................. 10 9 9 - 4 12 6 13 14 9

$251–299 ..................................... - - - - - - - - - -

$300 ............................................. 6 8 2 - 1 8 6 6 1 7

Greaater than $300 ..................... 18 17 14 - 15 19 24 13 4 20

Other ............................................... 1 1 1 - - 1 2 () 2 2 () 1

No deductible ..................................... 56 53 67 - 77 47 53 59 76 53

Not determinable ................................ 4 5 3 - - 6 9 - - 5

Average annual deductible individual .... $485 $469 $464 - $544 $473 $673 $360 $337 $501

Average annual deductible family ......... 1,115 1,070 1,092 - 1,288 1,076 1,600 797 813 1,149

1 The deductible is the amount of covered expenses that an individual or a

family must pay before any charges are paid by the medical care plan. Deductibles

that apply separately to a specific category of expense, such as a deductible for

each hospital admission, were excluded from this tabulation. 2 Less than 0.5 percent. 3 A provision in medical care plans that designates certain physicians and

hospitals as network providers. Services sought from health care providers who do

not belong to the network are reimbursed at a lower rate than that applicable to

network providers.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

14
Table 7. Indemnity plans with overall limits: Individual deductible1 difference between in-network and outside of network coverage, all private

industry workers, National Compensation Survey, 2003

Comparison of deductibles in

and outside of network

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity in and outside of network

without primary care physician

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Difference in deductible amounts

between in and outside of network ...... 34 37 29 35 33 35 33 35 21 36

Less than $200 .................................. 3 2 4 3 4 2 4 2 3 3

$200–$399 ......................................... 13 15 11 13 14 13 7 18 10 13

Greater than $399 .............................. 18 20 14 19 13 20 21 15 8 19

Amount not determinable ................... 2 ( ) 2 () 1 - 1 2 () 1 2 ( ) 2 ( ) 2 ( )

Overall deductible does not differ

between in and outside of network ...... 65 62 70 64 66 64 67 63 76 63

Not determinable ................................... 1 1 2 1 1 1 2 () 2 3 1

Average difference between in and

outside of network ................................ $527 $523 $554 $470 $489 $543 $583 $483 $428 $536

Indemnity in and outside of network

with primary care physician3

Total ...................................................... 100 100 100 - 100 100 100 100 100 100

Difference in deductible amounts

between in and outside of network ...... 39 37 45 - 48 35 29 46 59 35

Less than $200 .................................. 3 2 5 - 9 2 () 6 2 () - 3

$200–$399 ......................................... 10 9 13 - 9 11 2 16 31 6

Greater than $399 .............................. 9 12 4 - 4 11 7 10 3 10

Amount not determinable ................... 18 14 23 - 26 14 13 21 26 16

Overall deductible does not differ

between in and outside of network ...... 57 58 51 - 52 59 62 54 41 60

Not determinable ................................... 4 5 3 - - 6 9 - - 5

Average difference between in and

outside of network ................................ $354 $391 $283 - $229 $408 $296 $379 $307 $369

1 The deductible is the amount of covered expenses that an individual or a

family must pay before any charges are paid by the medical care plan. Deductibles

that apply separately to a specific category of expense, such as a deductible for

each hospital admission, were excluded from this tabulation. 2 Less than 0.5 percent. 3 A provision in medical care plans that designates certain physicians and

hospitals as network providers. Services sought from healthcare providers who do

not belong to the network are reimbursed at a lower rate than that applicable to

network providers.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

15
Table 8. Indemnity plans with overall limits: Relationship between individual and family deductible, all private industry workers, National

Compensation Suvey, 2003

Relationship between individual and

family deductibles

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Individual and family deductible

specified ............................................... 69 68 70 72 69 69 72 66 65 70

Family deductible is multiple of

individual deductible ......................... 64 63 65 69 63 65 66 63 63 64

Average multiple ............................. 2.4 2.4 2.5 2.5 2.4 2.4 2.5 2.4 2.4 2.5

Specified number of individual

deductibles must be met to satisfy

family deductible ............................... 5 5 5 3 6 4 7 4 1 6

Average number of individual

deductibles .................................... 2.8 2.8 2.8 2.8 2.8 2.7 2.8 2.7 3.0 2.8

No deductible or no family deductible ... 30 30 29 27 30 29 26 32 33 29

Not determinable ................................... 2 2 2 1 1 2 2 1 2 2

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

16
Table 9. Indemnity plans with overall limits: Coinsurance rates, all private industry workers, National Compensation Survey, 2003

Coinsurance amount All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With coinsurance1 ................................. 81 79 82 89 80 81 84 78 74 82

80 percent .......................................... 42 40 44 50 35 45 42 42 44 42

85 percent .......................................... 2 2 1 3 2 2 1 3 1 2

90 percent .......................................... 22 21 22 22 28 19 22 22 18 22

Other percentage ............................... 5 5 4 5 4 5 7 3 2 5

Percentage not determinable ............. 10 10 10 9 12 9 12 9 9 10

Other .................................................. 1 1 2 () - 2 () 1 2 () 1 2 () 1

Without coinsurance3 ............................ 19 21 18 11 20 19 16 22 26 18

Traditional Indemnity

Total ...................................................... 100 100 100 - 100 100 100 100 100 100

With coinsurance1 ................................. 99 98 99 - 99 99 100 98 100 98

80 percent .......................................... 77 74 83 - 89 72 81 74 88 73

90 percent .......................................... 6 6 7 - 10 4 6 6 10 5

Other percentage ............................... 12 13 9 - 2 ( ) 17 13 11 2 16

Other .................................................. 4 6 1 - - 5 - 6 - 5

Without coinsurance3 ............................ 1 2 1 - 1 1 - 2 2 () 2

Indemnity in and outside of network

without primary care physician

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With coinsurance1 ................................. 80 79 80 88 77 81 81 79 72 81

80 percent .......................................... 45 43 45 55 35 49 43 46 44 45

85 percent .......................................... 2 2 1 3 2 2 1 3 1 2

90 percent .......................................... 27 26 29 26 35 24 27 27 24 28

Other percentage ............................... 4 5 3 4 5 4 7 2 3 5

Percentage not determinable ............. 1 2 2 () - 2 () 2 3 2 ( ) 2 () 1

Other .................................................. 2 ( ) 2 ( ) 2 () - 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( )

Without coinsurance3 ............................ 20 21 20 12 23 19 19 21 28 19

Indemnity in and outside of network

with primary care physician4

Total ...................................................... 100 100 100 - 100 100 100 100 100 100

With coinsurance1 ................................. 78 77 75 - 82 76 87 71 59 81

80 percent .......................................... - - - - - - - - - -

85 percent .......................................... - - - - - - - - - -

90 percent .......................................... - - - - - - - - - -

Other percentage ............................... - - - - - - - - - -

Percentage not determinable ............. - - - - - - - - - -

Without coinsurance3 ............................ 22 23 25 - 18 24 13 29 41 19

1 Represents the initial coinsurance in plans that have 100-percent coverage

after the individual pays a specified dollar amount toward expenses. For example,

the plan pays 80 percent until the individual’s out-of-pocket expenses reach $1,000,

and then coverage is at 100 percent. A few plans have more than one coinsurance

rate. In those cases, the coinsurance rate shown is that which applies to the

majority of benefits under the plan. Includes variable coinsurance rates not shown

separately. 2 Less than 0.5 percent. 3 Includes plans with overall benefit limitations, such as maximum dollar

amounts and deductibles, in which the coinsurance rate is 100 percent. 4 A provision in medical care plans that designates certain physicians and

hospitals as network providers. Services sought from healthcare providers who do

not belong to the network are reimbursed at a lower rate than that applicable to

network providers.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

17
Table 10. Indemnity plans with overall limits: Coinsurance rate difference between in-network and outside-of-network coverage, all private

industry workers, National Compensation Survey, 2003

Coinsurance rate comparison All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity in and outside of network

without primary care physician

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Difference in coinsurance rates

between in and outside of network1 ..... 85 88 81 86 86 85 84 86 79 86

Less than 10 percent ......................... 2 () - 1 - 1 - 2 () - 1 -

10 percent .......................................... 14 14 16 11 16 14 15 14 18 14

11–19 percent .................................... 2 1 3 8 3 2 1 3 2 2

20 percent .......................................... 47 50 46 27 53 44 50 45 43 48

Greater than 20 percent ..................... 20 21 13 40 12 23 15 24 14 20

Difference not determinable ............... 2 2 1 - 1 2 3 2 ( ) 2 () 2

Overall coinsurance rates do not differ

between in and outside of network ...... 15 12 19 14 14 15 16 14 21 14

Average percent difference between in

and out of network ............................... 20.8 21.2 19.5 23.4 19.4 21.5 20.1 21.5 19.3 21.0

Indemnity in and outside of network

with primary care physician3

Total ...................................................... 100 100 100 - 100 100 100 100 100 100

Difference in coinsurance rates

between in and outside of network1 ..... 89 86 95 - 99 85 90 89 100 87

Less than 10 percent ......................... - - - - - - - - - -

10 percent .......................................... - - - - - - - - - -

20 percent .......................................... - - - - - - - - - -

Greater than 20 percent ..................... - - - - - - - - - -

Difference not determinable ............... - - - - - - - - - -

Overall coinsurance rates do not differ

between in and outside of network ...... 11 14 5 - 1 15 10 11 2 ( ) 13

Average percent difference between in

and outside of network ......................... 22.4 23.2 20.2 - 17.9 23.8 20.9 22.9 20.6 22.8

1 The coinsurance rate is higher if services are received from an approved

provider. For example, in-network physician office visits had a 90-percent

coinsurance payment, while out-of-network visits had an 80-percent payment. 2 Less than 0.5 percent. 3 A provision in medical care plans that designates certain physicians and

hospitals as network providers. Services sought from healthcare providers who do

not belong to the network are reimbursed at a lower rate than that applicable to

network providers.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

18
Table 11. Indemnity plans with overall limits: Maximum out-of-pocket expense provisions, all private industry workers, National

Compensation Survey, 2003

Type and amount of out-of-pocket

expense provision

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With limit on out-of-pocket expense ...... 80 82 76 82 78 81 83 78 64 83

With an annual dollar maximum on

out-of-pocket expense1 .................... 78 80 74 81 74 79 81 75 60 81

Per individual:

Less than $500 ............................ 3 3 2 3 3 2 2 3 2 3

$500 ............................................. 7 8 6 2 6 7 8 5 5 7

$501–$999 ................................... 6 5 6 7 9 4 4 7 4 6

$1,000 .......................................... 15 17 11 17 12 16 16 14 9 16

$1,001–$1,499 ............................. 5 6 5 3 5 5 3 7 5 5

$1500 ........................................... 11 10 11 10 8 12 13 9 11 11

$1,501–$1,999 ............................. 2 2 1 1 2 2 1 3 1 2

$2,000 .......................................... 12 12 11 12 11 12 14 10 5 13

Greater than $2,000 .................... 19 17 20 26 18 19 20 18 16 19

Per family:

Less than $1,000 ......................... 2 3 1 2 3 2 2 3 1 3

$1,000 .......................................... 4 4 4 2 4 4 6 3 5 4

$1,001–$1,999 ............................. 8 7 8 7 10 6 6 9 8 7

$2,000 .......................................... 8 9 6 16 7 9 9 8 5 9

$2,001–$2,999 ............................. 5 5 5 3 6 4 2 7 4 5

$3,000 .......................................... 10 12 9 3 7 11 12 9 5 11

Greater than $3,000 .................... 29 27 30 36 27 30 31 27 20 30

No family maximum ..................... 9 10 9 11 8 10 10 9 11 9

Family maximum cannot be

computed2 .................................. 2 2 2 2 3 2 3 1 3 () 3

Annual maximum on out-of-pocket

expense based on earnings .......... 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 () 1 3 ( ) 3 ( )

Annual maximum on out-of-pocket

expense varies by coinsurance

rate4 ............................................... 1 1 1 - 3 () 1 2 3 () 1 1

Other ............................................... 1 1 2 1 3 3 ( ) 3 () 2 4 1

No out-of-pocket expense required5 ..... 13 14 13 6 13 13 10 15 18 12

No limit on out-of-pocket expenses ....... 4 3 4 10 3 4 3 4 7 3

Not determinable ................................... 4 2 7 2 6 2 5 3 11 2

Average annual dollar maximum on

individual out-of-pocket expenses ....... $1,962 $1,885 $2,020 $2,299 $1,885 $1,993 $2,122 $1,819 $2,061 $1,949

Average annual dollar maximum on

family out-of-pocket expenses ............. 3,908 3,536 4,441 4,522 4,103 3,827 3,915 3,903 4,047 3,892

1 Deductible amounts were excluded from computation of the out-of-pocket

dollar limits. With rare exceptions, an out-of-pocket limit was specified on an annual

basis. Few workers were in plans in which the expense limit applied to a disability or

to a period other than a year. Charges for certain services, such as mental health

care, may not be counted toward the out-of-pocket maximum. 2 These are plans in which a family maximum is stated in such a way that it

cannot be computed. For example, the individual out-of-pocket expense is limited to

$1,000 per year, and the family out-of-pocket expense is limited to three

individuals. The family out-of-pocket expense cannot be computed because each of

the three individuals must separately reach an out-of-pocket limit of $1,000. Thus, if

two individuals each reach $1,000 in their out-of-pocket expenses, and two other

family members reach $900 and $800, respectively, in out-of-pocket expenses, the

family out-of-pocket limit would not have been met. 3 Less than 0.5 percent. 4 Some plans reimburse medical expenses at more than one coinsurance rate.

These plans impose a limit on out-of-pocket expenses by specifying a maximum on

covered medical expenses beyond which all expenses are paid at 100 percent. 5 All covered expenses are paid at 100 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

19
Table 12. Traditional indemnity plans with overall limits: Maximum out-of-pocket expense provisions, all private industry workers,

National Compensation Survey, 2003

Type and amount of out-of-pocket

expense provision

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

With limit on out-of-pocket expense ...... 73 77 71 86 68 71 75 60 78

With an annual dollar maximum on

out-of-pocket expense1 .................... 70 74 67 80 65 67 71 53 75

Per individual:

Less than $500 ............................ 3 6 2 () 1 4 - 6 1 4

$500 ............................................. 1 2 ( ) 2 () - 1 - 2 2 1

$501–$999 ................................... 9 12 7 17 6 7 11 2 12

$1,000 .......................................... 13 14 10 6 15 15 11 12 13

$1,001–$1,499 ............................. 4 8 1 4 5 5 4 2 () 6

$1500 ........................................... 6 3 11 13 3 2 ( ) 11 15 3

$1,501–$1,999 ............................. 1 2 1 3 1 1 2 1 1

$2,000 .......................................... 13 12 15 11 13 19 7 2 17

Greater than $2,000 .................... 19 17 22 24 17 20 18 18 19

Per family:

Less than $1,000 ......................... 5 9 2 () 1 6 2 () 8 2 () 6

$1,000 .......................................... 1 2 ( ) 2 () - 1 - 2 2 1

$1,001–$1,999 ............................. 4 6 3 13 2 () - 7 2 5

$2,000 .......................................... 7 7 6 4 8 8 6 7 7

$2,001–$2,999 ............................. 4 8 2 () 4 4 5 4 2 () 6

$3,000 .......................................... 7 6 8 8 6 8 6 11 5

Greater than $3,000 .................... 27 23 33 28 26 33 21 12 32

No family maximum ..................... 12 13 12 18 9 6 16 19 10

Family maximum cannot be

computed3 .................................. 3 3 4 4 3 7 1 - 4

Annual maximum on out-of-pocket

expense based on earnings .......... 2 ( ) 2 ( ) 2 () - 2 () - 2 () - 2 ( )

Annual maximum on out-of-pocket

expense varies by coinsurance

rate4 ............................................... 2 3 - - 2 4 - - 2

Other ............................................... 2 2 () 4 6 2 () - 4 7 2 ( )

No out-of-pocket expense required5 ..... 1 1 1 1 1 - 2 2 () 1

No limit on out-of-pocket expenses ....... 22 19 23 7 29 23 22 33 18

Not determinable ................................... 4 2 5 6 2 7 1 7 2

Average annual dollar maximum on

individual out-of-pocket expenses ....... $1,734 $1,609 $1,949 $1,801 $1,696 $1,905 $1,607 $1,818 $1,712

Average annual dollar maximum on

family out-of-pocket expenses ............. 3,486 3,171 4,007 3,297 3,579 4,134 2,984 3,054 3,572

1 Deductible amounts were excluded from computation of the

out-of-pocket dollar limits. With rare exceptions, an out-of-pocket limit was

specified on an annual basis. Few workers were in plans in which the

expense limit applied to a disability or to a period other than a year. Charges

for certain services, such as mental health care, may not be counted toward

the out-of-pocket maximum. 2 Less than 0.5 percent. 3 These are plans in which a family maximum is stated in such a way that

it cannot be computed. For example, the individual out-of-pocket expense is

limited to $1,000 per year, and the family out-of-pocket expense is limited to

three individuals. The family out-of-pocket expense cannot be computed

because each of the three individuals must separately reach an out-of-pocket

limit of $1,000. Thus, if two individuals each reach $1,000 in their

out-of-pocket expenses, and two other family members reach $900 and $800,

respectively, in out-of-pocket expenses, the family out-of-pocket limit would

not have been met. 4 Some plans reimburse medical expenses at more than one coinsurance

rate. These plans impose a limit on out-of-pocket expenses by specifying a

maximum on covered medical expenses beyond which all expenses are paid

at 100 percent. 5 All covered expenses are paid at 100 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category or data do

not meet publication criteria.

20
Table 13. Indemnity plans in and outside of network with overall limits: Maximum out-of-pocket expense provisions, all private industry

workers, National Compensation Survey, 2003

Type and amount of out-of-pocket

expense provision

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With limit on out-of-pocket expense ...... 81 82 77 85 77 82 84 79 66 83

With an annual dollar maximum on

out-of-pocket expense1 .................... 79 81 75 84 74 81 82 77 62 82

Per individual:

Less than $500 ............................ 3 3 2 3 4 2 2 3 3 3

$500 ............................................. 7 8 7 1 7 7 8 6 6 7

$501–$999 ................................... 5 4 6 7 8 4 4 6 5 5

$1,000 .......................................... 15 17 11 17 12 16 16 14 9 16

$1,001–$1,499 ............................. 5 6 5 3 5 5 3 8 7 5

$1500 ........................................... 11 11 11 11 7 13 14 9 10 12

$1,501–$1,999 ............................. 2 3 1 1 2 2 1 3 1 2

$2,000 .......................................... 12 12 11 12 11 12 14 10 6 13

Greater than $2,000 .................... 19 17 20 27 17 19 20 18 15 19

Per family:

Less than $1,000 ......................... 2 3 1 2 3 2 2 2 1 2

$1,000 .......................................... 4 4 5 1 5 4 6 3 6 4

$1,001–$1,999 ............................. 8 8 8 7 10 7 6 9 9 8

$2,000 .......................................... 9 9 6 17 7 9 10 8 5 9

$2,001–$2,999 ............................. 5 5 6 3 6 4 2 7 5 5

$3,000 .......................................... 11 13 9 2 7 12 12 9 4 12

Greater than $3,000 .................... 29 28 30 38 27 30 31 28 22 30

No family maximum ..................... 9 9 8 11 7 10 10 8 10 9

Family maximum cannot be

computed2 .................................. 2 2 2 2 3 2 3 2 1 2

Annual maximum on out-of-pocket

expense based on earnings .......... 3 ( ) 3 ( ) 3 ( ) 3 ( ) 3 () 1 3 () 1 3 ( ) 3 ( )

Annual maximum on out-of-pocket

expense varies by coinsurance

rate4 ............................................... 1 1 1 - 3 () 1 1 3 () 1 1

Other ............................................... 1 1 2 3 () 3 3 ( ) 3 () 1 3 1

No out-of-pocket expense required5 ..... 14 14 14 6 14 14 11 16 20 13

No limit on out-of-pocket expenses ....... 2 1 2 7 2 1 1 3 2 2

Not determinable ................................... 4 2 7 2 7 2 5 3 12 2

Average annual dollar maximum on

individual out-of-pocket expenses ....... $1,982 $1,908 $2,022 $2,351 $1,862 $2,030 $2,138 $1,843 $2,110 $1,966

Average annual dollar maximum on

family out-of-pocket expenses ............. 3,944 3,561 4,481 4,617 4,109 3,877 3,887 3,993 4,209 3,914

1 Deductible amounts were excluded from computation of the out-of-pocket

dollar limits. With rare exceptions, an out-of-pocket limit was specified on an annual

basis. Few workers were in plans in which the expense limit applied to a disability or

to a period other than a year. Charges for certain services, such as mental health

care, may not be counted toward the out-of-pocket maximum. 2 These are plans in which a family maximum is stated in such a way that it

cannot be computed. For example, the individual out-of-pocket expense is limited to

$1,000 per year, and the family out-of-pocket expense is limited to three

individuals. The family out-of-pocket expense cannot be computed because each of

the three individuals must separately reach an out-of-pocket limit of $1,000. Thus, if

two individuals each reach $1,000 in their out-of-pocket expenses, and two other

family members reach $900 and $800, respectively, in out-of-pocket expenses, the

family out-of-pocket limit would not have been met. 3 Less than 0.5 percent. 4 Some plans reimburse medical expenses at more than one coinsurance rate.

These plans impose a limit on out-of-pocket expenses by specifying a maximum on

covered medical expenses beyond which all expenses are paid at 100 percent. 5 All covered expenses are paid at 100 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

21
Table 14. Indemnity plans with overall limits: Maximum benefit provisions, all private industry workers, National Compensation Survey, 2003

Type and dollar amount of maximum All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With maximum limits ............................. 65 61 71 74 69 64 65 66 69 65

Lifetime maximum only1 ..................... 65 61 71 74 68 64 65 65 68 65

Less than $1,000,000 ..................... 3 2 6 2 3 3 4 2 12 2

$1,000,000 ...................................... 29 25 32 40 28 29 20 36 30 28

$1,000,001–$1,999,999 .................. 1 1 1 2 () 2 1 2 () 2 1 1

$2,000,000 ...................................... 21 21 22 14 24 19 23 19 18 21

Greater than $2,000,000 ................. 11 11 10 18 11 11 18 6 7 12

Other maximum ................................. 2 ( ) 2 ( ) 2 () 1 2 ( ) 2 ( ) 2 ( ) 2 () 1 2 ( )

Unlimited maximum ............................... 26 31 20 18 23 28 23 29 26 26

Not determinable ................................... 8 8 8 7 8 8 12 5 5 9

Average lifetime maximum (in

thousands) ........................................... $1,887 $1,966 $1,742 $2,018 $1,884 $1,889 $2,228 $1,609 $1,516 $1,955

1 Includes other lifetime maximum limits not shown separately. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

22
Table 15. Indemnity plans: Coverage for alternatives to hospital care, all private industry workers, National Compensation Survey, 2003

Category of care and extent of

coverage

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Extended care

Total ................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 4 5 2 1 3 4 3 4 4 4

Subject to internal limits only1 ......... 22 20 26 18 23 22 23 22 24 22

Subject to internal and overall

limits .............................................. 57 59 54 60 56 58 57 57 52 58

Subject to overall limits only2 .......... 17 16 18 21 18 17 16 18 20 17

Internal limits

Limit on days ............................ 72 72 70 71 70 72 73 71 70 72

Separate coinsurance .............. 5 6 5 4 6 5 5 6 8 5

Limit to maximum percentage

rate of prior hospital

confinement ............................ 1 1 2 3 () 2 1 1 1 1 1

Other limits ............................... 7 6 7 12 8 6 4 9 3 7

Limits not determinable ............ 1 3 () 2 3 ( ) 3 () 1 1 1 2 1

Home health care

Total ................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 9 9 10 2 10 9 9 9 14 8

Subject to internal limits only1 ......... 19 18 21 19 20 19 20 19 20 19

Subject to internal and overall

limits .............................................. 44 46 38 57 35 48 38 48 42 44

Subject to overall limits only2 .......... 28 27 31 22 35 25 33 24 25 29

Internal limits

Limit on days ............................ 46 49 42 49 42 48 42 50 44 47

Separate coinsurance .............. 11 14 6 8 7 12 8 13 7 11

Other limits ............................... 16 13 18 25 12 17 16 15 15 16

Limits not determinable ............ 3 ( ) 3 () 1 3 ( ) 3 ( ) 3 ( ) 3 () 1 2 3 ( )

Hospice care

Total ................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 14 13 16 6 14 13 11 16 23 12

Subject to internal limits only1 ......... 16 16 17 15 21 14 16 17 18 16

Subject to internal and overall

limits .............................................. 29 31 25 25 23 31 26 31 20 30

Subject to overall limits only2 .......... 41 40 41 54 41 41 48 36 39 42

Internal limits

Limit on dollars ......................... 15 13 16 21 17 14 11 18 12 15

Separate coinsurance .............. 13 16 9 9 10 14 12 14 12 13

Other limits ............................... 25 27 22 20 22 26 23 26 13 27

Limits not determinable ............ 1 3 () 1 3 () 1 3 () 1 1 2 3 ( )

1 Internal limits apply to individual categories of care; for example, internal limits

or benefits for hospitalization. Limits may be set in terms of dollar or day ceilings on

benefits, a requirement that the participant pay a percentage of costs (coinsurance),

or a requirement that the participant pay a specific amount (deductible or

copayment) before reimbursement begins or services are rendered. 2 Overall limits apply to all benefits under the plan, not selected individual

benefits. Overall limits are (1) deductibles and coinsurance percentages that must

be paid by the participant before any plan benefits begin, and (2) overall limits on

plan benefits that can be paid. 3 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

23
Table 16. Copayment provisions for hospital room and board by plan type, all private industry workers, National

Compensation Survey, 2003

Plan type and copayment provision All

workers

Occupational group Industry Establishment size

Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity

Total1 ..................................................... 100 100 100 100 100 100 100 100

Per confinement .............................. 82 85 78 79 84 72 88 82

Less than $100 ......................... 7 4 13 8 6 4 8 4

$100 ......................................... 18 19 18 20 17 23 14 18

$101–$199 ............................... 2 3 2 5 1 2 3 3

$200 ......................................... 16 13 11 11 18 8 21 17

$201–$249 ............................... 2 ( ) 2 () - - 2 () - 2 ( ) 2 ( )

$250 ......................................... 20 23 18 21 20 16 23 20

$251–$499 ............................... 5 5 6 6 5 11 2 5

$500 ......................................... 7 9 1 - 10 2 9 7

Greater than $500 .................... 5 5 5 5 5 6 4 5

Unspecified amount .................. 3 3 3 3 2 - 4 3

Limited to maximum dollar

copayment amount per year3 ........ 5 6 3 3 6 2 7 5

Copayment per year ....................... 13 12 15 14 12 23 7 13

Copayment per day ........................ 8 5 14 17 4 5 10 8

Copayment limited to a specified

number of days ............................. 6 3 12 14 3 4 7 6

Prepaid

Total1 ..................................................... 100 100 100 100 100 100 100 100

Per confinement .............................. 83 88 70 60 91 82 85 84

Less than $100 ......................... 1 1 - 1 1 - 2 1

$100 ......................................... 15 16 11 11 16 5 23 13

$101–$199 ............................... 4 7 2 () - 6 5 4 5

$200 ......................................... 3 3 2 4 2 1 4 3

$201–$249 ............................... 5 7 1 2 5 2 7 2

$250 ......................................... 29 26 25 36 27 27 31 29

$251–$499 ............................... 2 1 4 4 1 2 2 3

$500 ......................................... 20 20 27 1 27 31 11 23

Greater than $500 .................... 4 7 1 1 5 9 - 5

Unspecified amount .................. 2 ( ) 2 ( ) 2 ( ) 2 () - - 2 ( ) 2 ( )

Limited to maximum dollar

copayment amount per year3 ........ 15 9 6 7 18 11 18 15

Copayment per year ....................... 6 3 9 11 5 1 11 5

Copayment per day ........................ 11 9 21 29 6 17 6 12

Copayment limited to a specified

number of days ............................. 4 4 4 10 2 5 2 5

1 Sum of individual items is greater than the total because some

participants were in plans with more than one type of copayment. 2 Less than 0.5 percent. 3 Limits placed on the maximum copayment an individual pays

during the year. For example, an individual is subject to a copayment

of $100 per confinement with a limit of $300 per year.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this category

or data do not meet publication criteria.

24
Table 17. Prepaid plans: Coverage for selected services and alternatives to hospital care, all private industry workers, National

Compensation Survey, 2003

Category of care and extent of

coverage

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Hospital room and board ....................... 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 57 56 57 61 58 56 52 61 62 55

Subject to limits1 ............................. 43 44 43 39 42 44 48 39 38 45

Inpatient surgery .................................... 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 79 78 80 87 86 77 79 80 87 78

Subject to limits1 ............................. 21 22 20 13 14 23 21 20 13 22

Outpatient surgery2 ............................... 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 50 50 48 56 59 47 49 51 49 50

Subject to limits1 ............................. 50 50 52 44 41 53 51 49 51 50

Office physician visits ............................ 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 3 1 4 5 1 3 1 4 7 1

Subject to limits1 ............................. 97 99 96 95 99 97 99 96 93 99

Total subject to copayment per

visit3 ........................................... 97 99 95 95 98 97 99 96 92 99

$2 per visit ............................. 4 ( ) 4 () - 2 - 4 () - 4 () 1 4 ( )

$5 per visit ............................. 7 10 3 8 5 8 4 10 15 6

$6–$9 per visit ....................... 4 2 3 16 - 5 6 2 4 4

$10 per visit ........................... 38 40 37 26 44 36 26 48 45 36

$15 per visit ........................... 29 29 25 36 24 30 33 25 17 31

$20 per visit ........................... 14 10 22 6 17 13 21 7 8 15

Greater than $20 per visit ...... 5 6 4 1 6 4 8 2 2 5

Unspecified copayment ......... 1 1 4 ( ) 4 () 2 1 1 1 - 1

Total subject to other limits

only ......................................... 4 () - 1 - 1 - 4 ( ) 4 () 1 4 ( )

Extended care5 ...................................... 100 100 100 - 100 100 100 100 100 100

Covered in full ................................. 23 23 22 - 23 23 21 25 36 20

Subject to limits1 ............................. 77 77 78 - 77 77 79 75 64 80

Home health care5 ................................ 100 100 100 100 100 100 100 100 100 100

Covered in full ................................. 62 62 58 72 60 63 63 62 62 62

Subject to limits1 ............................. 38 38 42 28 40 37 37 38 38 38

Hospice care ......................................... 100 100 100 - 100 100 100 100 100 100

Covered in full ................................. 61 67 51 - 50 65 61 62 60 62

Subject to limits1 ............................. 39 33 49 - 50 35 39 38 40 38

1 Limits may be set in terms of dollar or day ceilings on benefits, a requirement

that the participant pay a percentage of costs (coinsurance), or a requirement that

the participant pay a specific amount (deductible or copayment) before

reimbursement begins or services are rendered. 2 Charges incurred in the outpatient department of a hospital and outside of the

hospital. 3 Includes other copayments not shown separately. 4 Less than 0.5 percent.

5 Some plans provide this care only to a patient who was previously

hospitalized and is recovering without need of the extensive care provided by a

general hospital.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

25
Table 18. Prepaid plans: Summary of selected features, all private industry workers, National Compensation Survey, 2003

Selected feature All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Group/staff model1 .......................... 15 11 16 29 11 16 17 13 18 14

Individual practice association

model2 ........................................... 43 44 46 31 48 41 47 40 45 43

Mixed model ................................... 21 20 23 22 29 18 23 19 20 21

Network model ................................ 5 6 5 1 7 5 3 7 9 4

Other ............................................... 3 ( ) 3 ( ) 3 ( ) 3 () - 3 ( ) 3 () - - 3 ( )

Not determinable ........................... 16 19 10 16 5 19 9 21 8 18

Federally qualified .............................. 45 43 44 52 55 41 51 40 42 46

1 Care is provided at centralized locations. 2 Care is provided by doctors working out of their offices. 3 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

26
Table 19. Prepaid plans: Extent of coverage for extended care facilities, all private industry workers, National Compensation

Survey, 2003

Type of coverage All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

Covered in full .................................... 23 23 22 23 23 21 25 36 20

Day limit ............................................. 74 72 77 76 73 74 74 64 76

Per year .......................................... 61 60 59 58 62 62 59 51 63

30 ............................................. 8 7 10 5 9 12 4 4 9

45 ............................................. 2 3 2 4 2 1 4 3 2

60 ............................................. 14 11 12 9 15 12 15 12 14

90 ............................................. 2 2 2 7 1 2 2 1 3

100 ........................................... 23 25 20 22 24 23 23 21 24

120 ........................................... 5 4 5 7 4 - 9 9 4

Other ........................................ 7 8 7 4 8 11 3 2 8

Per confinement .............................. 7 6 8 9 6 4 9 7 6

Per lifetime ...................................... 2 1 () 6 9 - 5 - 1 2

Not determinable ............................ 4 5 4 - 6 2 6 5 4

Other limits only ................................. 3 5 1 1 4 5 1 1 () 4

Not determinable ................................ 1 ( ) 1 () - - 1 () - 1 () - 1 ( )

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet

publication criteria.

27
Table 20. Outpatient prescription drug benefits: Summary of coverage, all private industry workers, National Compensation Survey, 2003

Type of coverage All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Coverage for brand name drugs ........... 98 99 97 99 98 98 98 99 98 98

Higher reimbursement for generic

drugs .................................................... 87 88 82 92 85 87 87 86 74 89

Coverage for mail order drugs ............... 72 73 70 68 70 72 64 78 70 72

Higher reimbursement for formulary

drugs .................................................... 30 31 28 38 33 29 31 30 19 33

Not determinable ................................... 3 3 3 2 3 4 3 3 8 2

NOTE: Where applicable, dash indicates no employees in this category, or data do not meet publication criteria.

28
Table 21. Mental health care and substance abuse treatment benefits: Comparison with coverage for other illnesses, all private industry

workers, National Compensation Survey, 2003

Comparison with coverage for other

illnesses

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Mental health care

Inpatient

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 10 10 10 8 11 10 9 10 9 10

Covered differently ............................. 90 90 90 92 89 90 91 90 91 90

Outpatient1

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 5 5 5 3 7 4 6 4 4 5

Covered differently ............................. 95 95 95 97 93 96 94 96 96 95

Alcohol abuse

Inpatient detoxification2

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 15 15 14 15 14 15 15 15 15 15

Covered differently ............................. 85 85 86 85 86 85 85 85 85 85

Inpatient rehabilitation3

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 7 8 6 7 6 7 7 7 3 8

Covered differently ............................. 93 92 94 93 94 93 93 93 97 92

Outpatient rehabilitation1

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 7 7 7 6 6 7 9 5 5 7

Covered differently ............................. 93 93 93 94 94 93 91 95 95 93

Drug abuse

Inpatient detoxification2

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 15 15 15 16 14 15 15 15 15 15

Covered differently ............................. 85 85 85 84 86 85 85 85 85 85

Inpatient rehabilitation3

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 7 8 5 6 6 7 7 7 3 7

Covered differently ............................. 93 92 95 94 94 93 93 93 97 93

Outpatient rehabilitation1

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Covered the same .............................. 6 7 6 6 6 6 8 5 5 7

Covered differently ............................. 94 93 94 94 94 94 92 95 95 93

1 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated. 2 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse.

3 Rehabilitation is designed to alter the abusive behavior in patients once they

are free of acute physical and mental complications.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

29
Table 22. Mental healthcare and substance abuse treatment benefits: Coverage in prepaid plans, all private industry workers, National

Compensation Survey, 2003

Coverage limitation All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Mental health care

Inpatient

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 11 13 7 14 7 12 9 13 11 11

Subject to limits1 ................................ 89 87 93 86 93 88 91 87 89 89

Outpatient2

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 1 2 2 3 () 1 1 3 () 2 4 1

Subject to limits1 ................................ 99 98 98 100 99 99 100 98 96 99

Alcohol abuse

Inpatient detoxification4

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 21 23 19 16 23 20 27 16 17 22

Subject to limits1 ................................ 79 77 81 84 77 80 73 84 83 78

Inpatient rehabilitation5

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 6 7 5 3 () 5 6 6 6 4 6

Subject to limits1 ................................ 94 93 95 100 95 94 94 94 96 94

Outpatient2

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 1 1 1 - 2 1 2 3 () 1 1

Subject to limits1 ................................ 99 99 99 100 98 99 98 100 99 99

Drug Abuse

Inpatient detoxification4

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 20 22 16 16 22 19 26 14 14 21

Subject to limits1 ................................ 80 78 84 84 78 81 74 86 86 79

Inpatient rehabilitation5

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 5 7 5 3 () 3 6 3 7 6 5

Subject to limits1 ................................ 95 93 95 100 97 94 97 93 94 95

Outpatient rehabilitation2

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered in full .................................... 3 () 1 3 () - 3 () 1 1 3 ( ) 3 () 1

Subject to limits1 ................................ 100 99 100 100 100 99 99 100 100 99

1 Limits may be set in terms of dollar or day ceilings on benefits, a requirement

that the participant pay a percentage of cost (coinsurance), or a requirement that

the participant pay a specific amount (deductible or copayment) before

reimbursement begins or services are rendered. 2 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated. 3 Less than 0.5 percent.

4 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse. 5 Rehabilitation is designed to alter the abusive behavior in patients once they

are free of acute physical and mental complications.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

30
Table 23. Mental healthcare benefits: Separate limits on coverage in indemnity and prepaid plans, all private industry workers, National

Compensation Survey, 2003

Coverage limitation All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Indemnity

Inpatient

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits1 ............................. 13 14 11 14 12 13 11 14 14 12

Subject to separate limits2 ................. 87 86 89 86 88 87 89 86 86 88

Days ................................................ 78 78 79 79 76 80 80 77 72 80

Dollars ............................................. 9 9 10 10 10 9 13 7 14 9

Coinsurance .................................... 10 9 11 8 11 9 12 8 11 10

Copayment ..................................... 7 8 5 8 6 8 7 7 3 8

Other3 ............................................. 6 6 5 2 5 6 3 8 7 5

Outpatient4

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits1 ............................. 9 9 9 5 10 8 10 8 8 9

Subject to separate limits2 ................. 91 91 91 95 90 92 90 92 92 91

Days ................................................ 71 71 68 76 68 72 66 74 67 71

Dollars ............................................. 10 9 12 10 11 10 13 9 15 10

Coinsurance .................................... 16 14 18 20 16 16 13 18 22 15

Copayment ..................................... 20 22 18 21 20 20 18 22 13 21

Other3 ............................................. 16 17 16 11 15 17 17 15 14 17

Prepaid

Inpatient

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits1 ............................. 20 21 20 17 17 21 23 17 12 22

Subject to separate limits2 ................. 80 79 80 83 83 79 77 83 88 78

Days ................................................ 78 78 78 82 81 77 75 81 85 76

Dollars ............................................. 3 4 1 6 - 4 4 3 5 () 4

Coinsurance .................................... 3 4 1 8 5 () 4 4 3 1 4

Copayment ..................................... 16 15 14 23 18 15 17 14 12 17

Other3 ............................................. 1 1 1 5 () 1 1 5 () 1 1 1

Outpatient4

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits1 ............................. 5 6 6 2 10 4 5 6 8 5

Subject to separate limits2 ................. 95 94 94 98 90 96 95 94 92 95

Days ................................................ 80 81 77 76 74 82 77 82 86 78

Dollars ............................................. 1 1 1 - - 1 1 1 5 () 1

Coinsurance .................................... 4 4 3 7 5 4 3 5 1 5

Copayment ..................................... 52 51 55 52 62 49 54 51 45 54

Other3 ............................................. 6 4 8 13 7 6 6 6 12 5

1 These include plans that provide coverage without any separate limits; they

also include plans that provide coverage subject to only the major medical limits of

the plan. 2 Separate limitations indicate that mental healthcare benefits are more

restrictive than benefits for other treatments. For example, if a plan limits inpatient

mental healthcare to 30 days per year, the plan contains separate limits. The total is

less than the sum of the individual items because many plans had more than one

type of limitation. 3 These are plans for which comparisons were made between copayments and

coinsurances for mental healthcare and all other illnesses. For example, outpatient

mental healthcare had a 50-percent coinsurance payment, while office visits for

other illnesses had a $10 copayment. 4 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated. 5 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

31
Table 24. Alcohol and drug abuse treatment benefits: Relationship between provisions in indemnity and prepaid plans, all private industry

workers, National Compensation Survey, 2003

Coverage All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Covered together1 ................................. 63 65 60 66 63 63 59 67 61 64

Covered separately but with the same

limits2 ................................................... 6 5 7 7 6 6 6 6 9 6

Other3 .................................................... 24 23 27 23 26 24 28 21 24 24

Alcohol and drug abuse treatment not

covered ................................................ 1 1 1 1 2 1 1 2 4 () 2

Not determinable ................................... 5 5 5 3 4 5 6 4 5 5

1 These are plans in which all limits that apply to alcohol abuse treatment also

apply to drug abuse treatment. When care is received for one of these types of

treatment, it reduces the availability of care from the other. For example, if alcohol

and drug abuse treatments are limited to 30 days per year and 20 days are used for

alcohol abuse treatment, then there are 10 days left for drug abuse treatment. 2 These are plans in which alcohol and drug abuse treatments are subject to

separate, but identical, limits. For example, alcohol abuse treatment is limited to 30

days per year and drug abuse treatment is limited to a separate 30 days per year.

3 Includes plans in which alcohol abuse treatment coverage differs from drug

abuse treatment coverage. 4 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

32
Table 25. Alcohol abuse treatment benefits: Separate limits on coverage in indemnity plans, all private industry workers, National

Compensation Survey, 2003

Coverage limitation All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Inpatient detoxification1

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 15 15 13 28 12 17 16 15 14 16

Subject to separate limits3 ................. 85 85 87 72 88 83 84 85 86 84

Days ................................................ 67 69 69 48 66 67 68 66 63 68

Dollars ............................................. 24 23 25 28 26 23 23 25 33 23

Coinsurance .................................... 10 10 11 13 11 10 11 9 11 10

Copayment ..................................... 7 8 5 7 6 8 7 8 3 8

Other4 ............................................. 5 6 5 2 5 6 3 7 6 5

Inpatient rehabilitation5

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 10 11 8 19 7 12 12 9 6 11

Subject to separate limits3 ................. 90 89 92 81 93 88 88 91 94 89

Days ................................................ 72 72 73 57 70 72 72 71 71 72

Dollars ............................................. 26 25 28 31 28 25 24 28 35 25

Coinsurance .................................... 11 10 12 11 13 10 12 10 11 10

Copayment ..................................... 7 8 5 8 6 8 7 8 3 8

Other4 ............................................. 6 6 6 3 5 6 3 8 6 6

Outpatient rehabilitation6

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 9 10 8 9 6 11 11 7 7 10

Subject to separate limits3 ................. 91 90 92 91 94 89 89 93 93 90

Days ................................................ 61 63 59 58 59 62 58 64 60 61

Dollars ............................................. 26 24 28 31 31 24 24 28 31 25

Coinsurance .................................... 14 12 15 15 14 13 11 16 17 13

Copayment ..................................... 19 21 16 22 21 19 18 21 12 21

Other4 ............................................. 16 17 15 11 15 16 17 15 12 17

1 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse. 2 These include plans that provide coverage without any separate limits; they

also include plans that provide coverage subject to only the major medical limits of

the plan. 3 Separate limitations indicate that alcohol abuse treatment benefits are more

restrictive than benefits for other treatments. For example, if a plan limits inpatient

rehabilitation care to 30 days per year, but the limit on inpatient care for any other

type of illness is greater than 30 days per year, the plan contains separate limits.

The total is less than the sum of the individual items because many plans had more

than one type of limitation. 4 These are plans for which comparisons were made between copayments and

coinsurances for alcohol abuse treatment and all other illnesses. For example,

outpatient alcohol abuse treatment had a 50-percent coinsurance payment, while

office visits for other illnesses had a $10 copayment. 5 Rehabilitation is designed to alter the abusive behavior in patients once they

are free of acute physical and mental complications. 6 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

33
Table 26. Alcohol abuse treatment benefits: Separate limits on coverage in prepaid plans, all private industry workers, National Compensation

Survey, 2003

Coverage limitation All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Inpatient detoxification1

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 34 37 36 21 38 33 44 27 29 36

Subject to separate limits3 ................. 66 63 64 79 62 67 56 73 71 64

Days ................................................ 57 52 59 73 56 57 52 61 64 55

Dollars ............................................. 5 5 3 11 3 6 2 8 1 6

Coinsurance .................................... 4 4 4 1 4 4 5 3 2 4

Copayment ..................................... 16 14 14 25 16 15 16 16 13 16

Other4 ............................................. 3 4 2 5 () 1 4 1 5 3 3

Inpatient rehabilitation6

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 12 13 13 5 15 11 14 11 5 14

Subject to separate limits3 ................. 88 87 87 95 85 89 86 89 95 86

Days ................................................ 79 76 80 88 81 78 81 77 84 77

Dollars ............................................. 7 7 5 14 4 9 3 11 5 8

Coinsurance .................................... 6 6 5 10 5 7 10 3 2 7

Copayment ..................................... 17 14 17 31 19 17 20 15 17 17

Other4 ............................................. 4 5 3 5 () 1 4 5 () 6 5 3

Outpatient rehabilitation7

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 8 8 11 4 14 6 12 5 8 8

Subject to separate limits3 ................. 92 92 89 96 86 94 88 95 92 92

Days ................................................ 74 74 71 82 65 77 69 78 81 72

Dollars ............................................. 5 5 4 6 4 5 4 6 1 6

Coinsurance .................................... 3 3 2 8 2 4 6 2 1 4

Copayment ..................................... 45 45 46 40 55 41 43 46 37 46

Other4 ............................................. 6 6 7 2 7 5 4 7 11 4

1 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse. 2 These include plans that provide coverage without any separate limits; they

also include plans that provide coverage subject to only the major medical limits of

the plan. 3 Separate limitations indicate that alcohol abuse treatment benefits are more

restrictive than benefits for other treatments. For example, if a plan limits inpatient

rehabilitation care to 30 days per year, but the limit on inpatient care for any other

type of illness is greater than 30 days per year, the plan contains separate limits.

The total is less than the sum of the individual items because many plans had more

than one type of limitation. 4 These are plans for which comparisons were made between copayments and

coinsurances for alcohol abuse treatment and all other illnesses. For example,

outpatient alcohol abuse treatment had a 50-percent coinsurance payment, while

office visits for other illnesses had a $10 copayment. 5 Less than 0.5 percent. 6 Rehabilitation is designed to alter the abusive behavior in patients once they

are free of acute physical and mental complications. 7 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

34
Table 27. Drug abuse treatment benefits: Separate limits on coverage in indemnity plans, all private industry workers, National Compensation

Survey, 2003

Coverage limitation All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Inpatient detoxification1

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 15 14 13 29 12 16 16 15 14 15

Subject to separate limits3 ................. 85 86 87 71 88 84 84 85 86 85

Days ................................................ 68 69 69 49 66 68 68 67 64 68

Dollars ............................................. 24 22 25 27 26 23 23 24 32 22

Coinsurance .................................... 10 10 11 12 11 10 11 9 11 10

Copayment ..................................... 7 8 5 7 6 8 7 8 3 8

Other4 ............................................. 6 6 5 2 5 6 3 8 6 6

Inpatient rehabilitation5

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 10 10 7 17 7 11 11 8 6 10

Subject to separate limits3 ................. 90 90 93 83 93 89 89 92 94 90

Days ................................................ 72 72 74 56 70 73 73 71 71 72

Dollars ............................................. 26 25 28 33 28 26 24 29 35 25

Coinsurance .................................... 11 10 12 14 13 10 11 10 11 11

Copayment ..................................... 7 8 5 8 6 8 7 8 3 8

Other4 ............................................. 6 7 6 2 5 7 3 8 6 6

Outpatient rehabilitation6

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 9 10 7 9 6 10 11 7 7 9

Subject to separate limits3 ................. 91 90 93 91 94 90 89 93 93 91

Days ................................................ 61 63 60 56 59 62 58 64 60 61

Dollars ............................................. 26 24 29 32 31 24 24 28 31 25

Coinsurance .................................... 14 13 15 17 14 14 11 16 17 13

Copayment ..................................... 19 21 16 21 21 19 18 20 12 21

Other4 ............................................. 16 17 16 10 15 17 17 16 12 17

1 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse. 2 These include plans that provide coverage without any separate limits; they

also include plans that provide coverage subject to only the major medical limits of

the plan. 3 Separate limitations indicate that drug abuse treatment benefits are more

restrictive than benefits for other treatments. For example, if a plan limits inpatient

rehabilitation care to 30 days per year, but the limit on inpatient care for any other

type of illness is greater than 30 days per year, the plan contains separate limits.

The total is less than the sum of the individual items because many plans had more

than one type of limitation. 4 These are plans for which comparisons were made between copayments and

coinsurances for drug abuse treatment and all other illnesses. For example,

outpatient drug abuse treatment had a 50-percent coinsurance payment, while

office visits for other illnesses had a $10 copayment. 5 Rehabilitation is designed to alter the abusive behavior in patients once they

are free of acute physical and mental complications. 6 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

35
Table 28. Drug abuse treatment benefits: Separate limits on coverage in prepaid plans, all private industry workers, National Compensation

Survey, 2003

Coverage limitation All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Inpatient detoxification1

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 33 36 33 21 37 32 42 26 26 35

Subject to separate limits3 ................. 67 64 67 79 63 68 58 74 74 65

Days ................................................ 58 53 60 73 58 58 54 61 65 56

Dollars ............................................. 6 5 4 11 3 7 2 9 4 6

Coinsurance .................................... 4 4 4 1 4 4 5 3 2 4

Copayment ..................................... 16 14 14 25 16 15 16 16 13 16

Other4 ............................................. 3 4 2 5 () 1 4 1 5 3 3

Inpatient rehabilitation6

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 12 13 12 5 13 11 11 12 7 13

Subject to separate limits3 ................. 88 87 88 95 87 89 89 88 93 87

Days ................................................ 80 77 82 88 82 79 84 77 85 79

Dollars ............................................. 7 7 4 14 4 8 3 9 2 8

Coinsurance .................................... 6 6 5 10 5 7 10 3 2 7

Copayment ..................................... 17 14 17 31 19 17 20 15 17 17

Other4 ............................................. 4 5 3 5 () 1 4 5 () 6 5 3

Outpatient rehabilitation7

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

No separate limits2 ............................. 8 8 9 4 12 6 11 5 7 8

Subject to separate limits3 ................. 92 92 91 96 88 94 89 95 93 92

Days ................................................ 74 74 72 82 67 77 70 78 82 72

Dollars ............................................. 5 5 4 6 4 5 4 6 1 6

Coinsurance .................................... 3 3 2 8 2 4 6 2 1 4

Copayment ..................................... 45 45 46 40 55 41 43 46 37 46

Other4 ............................................. 6 6 7 2 7 5 4 7 11 4

1 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse. 2 These include plans that provide coverage without any separate limits; they

also include plans that provide coverage subject to only the major medical limits of

the plan. 3 Separate limitations indicate that drug abuse treatment benefits are more

restrictive than benefits for other treatments. For example, if a plan limits inpatient

rehabilitation care to 30 days per year, but the limit on inpatient care for any other

type of illness is greater than 30 days per year, the plan contains separate limits.

The total is less than the sum of the individual items because many plans had more

than one type of limitation. 4 These are plans for which comparisons were made between copayments and

coinsurances for drug abuse treatment and all other illnesses. For example,

outpatient drug abuse treatment had a 50-percent coinsurance payment, while

office visits for other illnesses had a $10 copayment. 5 Less than 0.5 percent. 6 Rehabilitation is designed to alter the abusive behavior in patients once they

are free of acute physical and mental complications. 7 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

36
Table 29. Mental health care and substance abuse treatment benefits: Application to out-of-pocket expense provisions in indemnity plans, all

private industry workers, National Compensation Survey, 2003

Type of coverage All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Mental health care

Inpatient

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 44 47 38 47 39 46 37 50 38 45

Not subject to plan’s

 out-of-pocket limits .......................... 51 47 56 51 54 49 57 45 59 49

Not determinable ................................ 5 5 6 1 7 5 6 5 3 6

Outpatient1

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 42 44 34 60 35 46 34 49 36 43

Not subject to plan’s

 out-of-pocket limits .......................... 52 50 59 38 58 50 60 46 61 51

Not determinable ................................ 5 5 7 1 7 5 6 5 3 6

Alcohol abuse

Inpatient detoxification2

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 45 49 36 51 38 48 39 51 40 46

Not subject to plan’s

 out-of-pocket limits .......................... 50 46 57 48 55 47 55 45 57 49

Not determinable ................................ 5 5 6 1 7 4 6 4 3 5

Inpatient rehabilitation3

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 45 49 37 51 38 49 39 51 41 46

Not subject to plan’s

 out-of-pocket limits .......................... 49 46 57 43 56 46 55 44 56 48

Not determinable ................................ 6 5 6 7 7 5 7 5 3 6

Outpatient rehabilitation1

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 45 47 36 66 36 48 37 51 38 46

Not subject to plan’s

 out-of-pocket limits .......................... 50 49 57 33 57 48 58 44 59 49

Not determinable ................................ 5 4 7 1 7 4 5 5 3 5

See footnotes at end of table.

37
Table 29. Mental health care and substance abuse treatment benefits: Application to out-of-pocket expense provisions in indemnity plans, all

private industry workers, National Compensation Survey, 2003 — Continued

Type of coverage All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Drug abuse

Inpatient detoxification2

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 45 49 36 51 38 48 39 51 40 46

Not subject to plan’s

 out-of-pocket limits .......................... 50 46 57 48 55 47 55 45 57 49

Not determinable ................................ 5 5 6 1 7 4 6 4 3 5

Inpatient rehabilitation3

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 45 49 37 51 38 48 39 51 41 46

Not subject to plan’s

 out-of-pocket limits .......................... 49 46 57 43 56 46 55 45 56 48

Not determinable ................................ 6 5 6 7 7 5 7 5 3 6

Outpatient rehabilitation1

Total ..................................................... 100 100 100 100 100 100 100 100 100 100

Subject to plan’s

 out-of-pocket limits .......................... 45 47 36 66 36 48 37 51 38 46

Not subject to plan’s

 out-of-pocket limits .......................... 50 49 57 33 57 48 57 44 59 49

Not determinable ................................ 5 4 7 1 7 4 5 5 3 5

1 Includes treatment in one or more of the following: outpatient department of a

hospital, residential treatment center, organized outpatient clinic, day-night

treatment center, or doctor’s office. If benefits differed by location of treatment, the

location offering the most beneficial coverage was tabulated. 2 Detoxification is the systematic use of medication and other methods under

medical supervision, to reduce or eliminate the effects of substance abuse.

3 Rehabilitation is designed to alter the abusive behavior in patients once they

are free of acute physical and mental complications.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

38
Table 30. Dental care benefits: Coverage for selected procedures and average percentage of usual, customary, and reasonable charge, all

private industry workers, National Compensation Survey, 2003

Categories of care and extent of

coverage

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Exams

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 100 100 100 100 100 100 100 100 100 100

In full2 .............................................. 31 31 32 35 27 33 32 31 24 33

Scheduled cash allowance ............. 3 1 6 5 7 1 2 3 5 2

Subject to copayment3 .................... 3 3 2 4 2 3 4 2 4 2

Percent of usual, customary, and

reasonable charge ........................ 63 65 60 55 64 62 62 63 66 62

Other4 ............................................. 5 ( ) 5 () 1 1 5 ( ) 5 ( ) 5 () 1 5 ( ) 5 ( )

Not covered ........................................... - - - - - - - - - -

Not determinable ................................... - - - - - - - - - -

Average percent .................................... 96 96 96 96 97 96 97 95 95 96

Xrays

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 100 100 100 100 100 100 100 100 100 100

In full2 .............................................. 31 30 31 34 25 33 31 31 23 33

Scheduled cash allowance ............. 3 1 6 5 6 1 2 3 5 2

Subject to copayment3 .................... 2 3 1 4 1 3 4 2 3 2

Percent of usual, customary, and

reasonable charge ........................ 63 65 61 56 66 62 63 63 67 62

Other4 ............................................. 1 5 () 3 1 3 1 1 1 4 1

Not covered ........................................... - - - - - - - - - -

Not determinable ................................... - - - - - - - - - -

Average percent .................................... 95 96 95 96 96 95 97 95 94 96

Fillings

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 99 99 98 99 98 99 100 99 96 100

In full2 .............................................. 4 4 4 6 2 5 4 4 4 4

Scheduled cash allowance ............. 6 4 9 8 8 5 8 5 11 5

Subject to copayment3 .................... 3 3 2 5 2 4 4 2 2 3

Percent of usual, customary, and

reasonable charge ........................ 86 88 84 80 86 86 85 87 79 88

Other4 ............................................. 1 5 () 2 1 1 1 5 () 1 2 1

Not covered ........................................... - - - - - - - - - -

Not determinable ................................... 1 1 2 1 2 1 5 () 1 4 5 ( )

Average percent .................................... 79 79 79 79 79 79 80 79 81 79

See footnotes at end of table.

39
Table 30. Dental care benefits: Coverage for selected procedures and average percentage of usual, customary, and reasonable charge, all

private industry workers, National Compensation Survey, 2003 — Continued

Categories of care and extent of

coverage

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Surgery6

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 99 99 99 98 99 99 100 99 97 100

In full2 .............................................. 2 3 2 2 1 3 1 3 2 2

Scheduled cash allowance ............. 6 5 7 8 5 6 8 4 11 4

Subject to copayment3 .................... 5 5 3 8 2 6 6 4 4 5

Percent of usual, customary, and

reasonable charge ........................ 87 88 87 81 89 86 86 87 80 89

Other4 ............................................. 1 5 () 3 2 3 1 5 () 2 2 1

Not covered ........................................... 5 ( ) 5 () 1 - 1 5 ( ) 5 ( ) 5 () 1 5 ( )

Not determinable ................................... 1 1 5 () 2 - 1 5 () 1 2 5 ( )

Average percent .................................... 79 79 79 78 79 79 79 79 80 78

Periodontal care

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 98 98 99 100 99 98 98 99 98 98

In full2 .............................................. 1 2 1 1 1 2 1 2 2 1

Scheduled cash allowance ............. 6 4 8 8 7 5 8 4 10 4

Subject to copayment3 .................... 5 5 3 8 2 6 6 4 3 5

Percent of usual, customary, and

reasonable charge ........................ 87 88 86 82 89 86 85 88 84 88

Other4 ............................................. 1 5 () 2 2 1 1 5 () 1 2 1

Not covered ........................................... 1 5 () 1 5 () 1 5 () - 1 1 5 ( )

Not determinable ................................... 1 1 1 - - 1 2 1 5 () 1

Average percent .................................... 76 76 77 75 77 76 77 76 78 76

Endodontics

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 99 99 99 99 99 99 99 99 97 99

In full2 .............................................. 1 1 1 1 1 1 1 2 2 1

Scheduled cash allowance ............. 5 4 8 8 6 5 8 4 10 4

Subject to copayment3 .................... 5 5 3 8 2 6 6 4 3 5

Percent of usual, customary, and

reasonable charge ........................ 88 89 87 80 89 87 86 89 83 89

Other4 ............................................. 1 5 () 2 2 1 1 5 () 1 2 1

Not covered ........................................... 5 ( ) 5 ( ) 5 ( ) 5 () 1 5 () - 5 () 1 5 ( )

Not determinable ................................... 1 1 5 () 1 5 () 1 1 1 2 1

Average percent .................................... 74 75 74 74 74 74 75 74 76 74

See footnotes at end of table.

40
Table 30. Dental care benefits: Coverage for selected procedures and average percentage of usual, customary, and reasonable charge, all

private industry workers, National Compensation Survey, 2003 — Continued

Categories of care and extent of

coverage

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Crowns

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 96 97 96 96 96 97 99 95 92 97

In full2 .............................................. 5 ( ) 5 ( ) 5 ( ) 5 ( ) 5 ( ) 5 ( ) 5 ( ) 5 () 1 5 ( )

Scheduled cash allowance ............. 6 4 10 6 7 6 8 5 11 5

Subject to copayment3 .................... 5 5 3 8 2 6 6 4 3 5

Percent of usual, customary, and

reasonable charge ........................ 86 88 85 80 86 86 86 86 80 88

Other4 ............................................. 1 5 () 1 2 1 1 5 () 1 5 () 1

Not covered ........................................... 3 2 3 3 2 3 1 3 3 2

Not determinable ................................... 1 1 2 1 2 1 - 2 4 5 ( )

Average percent .................................... 56 55 58 57 57 55 55 57 60 55

Prosthetics

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 95 95 96 96 97 95 96 95 95 95

In full2 .............................................. 5 ( ) 5 ( ) 5 () - 5 ( ) 5 ( ) 5 ( ) 5 ( ) 5 ( ) 5 ( )

Scheduled cash allowance ............. 6 4 10 6 7 5 8 5 10 5

Subject to copayment3 .................... 5 5 3 8 2 6 6 4 3 5

Percent of usual, customary, and

reasonable charge ........................ 86 86 86 81 87 85 84 87 85 86

Other4 ............................................. 1 5 () 1 2 1 1 5 () 1 - 1

Not covered ........................................... 3 3 4 3 3 3 2 4 5 3

Not determinable ................................... 2 2 - 1 1 2 2 1 5 () 2

Average percent .................................... 55 54 56 54 55 54 54 55 58 54

Orthodontia

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1,7 ............................................. 74 76 70 69 71 75 68 77 78 73

In full2 .............................................. 5 ( ) 5 () - - - 5 () - 5 () - 5 ( )

Scheduled cash allowance ............. 11 10 12 7 15 9 9 12 21 8

Subject to copayment3 .................... 6 7 3 8 4 6 5 6 5 6

Percent of usual, customary, and

reasonable charge ........................ 59 62 56 53 55 61 56 61 55 60

Other4 ............................................. 4 4 4 4 3 4 6 3 6 4

Not covered ........................................... 23 21 25 29 25 22 27 20 19 24

Not determinable ................................... 4 3 5 1 4 4 6 3 4 4

Average percent .................................... 52 52 54 51 53 52 53 52 56 52

1 Sum of individual items is greater than total because some participants were

in plans with more than one limit. 2 Includes plans that paid the full cost, with no deductible or maximum dollar

amount. 3 Participant pays a specific amount per procedure and plan pays all remaining

expenses. In the case of orthodontia, the copayment is generally applied once per

lifetime. 4 Includes plans that provide care based on an incentive schedule or discounted

benefit. An incentive schedule is a reimbursement arrangement in which the

percentage of dental expenses paid by the plan increases if regular dental

appointments are scheduled. Discounted benefits are available if obtained from an

approved provider. 5 Less than 0.5 percent. 6 Excludes plans that limited coverage to accidental injuries, removal of

impacted wisdom teeth, or repair of jaw. 7 Includes plans that have coverage, but the type is unknown. Previously, these

plans were included under the category "Not determinable".

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

41
Table 31. Dental care benefits: Amount of individual deductible,1 all private industry workers, National Compensation Survey, 2003

Type of deductible All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Subject to separate dental deductible2 .. 67 70 59 68 60 69 64 68 44 72

Yearly deductible only ....................... 66 70 59 68 60 69 64 67 44 72

$25 ................................................ 14 13 13 27 14 14 11 16 13 14

$50 ................................................ 47 51 43 38 43 49 50 46 28 52

Other ............................................. 4 5 2 2 2 4 1 5 1 4

Unspecified ........................................ 1 1 2 1 3 () 2 3 3 () 2 1

Lifetime deductible only ..................... 3 ( ) 3 () - 3 () - 3 () - 3 ( ) 3 ( ) 3 ( )

Both yearly and lifetime deductible .... - - - - - - - - - -

No deductible ........................................ 26 24 31 24 33 24 30 24 39 23

Not determinable ................................... 7 6 9 8 8 7 6 8 17 5

Average employee yearly deductible .... $47 $48 $45 $41 $45 $48 $46 $47 $42 $47

1 Amount of deductible described is for each insured person. In some plans,

the individual and family deductibles are identical. Excludes separate deductibles for

orthodontic procedures. 2 A single deductible may not apply to all covered dental procedures. If separate

deductibles applied to different procedures, the sum of the deductible amounts was

tabulated.

3 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

42
Table 32. Dental care benefits: Relationship of yearly family deductibles to yearly individual deductibles, all private industry workers, National

Compensation Survey, 2003

Relationship between individual and

family deductible

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total1 .................................................. 100 100 100 100 100 100 100 100 100 100

With individual and family

deductible ......................................... 50 55 41 53 46 52 47 52 30 55

Family deductible is

2 times individual deductible ......... 12 13 11 15 14 12 10 14 11 13

 3 times individual deductible ......... 37 40 30 37 32 38 36 37 19 41

 Other ............................................. 1 2 2 () 1 2 () 2 2 () 2 2 () 2

No deductible or no family

deductible ......................................... 41 38 47 38 46 39 44 39 51 39

Not determinable ................................ 7 6 9 8 8 7 6 8 17 5

1 Includes workers where the individual or family deductible is unspecified. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

43
Table 33. Dental care benefits: Maximum benefit provision,1 all private industry workers, National Compensation Survey, 2003

Dollar amount2 All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Yearly maximum specified3 ................... 88 89 90 80 92 87 88 89 88 89

Less than $1,000 ............................... 5 4 7 3 6 5 5 5 7 5

$1,000 ............................................... 38 34 44 44 46 35 42 36 31 40

$1,001–$1,499 .................................. 7 8 6 5 6 8 5 8 12 6

$1,500 ............................................... 25 28 21 22 22 26 22 27 23 26

Greater than $1,500 .......................... 13 15 11 5 11 14 15 12 15 13

Unspecified ........................................ - - - - - - - - - -

No yearly maximum ............................... 8 8 6 14 6 9 8 8 7 8

Maximum provision not determinable .... 4 3 4 6 3 4 4 4 5 3

Average yearly maximum ...................... $1,304 $1,346 $1,248 $1,210 $1,246 $1,329 $1,312 $1,300 $1,327 $1,299

1 Includes all covered dental procedures except orthodontia. Amount of

maximum specified is for each insured person. 2 Coverage for dental procedures may be subject to scheduled allowance,

deductible, or coinsurance provisions, in addition to maximum dollar limitations. 3 If separate yearly maximums applied to different procedures, the sum of the

maximum was tabulated. Maximums applied to dental expenses only.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

44
Table 34. Orthodontia care benefits: Maximum benefit provision,1 all private industry workers, National Compensation Survey, 2003

Dollar amount All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Lifetime maximum specified ................. 85 86 83 78 89 83 80 87 89 84

Less than $1,000 ............................... 5 6 2 6 2 6 7 4 3 6

$1,000 ............................................... 34 34 33 37 33 34 36 32 24 36

$1,001–$1,499 .................................. 6 6 5 3 4 7 7 5 8 5

$1,500 ............................................... 27 29 25 25 29 27 20 31 29 27

Greater than $1,500 .......................... 13 11 17 7 20 10 10 14 23 10

Dollar amount unspecified ................. 1 2 () 1 - 1 2 ( ) 2 () 1 2 2 ( )

No lifetime maximum ............................. 14 13 16 18 11 16 19 12 11 15

Not determinable ................................... 1 1 2 () 4 1 1 1 1 2 () 1

Average lifetime maximum3 .................. $1,331 $1,295 $1,419 $1,257 $1,448 $1,282 $1,328 $1,332 $1,522 $1,278

1 Coverage for orthodontic procedure may be subject to scheduled allowance,

deductible, or coinsurance provisions, in addition to maximum dollar limitations. 2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude workers

without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

45
Table 35. Orthodontia care benefits: Percent of participants in plans with orthodontic benefits by type of individuals covered, all private

industry workers, National Compensation Survey, 2003

Type of individual covered All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Dependent children only ................... 55 52 61 58 60 53 58 54 55 55

Employee and dependents ................ 40 44 33 40 35 42 35 43 40 40

Not determinable ............................... 5 4 6 2 5 5 8 3 4 5

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

46
Table 36. Vision care benefits: Coverage for selected procedures, all private industry workers, National Compensation Survey, 2003

Type of vision benefit All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Exams

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 100 100 100 99 100 99 100 99 99 100

In full ............................................... 22 20 26 21 24 21 18 24 29 20

Scheduled cash allowance ............. 24 21 28 24 25 23 23 24 33 21

Subject to copayment ..................... 54 57 48 50 50 55 59 51 41 58

Retail discount ................................ 3 3 3 3 2 4 4 3 1 4

Other2 ............................................. 5 4 7 5 8 4 5 5 9 3

Not covered ........................................... 3 ( ) 3 ( ) 3 () - - 3 () - 3 ( ) 3 ( ) 3 ( )

Not determinable ................................... 3 ( ) 3 () - 1 - 3 () - 3 ( ) 3 ( ) 3 ( )

Glasses

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 100 99 100 100 100 100 100 99 100 100

In full ............................................... 11 9 17 5 15 9 14 10 16 10

Scheduled cash allowance ............. 46 46 49 39 48 45 46 46 55 43

Subject to copayment ..................... 35 41 25 32 25 39 37 34 24 38

Retail discount ................................ 17 16 15 26 15 18 13 19 11 19

Other2 ............................................. 5 3 10 3 11 3 4 6 10 4

Not covered ........................................... 3 () 1 - - - 3 () - 1 - 3 ( )

Not determinable ................................... - - - - - - - - - -

Contacts4

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Covered1 ............................................... 97 96 98 96 97 97 98 96 98 97

In full ............................................... 6 6 7 3 7 5 6 6 5 6

Scheduled cash allowance ............. 63 66 64 46 63 63 67 62 70 61

Subject to copayment ..................... 27 32 20 19 20 29 29 25 19 29

Retail discount ................................ 15 14 11 32 12 16 7 19 9 17

Other2 ............................................. 6 4 10 3 11 4 4 7 10 4

Not covered ........................................... 2 2 1 4 1 2 1 2 1 2

Not determinable ................................... 1 2 1 3 () 2 1 1 2 1 1

1 The total is less than the sum of individual items because many participants

are in plans with more than one type of limitation. 2 Includes plans subject to coinsurance and retail discount. 3 Less than 0.5 percent. 4 Includes plans that provide coverage for elected purchase of contact lenses;

medically necessary contact lenses (that is, cataract surgery) normally are provided

under the surgical portion of the medical plan and are not described in this table.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category.

47
49

Chapter 2. Retirement Income

Benefits

Retirement plans are classified as either defined benefit or defined contribution plans. Defined benefitplans determine payments according to a fixed formula based on salary, years of service, and age. Defined

contribution plans determine payouts on the amount of

money contributed and the rate of return on the money invested.

Defined Benefit Plans

Defined benefit pension plans provide employees with guaranteed retirement benefits based on benefit formulas. A

participant’s retirement age, length of service, and

preretirement earnings may affect the benefits received. Definitions, key provisions, and related terms follow.

Traditional

Terminal earnings formulas. Benefits are based on a percentage of average earnings during a specified number of

years at the end of a worker’s career (or when earnings are

highest), multiplied by the number of years of service recognized by the plan.

Career earnings formulas. Benefits are based on a percentage of an average of career earnings for every year of service

recognized by the plan.

Dollar amount formulas. Benefits are based on a dollar

amount per month for each year of service recognized by the

plan.

Percentage-of-contribution formulas. Benefits are based on

employer and, occasionally, employee contributions. Benefits equal a percentage of total contributions.

Other types

Cash balance formulas. Benefits are computed as a percentage of each employee’s retirement account balance. Employers specify a contribution, and a rate of interest on that contribution, that will provide a set amount at retirement, generally as a lump sum.

Pension equity. For each year of work, employees are credited with a percentage applied to their final average earnings.

Benefits are generally disbursed as a lump sum.

Normal retirement

Normal retirement is the age at which plan participants may

retire and receive all accrued benefits.

Early retirement

Early retirement is the age (or a combination of age and service) at which plan participants may retire and receive all

accrued benefits, minus a reduction for the years remaining

until they reach their normal retirement age.

Benefit payment methods

Payments from defined benefit plans may be in the form of a

straight life annuity, a joint-and-survivor annuity, a percentage of unreduced accrued benefit, or a lump sum.

Straight life annuity. A periodic payment made for the life of

the retiree, with no additional payments to survivors.

Joint-and-survivor annuity. The Employee Retirement Income Security Act of 1974 (ERISA) requires defined benefit

pension plans that offer an annuity as a payment option to

provide a qualified joint-and-survivor annuity (QJSA) as the

normal benefit payment for married participants. A QJSA is

an immediate annuity for the life of the participant and a

survivor annuity for the life of the participant’s spouse. The

amount of the survivor annuity may not be less than 50

percent, or more than 100 percent, of the amount payable

during the time the participant and spouse are both alive.

The annuity payable for the life of the participant is lower

than that for a straight life annuity; to account for the increased length of time over which payments will be made,

this reduction may be a percentage of the straight life benefit, such as 10 percent, or may be based on the life expectancy of the participant and spouse (the so-called actuarial

reduction).

Percentage of unreduced accrued benefit. Under this method,

the participant’s pension is not reduced to adjust for survivor benefits. The participant will receive an amount equal to

the straight life annuity, and the spouse will receive a proportion of that amount, often 50 percent, should the participant die.

Lump-sum payment. The participant may opt for a full lump

sum, with no further benefits received from the plan. If a plan

provides for a partial lump-sum payment, the participant usually will receive a reduced annuity as well.

Vesting

Vesting. This term refers to the amount of time a participant

must work before earning a nonforfeitable right to a retirement benefit. Once vested, the worker retains the accrued
50

benefit even if he or she leaves the employer before reaching

retirement age.

Cliff vesting. No vesting occurs until an employee satisfies

the service requirements for 100-percent vesting—for example, 5 years.

Graded vesting. An employee’s nonforfeitable percentage

of employer contributions increases over time, until reaching 100 percent.

Integration with Social Security

Defined benefit plans may integrate retirement benefits with

Social Security benefits. Under this approach, the employer’s

contribution to Social Security (FICA taxes) is taken into

account when plan benefits are computed. Integration may

be accomplished by an offset or a step-rate method.

Offset. Part of a participant’s Social Security benefit is subtracted from the benefit otherwise payable by the plan. The

maximum allowable offset is 83.3 percent of the Social Security benefit. The most common offset is 50 percent.

Step rate. Lower benefit rates are applied to earnings up to

the specified taxable Social Security wage base (that is, the

earnings subject to Social Security tax) in a given year.

Portability

Portability is a participant’s ability to maintain and transfer

accumulated pension benefits when changing jobs. Portability provisions in defined benefit plans generally cover

portability of assets, portability of credited service, or both.

Portability of assets. Participants can withdraw their accumulated pension benefits or transfer them to another retirement arrangement.

Portability of credited service. Participants are allowed to

count the years of service with a previous employer when

determining benefits from their current employer.

Disability retirement

Retirement resulting from a totally disabling injury or illness

prior to eligibility for early or normal retirement. Plans providing disability retirement benefits may have a service requirement of 10 years or more. Benefits may be immediate or

deferred.

Defined Contribution Plans

Defined contribution plans are retirement plans that specify

the level of employer contributions and place those contributions into individual employee accounts.

Plan types

Savings and thrift plans. Employees may contribute a portion of earnings (usually pretax)—all or part of which the

employer matches—to an individual account. Employers may

match a fixed percentage of employee contributions or a percentage that varies by length of service, the amount of employee contribution, or other factors. Contributions are invested as directed by the employee or employer. Although

usually designed as a long-term savings vehicle, savings

and thrift plans may allow withdrawals and loans before retirement.

Deferred profit-sharing plans. A company credits a portion

of company profits to employees’ accounts. Plans may establish a formula for sharing profits, but this is not a requirement. Most plans hold money in employee accounts until

retirement, disability, or death.

Money purchase pension plans. Fixed employer contributions, typically calculated as a percentage of employee earnings, are allocated to individual employee accounts each

year. Some plans may allow employee contributions, but

employees usually are not required to make any contributions. Employers also may make profit-sharing contributions

to these plans at their discretion.

Employee stock ownership plan (ESOP). The employer pays

a designated amount, often borrowed, into a fund that then

invests primarily in company stock. Any debt incurred in the

purchase of the stock is repaid by the company. Stock then

is distributed to employees according to a formula.

Individual retirement account (IRA). An IRA is a retirement

savings plan. There are several types of IRAs: Traditional

IRAs, Roth IRAs, SEP IRAs, and SIMP IRAs. Traditional

and Roth IRAs are established by individuals who are allowed to contribute earnings up to a set maximum dollar

amount. SEPs and SIMPs are retirement plans established

by employers. (See SEP and SIMP definitions for more details.)

Simplified employee pensions (SEPs). An individual retirement account (IRA) is established for each eligible employee.

The employee immediately is vested in employer contributions and generally directs the investment of the money.

These arrangements sometimes are called SEP-IRAs.

Savings-incentive match plans (SIMPs). These plans can

be adopted by employers who have 100 or fewer employees

and who do not offer any other retirement plans. The plans

can either be IRAs established for each employee or be part

of a 401(k) plan (defined later in this chapter under “Related

plans and terms”). Within limits, contributions to these

plans are not tax deductible until withdrawn. SIMPs are subject to simplified reporting requirements.

Investment choices

Company stock. Employees receive equity in the company

that sponsors the defined contribution plan.
51

Common stock fund. This is a professionally managed fund

invested in the common stock of a variety of companies.

Fixed-interest securities. These securities include bonds and

other non-Federal instruments that pay a fixed interest rate

over a period of time.

Diversified investments. These are professionally managed

funds that are invested in more than one type of equity or

debt instrument.

Money market fund. This is a professionally managed mutual fund that invests in short-term Treasury bills, certificates of deposit, or corporate bonds. The fund managers sell

shares to investors, who receive regular payments of interest.

Withdrawals and loans

Withdrawals. Prior to normal payout (usually at retirement),

defined contribution plan participants may be allowed to

withdraw all or a portion of the employer funds from their

accounts. While most early withdrawals incur tax penalties,

hardship withdrawals do not. (See below.) To avoid tax penalties, many plans have loan provisions that allow employees to borrow from their accounts, with interest, for a specified period.

Hardship withdrawals. Employees usually are not penalized when money is withdrawn as a result of a hardship,

often defined as a death or illness of a family member, education expenses, sudden uninsured losses, or a need to prevent eviction from one’s primary residence.

Loans. Defined contribution plans may allow participants to

borrow employer funds, with interest, from their accounts.

Loan amounts often are limited to a portion of the account

balance. They usually have to be repaid within 5 years, but

longer payment periods may apply for home purchase or

renovation loans.

Transfers or rollovers. A rollover is a direct payment of plan

benefits from a defined contribution plan into an IRA or another employer’s plan. In a direct rollover, the employee is

not taxed on the payment until it is later withdrawn or distributed.

Vesting

Vesting refers to the amount of time a participant must work

before earning a nonforfeitable right to a retirement benefit.

Once vested, the worker retains the accrued benefit even if

he or she leaves the employer before reaching retirement

age. Under ERISA, defined contribution plans are subject to

the same vesting rules as defined benefit plans, but vesting

schedules vary. Vesting schedules apply only to employer

contributions; employee contributions (including pretax contributions) always are 100-percent vested.

Immediate full vesting. Employees are immediately eligible

to receive 100 percent of employer contributions.

Graded vesting. An employee’s nonforfeitable percentage

of employer contributions increases over time, until it reaches

100 percent.

Cliff vesting. No vesting occurs until an employee satisfies

the service requirements for 100-percent vesting—for

example, 5 years.

Employer contribution methods

Specified matching percentage. This feature is common in

savings and thrift plans. The employer matches a specified

percentage of employee contributions. The matching percentage can vary by length of service, amount of employee

contribution, and other factors.

Fixed percentage of profits. This feature is common in deferred profit-sharing plans. The employer contributes a fixed

percentage of total annual profits to the plan. For example,

no matter what the level of profits, 5 percent is contributed to

the plan. Profits may include those for the entire company or

just those in a specific business unit. In a variation of this

formula, employers set aside a reserve amount of profits (for

example, $1 million) and pay only a fixed percentage of any

profits above this amount into employees’ defined contribution plan.

Percentage of employee earnings. The employer contributes a fixed percentage of each employee’s earnings to his or

her individual account. This feature is common in money

purchase plans.

Related plans and terms

Stock bonus plan. Contributions are placed in a trust fund

that is invested in securities, including those of the employing company. This type of plan is financed by the employer

or jointly by the employer and employee. Upon the employee’s

retirement or separation from the company, proceeds from

the trust fund are paid out in the form of company stock or

cash.

Internal Revenue Code (IRC) Section 401(k) plan. This

plan allows employees to make pretax contributions to deferred compensation plans through salary reduction agreements. These arrangements often are associated with savings and thrift and other defined contribution plans.

Automatic enrollment. Employees are automatically enrolled

in an employer’s retirement plan upon eligibility but have the

right to opt out at any time. In the case of defined contribution plans, a default contribution is usually set, but employees may choose to contribute a different percentage.
Table 37. Defined benefit plans: Summary of plan provisions, all private industry workers, National Compensation Survey, 2003

Plan provisions All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Benefits based on earnings ................... 52 58 43 57 46 55 32 59 37 60

Benefits with integrated formula ............ 23 28 14 33 19 25 12 27 10 30

Benefits subject to a maximum ............. 20 20 16 34 15 21 15 21 13 23

Early retirement benefits available ........ 84 78 91 95 93 80 76 86 93 79

Disability retirement benefits available .. 74 69 80 89 88 67 72 74 85 68

NOTE: Where applicable, dash indicates no employees in this category or data do not meet publication criteria.

52
Table 38. Defined benefit plans: Eligibility requirements, all private industry workers, National Compensation Survey, 2003

Eligibility requirement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Plan participation available to new

employees ........................................... 94 96 91 98 87 98 95 94 90 97

With minimum age or service

requirements .................................... 79 83 71 90 61 88 80 79 73 83

Service requirement only ............... 29 26 32 30 35 26 29 28 28 29

Less than 1 year ........................ 6 5 7 6 8 5 2 7 8 5

1 year ........................................ 22 21 24 24 26 20 27 21 20 23

Greater than 1 year ................... 1 ( ) 1 () 1 - 1 1 () - 1 () 1 1 ( )

Age 21 ........................................... 47 53 37 57 26 58 44 49 43 50

No service requirement ............. 5 6 3 1 3 5 8 3 4 5

Less than 1 year ........................ 3 3 3 4 2 4 5 2 4 2

1 year ........................................ 38 44 28 52 21 47 30 41 31 42

Greater than 1 year ................... 1 1 () 4 - - 2 - 2 4 -

Other than age 21 ......................... 3 4 2 3 1 () 5 7 2 1 4

No service requirement ............. 1 () 1 1 () - - 1 1 1 () - 1

Less than 1 year ........................ 1 ( ) 1 ( ) 1 () - - 1 1 ( ) 1 ( ) 1 ( ) 1 ( )

1 year ........................................ 3 3 1 3 1 () 4 6 1 1 3

No minimum age or service

requirement ...................................... 15 13 20 8 26 10 15 15 17 14

Plan participation not available to new

employees ........................................... 1 1 1 - 2 1 () - 1 - 1

Not determinable ................................... 5 3 8 2 11 2 5 5 10 2

Average service requirement (in

months) ................................................ 11 11 12 11 11 11 11 11 12 11

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

53
Table 39. Defined benefit plans: Plan sponsor, all private industry workers, National Compensation Survey, 2003

Plan sponsor All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Single employer ................................. 86 96 70 88 75 92 69 92 66 97

Multiemployer group .......................... 14 4 30 12 25 8 31 8 34 3

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

54
Table 40. Defined benefit plans: Primary formula, all private industry workers, National Compensation Survey, 2003

Characteristics

Traditional

Cash

balance

Pension

equity Total

Percent of

terminal

earnings

Percent of

career

earnings

Dollar

amount

formula

Percent of

contribution

formula

All workers ............................................. 77 43 10 17 8 21 2

Worker characteristics

White collar ............................................ 69 47 11 8 2 30 2

Blue collar .............................................. 89 35 8 30 16 9 2

Service .................................................. 87 49 8 19 11 12 1

Full time ................................................. 77 43 9 17 8 21 2

Part time ................................................ 79 35 22 14 9 21 1 ( )

Union ..................................................... 92 25 12 34 21 8 1 ( )

Nonunion ............................................... 69 52 9 8 1 29 3

Average wage less than $15 per hour ... 79 40 10 19 10 19 2

Average wage $15 per hour or higher ... 76 44 10 16 7 22 2

Establishment characteristics

Goods producing ................................... 91 40 6 33 12 8 1

Service producing .................................. 70 44 11 9 6 28 2

1 to 99 workers ...................................... 73 27 6 25 15 24 3

100 workers or more ............................. 78 48 11 14 5 20 2

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do

not meet publication criteria.

55
Table 41. Defined benefit plans: Integration with Social Security, all private industry workers, National Compensation Survey, 2003

Integration with Social Security All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With integrated formula ......................... 23 28 14 33 19 25 12 27 10 30

Step-rate excess1 .............................. 16 19 9 30 9 19 11 18 8 20

Social Security breakpoint ............. 16 19 8 30 7 19 11 17 8 20

Dollar amount breakpoint .............. 2 ( ) 2 () 1 - 1 - - 1 - 1

Offset by Social Security3 .................. 8 9 6 3 10 7 2 9 2 11

Without integrated formula .................... 77 72 86 67 81 75 88 73 90 70

Not covered under Social Security ........ 2 ( ) 2 ( ) 2 () - - 2 ( ) 2 ( ) 2 ( ) 2 ( ) 2 ( )

1 Formula applies lower benefit rate to earnings subject to FICA (Social

Security) taxes or below a specific dollar breakpoint. 2 Less than 0.5 percent. 3 Benefit as calculated by formula is reduced by portion of primary Social

Security payment.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

56
Table 42. Defined benefit plans: Terminal earnings formulas, all private industry workers, National Compensation Survey, 2003

Terminal earnings All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

Flat percent per year of service ............. 48 47 55 64 41 40 49 54 46

Less than 1.00 percent ...................... 7 7 8 9 6 1 8 - 9

1.00–1.24 percent ............................. 5 4 7 10 3 6 5 1 6

1.25–1.49 percent ............................. 1 ( ) 1 () 1 1 1 () - 1 ( ) 1 ( ) 1 ( )

1.50–1.74 percent ............................. 21 22 20 26 19 11 23 24 21

1.75–1.99 percent ............................. 10 8 17 17 8 10 11 24 7

2.00–2.24 percent ............................. 3 3 2 2 3 9 1 3 3

2.25 percent or greater ...................... 1 2 - - 1 3 1 2 1

Percent per year varies ......................... 40 42 31 23 48 43 40 31 43

By service .......................................... 7 7 8 5 8 2 8 8 7

By earnings ....................................... 20 19 14 8 25 20 20 20 20

By age ............................................... 1 1 - 3 - - 1 - 1

By earnings and service .................... 12 15 9 7 15 21 11 3 15

Other ..................................................... 12 11 14 13 12 16 11 14 11

Average flat percent per year of

service ................................................. 1.53 1.55 1.49 1.46 1.57 1.77 1.49 1.79 1.45

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet

publication criteria.

57
Table 43. Defined benefit plans: Definitions of terminal earnings, all private industry workers, National Compensation Survey, 2003

Terminal earnings definition All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

One year ................................................ 1 1 1 () - 1 - 1 1 1

Three years ........................................... 6 5 9 15 3 1 () 8 2 8

Last 3 ................................................. 1 1 - - 1 - 1 1 () 1

High 3 ................................................ 2 1 () 4 5 1 ( ) 1 () 2 1 () 2

Of career ....................................... 2 1 () 4 5 1 ( ) 1 () 2 1 () 2

High consecutive 3 ............................ 4 4 5 11 1 - 5 1 5

Of last 10 ....................................... 2 1 3 3 1 - 2 1 2

Of career ....................................... 2 3 1 7 - - 3 1 () 3

Five years .............................................. 85 89 76 73 90 75 86 74 87

Last 5 ................................................. 1 1 2 3 1 2 1 - 2

High 5 ................................................ 24 26 19 19 26 16 25 10 27

Of last 10 ....................................... 19 21 14 17 19 10 20 10 21

Of career ....................................... 5 5 5 1 6 6 4 - 6

Of other time period ....................... 1 ( ) 1 ( ) 1 () - 1 () - 1 () - 1 ( )

High consecutive 5 ............................ 60 62 55 52 63 58 60 64 58

Of last 10 ....................................... 46 48 44 45 47 42 47 53 45

Of career ....................................... 13 14 11 7 16 15 13 11 14

Of other time period ....................... 1 ( ) 1 () - - 1 () 1 1 () - 1 ( )

Other period .......................................... 5 3 9 6 5 10 5 14 3

Not determinable ................................... 3 1 6 5 2 15 1 10 1

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet

publication criteria.

58
Table 44. Defined benefit plans: Dollar amount formulas, all private industry workers, National Compensation Survey, 2003

Dollar amount formula All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

Flat monthly amount per year of

service ................................................. 78 83 78 79 74 62 87 79 73

Less than $20.00 ............................... 10 3 14 16 1 3 15 8 16

$20.00–$24.99 ................................... 6 5 8 10 - - 10 9 1 ( )

$25.00–$29.99 ................................... 7 7 7 7 8 8 7 10 -

$30.00–$34.99 ................................... 3 1 4 4 - - 4 3 1

$35.00–$39.99 ................................... 9 15 5 2 22 17 5 4 21

$40.00–$44.99 ................................... 11 21 8 10 12 11 11 9 15

$45.00–$49.99 ................................... 13 14 14 21 - 1 ( ) 21 17 5

$50.00–$54.99 ................................... 10 11 10 1 ( ) 27 9 11 14 1

$55.00–$59.99 ................................... 5 7 5 5 5 9 2 2 12

$60.00 or more ................................... 2 1 () 3 3 1 () 5 1 () 2 1

Dollar amount varies ............................. 22 17 22 21 26 38 13 21 27

By service .......................................... 20 12 20 17 26 38 9 21 18

By earnings ........................................ 3 5 2 4 - - 4 1 () 8

Average flat dollar amount per year of

service ................................................. $38.47 $40.47 $37.63 $36.23 $42.53 $46.38 $35.18 $38.60 $38.13

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet

publication criteria.

59
Table 45. Defined benefit plans: Maximum benefit provisions, all private industry workers, National Compensation Survey, 2003

Maximum benefit provisions All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Subject to maximum years of credited

service ................................................. 20 20 16 34 15 21 15 21 13 23

Less than 30 ...................................... 6 7 4 8 3 7 6 6 4 7

30 ...................................................... 3 4 2 10 3 4 4 3 3 3

31–34 ................................................ 1 () 1 1 () - - 1 - 1 1 () 1

35 ...................................................... 8 7 7 13 7 8 4 9 4 10

36–39 ................................................ - - - - - - - - - -

40 ...................................................... 2 2 1 3 1 2 1 2 1 2

Greater than 40 ................................. 1 1 () 1 - 1 1 ( ) 1 () 1 1 1

Not subject to maximum ........................ 69 67 76 54 76 66 77 67 77 66

Not determinable ................................... 11 13 8 12 8 13 8 12 11 11

Average credited service maximum ...... 31.2 30.8 32.1 30.9 32.1 30.9 28.6 31.8 30.2 31.5

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

60
Table 46. Defined benefit plans: Selected age and service requirements for normal retirement,1 all private industry workers, National

Compensation Survey, 2003

Age or service requirement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

No age requirement ........................... 6 9 3 1 2 8 10 5 4 7

Less than 30 years of service ........ 5 8 1 1 1 7 8 4 2 () 7

30 years of service ........................ 1 1 2 - 1 2 2 1 4 2 ( )

Age 55 ............................................... 1 1 1 2 1 1 1 1 1 1

Less than 30 years of service ........ 2 () 1 2 () 1 2 () 1 2 ( ) 2 ( ) 2 () 1

30 years of service ........................ 1 1 1 1 1 1 1 2 () 1 2 ( )

Age 603 ............................................. 7 7 5 7 3 8 5 7 9 5

No service requirement ................. 1 1 2 - 2 1 2 1 1 1

5 years of service .......................... 3 4 2 - 1 5 3 3 6 2

10 years of service ........................ 2 1 2 6 - 2 2 () 2 3 1

Age 623 ............................................. 9 6 13 20 11 8 23 5 15 6

No service requirement ................. 2 2 3 7 4 2 2 2 3 2

5 years of service .......................... 3 2 4 3 3 3 8 1 3 3

10 years of service ........................ 2 1 4 - 4 1 5 1 4 1

Age 653 ............................................. 73 76 68 71 75 71 61 77 59 80

No service requirement ................. 28 33 19 37 18 32 25 29 13 35

5 years of service .......................... 35 36 35 34 39 34 33 36 32 37

10 years of service ........................ 2 1 3 - 1 2 3 2 2 1

Sum of age plus service4 .................. 5 4 8 - 9 4 - 7 8 4

Equals less than 80 ....................... 2 3 - - - 2 - 2 2 () 2

Equals 80 ...................................... 3 1 6 - 8 2 () - 3 8 2 ( )

Equals more than 80 ..................... 1 1 2 - 1 1 - 1 1 1

1 Normal retirement is defined as the point at which the participant could retire

and immediately receive all accrued benefits by virtue of service and earnings,

without reduction due to age. If a plan had alternative age and service

requirements, the earliest age and associated service were tabulated; if one

alternative did not specify an age, it was the requirement tabulated. Some age and

service requirements are not shown separately. 2 Less than 0.5 percent. 3 Includes other service requirements not shown separately.

4 In some plans, participants must also satisfy a minimum age or service

requirement. These plans are also included in the totals for specific age and service

requirements.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

61
Table 47. Defined benefit plans: Availability of lump-sum benefits at retirement, all private industry workers, National Compensation Survey,

2003

Option All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With lump sum available ....................... 48 59 31 43 29 57 48 48 31 57

Full lump sum available ................... 40 49 26 35 24 48 41 40 23 49

Partial lump sum with reduced

annuity ........................................... 7 9 5 7 5 8 8 7 7 7

Other ............................................... 1 1 1 1 1 1 - 1 1 1

No lump sum available .......................... 41 32 55 54 51 37 49 39 53 35

Not determinable ................................... 10 9 14 3 20 6 3 13 16 8

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

62
Table 48. Defined benefit plans: Selected age and service requirements for early retirement,1 all private industry workers, National

Compensation Survey, 2003

Age or service requirement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With early retirement available .............. 84 78 91 95 93 80 76 86 93 79

No age requirement ........................... 1 1 2 () - 1 1 - 1 2 () 1

Less than 30 years of service ........ 2 () 1 - - - 1 - 1 - 1

30 years of service ........................ 2 ( ) 2 ( ) 2 () - 1 - - 2 ( ) 2 ( ) 2 ( )

Less than age 55 ............................... 8 7 10 7 11 6 12 7 14 5

5 years of service .......................... 2 ( ) 2 () - - - 2 () 1 - - 2 ( )

10 years of service ........................ 3 1 5 - 6 1 5 2 5 1

15 years of service ........................ 1 2 2 () - 2 1 - 2 2 () 2

20 years of service ........................ 1 1 2 6 2 1 3 1 3 1

25 years of service ........................ 2 2 2 2 - 3 3 1 4 1

Age 55 ............................................... 68 68 66 86 67 69 53 73 65 70

No service requirement3 ................ 3 3 2 14 1 4 6 2 1 4

5 years of service .......................... 23 26 16 36 15 27 13 26 20 25

10 years of service ........................ 35 31 42 23 45 29 32 35 38 33

15 years of service ........................ 5 5 5 12 5 6 2 () 7 5 6

20 years of service ........................ 2 2 2 2 () 1 3 2 2 1 3

25 years of service ........................ 2 ( ) 2 ( ) 2 () - - 2 ( ) 2 () - - 2 ( )

Age 60 ............................................... 2 1 4 2 () 4 2 3 2 4 1

5 years of service .......................... 1 1 2 - 3 2 () - 1 2 1

10 years of service ........................ 1 2 () 2 - - 1 3 - 2 2 ( )

15 years of service ........................ 2 ( ) 2 ( ) 2 () - 1 2 () 1 2 () 1 2 ( )

Age 62 ............................................... 1 - 2 - 2 - 1 1 1 1

Sum of age plus service4 .................. 3 2 7 1 6 2 3 4 7 2

Equals less than 80 ....................... 1 1 1 1 3 2 () - 1 2 () 2

Equals 80 ...................................... 2 2 () 4 - 1 2 - 2 5 -

Equals more than 80 ..................... 1 2 () 2 - 2 - 3 - 2 2 ( )

Early retirement not available ................ 14 19 7 3 4 18 23 10 6 18

Not determinable ................................... 3 3 2 2 3 2 1 3 1 3

1 Early retirement is defined as the point at which a worker could retire and

immediately receive accrued benefits based on service and earnings, but reduced

for each year prior to normal retirement age. If a plan had alternative age and

service requirements, the earliest age and associated service were tabulated; if one

alternative did not specify an age, it was the requirement tabulated. Many age and

service requirements are not shown separately. 2 Less than 0.5 percent. 3 Where no service requirement is specified for early retirement, the service

required for full vesting, usually 5 years, applies. 4 In some plans, participants must also satisfy a minimum age or service

requirement. These plans are also included in the totals for specific age and service

requirements.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

63
Table 49. Traditional defined benefit plans: Selected age and service requirements for early retirement,1 all private industry

workers, National Compensation Survey, 2003

Age or service requirement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

With early retirement available .............. 98 99 98 97 99 96 99 98 98

No age requirement ........................... 2 ( ) 2 ( ) 2 ( ) 2 () - - 2 ( ) 2 () -

Less than 30 years of service ........ - - - - - - - - -

30 years of service ........................ 2 ( ) 2 ( ) 2 ( ) 2 () - - 2 ( ) 2 () -

Less than age 55 ............................... 10 9 11 13 9 16 9 16 7

5 years of service .......................... 2 () 1 - - 2 () 1 - - 2 ( )

10 years of service ........................ 3 2 6 6 2 6 3 6 2

15 years of service ........................ 1 3 2 () 2 1 - 2 2 () 2

20 years of service ........................ 2 1 2 3 1 4 1 3 1

25 years of service ........................ 2 3 2 - 4 4 2 4 1

Age 55 ............................................... 79 85 70 70 84 65 83 68 87

No service requirement3 ................ 3 3 1 1 4 8 1 1 4

5 years of service .......................... 27 35 17 16 34 17 30 20 32

10 years of service ........................ 39 37 45 47 35 37 40 40 39

15 years of service ........................ 7 7 5 5 7 2 () 9 5 8

20 years of service ........................ 3 3 2 1 4 2 3 1 4

25 years of service ........................ 2 ( ) 2 ( ) 2 () - 2 () 1 - - 2 ( )

Age 60 ............................................... 3 2 3 3 2 5 2 4 2

5 years of service .......................... 1 1 1 3 2 () - 1 1 1

10 years of service ........................ 1 2 () 2 - 1 4 - 2 2 ( )

15 years of service ........................ 1 1 1 1 1 1 2 () 1 2 ( )

Age 62 ............................................... 1 - 2 2 - 1 1 1 1

Sum of age plus service4 .................. 4 2 8 7 3 4 5 7 3

Equals less than 80 ....................... 1 2 1 3 2 () - 2 2 () 2

Equals 80 ...................................... 2 2 () 5 1 3 - 3 5 -

Equals more than 80 ..................... 1 2 () 2 2 - 4 - 2 2 ( )

Early retirement not available ................ 1 1 1 2 2 () 3 1 1 1

Not determinable ................................... 1 2 () 1 2 () 1 2 2 () 1 2 ( )

1 Early retirement is defined as the point at which a worker could retire

and immediately receive accrued benefits based on service and earnings, but

reduced for each year prior to normal retirement age. If a plan had alternative

age and service requirements, the earliest age and associated service were

tabulated; if one alternative did not specify an age, it was the requirement

tabulated. Many age and service requirements are not shown separately. 2 Less than 0.5 percent. 3 Where no service requirement is specified for early retirement, the

service required for full vesting, usually 5 years, applies. 4 In some plans, participants must also satisfy a minimum age or service

requirement. These plans are also included in the totals for specific age and

service requirements

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category or data do

not meet publication criteria.

64
Table 50. Defined benefit plans: Early retirement reductions,1 all private industry workers, National Compensation Survey, 2003

Early retirement reduction All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Uniform percentage of reduction2 ......... 40 35 48 28 53 33 54 36 46 37

Reduction varies by age3 or service ...... 34 35 33 31 30 36 19 38 35 33

Actuarial reduction ................................. 18 22 13 18 12 21 13 19 13 21

Other reduction4 .................................... 1 2 - - - 1 5 () 1 - 2

Not determinable ................................... 7 6 6 23 5 8 14 5 7 7

1 Reduction for each year prior to normal retirement. 2 In specific cases, uniform percentage reductions may approximate actuarial

reductions, such as early retirement at age 55 with a reduction of 6 percent per year

between age 55 and the plan’s normal retirement age of 62. 3 The rate of reduction is held constant within age brackets, but differs among

brackets, sometimes in approximation of an actuarial table. For example, benefits

may be reduced by 6 percent for each year between age 60 and the plan’s normal

retirement age, and by 3 percent for each year retirement precedes age 60. Also

includes some plans that reduce benefits arithmetically for each year immediately

below normal retirement age and actuarially below a specified age, usually 55. 4 Reduced amount was not derived from normal retirement formula. 5 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

65
Table 51. Traditional defined benefit plans: Early retirement reductions,1 all private industry workers, National Compensation

Survey, 2003

Early retirement reduction All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

Uniform percentage of reduction2 ......... 42 38 48 52 35 58 37 46 39

Reduction varies by age3 or service ...... 37 39 35 32 40 21 41 35 38

Actuarial reduction ................................. 15 18 12 12 17 7 18 12 17

Other reduction4 .................................... 1 2 - - 2 5 () 1 - 2

Not determinable ................................... 5 3 5 4 6 14 3 7 4

1 Reduction for each year prior to normal retirement. 2 In specific cases, uniform percentage reductions may approximate

actuarial reductions, such as early retirement at age 55 with a reduction of 6

percent per year between age 55 and the plan’s normal retirement age of 62. 3 The rate of reduction is held constant within age brackets, but differs

among brackets, sometimes in approximation of an actuarial table. For

example, benefits may be reduced by 6 percent for each year between age

60 and the plan’s normal retirement age, and by 3 percent for each year

retirement precedes age 60. Also includes some plans that reduce benefits

arithmetically for each year immediately below normal retirement age and

actuarially below a specified age, usually 55. 4 Reduced amount was not derived from normal retirement formula. 5 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. 

Where applicable, dash indicates no employees in this category or data do

not meet publication criteria.

66
Table 52. Defined benefit plans: Initiation of disability retirement benefits, all private industry workers, National Compensation Survey, 2003

Characteristics All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With disability retirement available ........ 74 69 80 89 88 67 72 74 85 68

Benefits begin:

Immediately1 ................................. 47 40 59 49 65 39 55 45 64 38

Deferred ........................................ 23 25 18 27 19 24 14 26 16 26

Not determinable ........................... 4 4 3 12 4 4 3 4 5 3

Disability coverage not available ........... 15 17 13 4 5 20 20 13 10 18

Not determinable ................................... 11 14 8 7 7 13 8 12 5 14

1 Immediate disability pensions may be supplemented by additional allowances

until an employee reaches a specified age or becomes eligible for Social Security.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

67
Table 53. Defined benefit plans: Postretirement survivor benefits, all private industry workers, National Compensation Survey, 2003

Survivor benefit All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With postretirement survivor benefits .... 99 99 100 93 99 99 100 99 99 99

Joint-and-survivor annuity1 ................ 95 97 93 92 90 98 100 94 92 97

50 percent only .............................. 26 20 33 30 20 28 34 23 35 20

51–99 percent only ........................ 4 3 6 1 7 2 - 5 6 2

100 percent only ............................ 1 2 1 - 1 2 3 1 2 () 2

Retiree choice of percentages ....... 63 71 52 57 62 64 61 64 49 71

Not determinable ........................... 2 2 1 3 2 () 2 2 1 2 2

Percent of accrued benefit ................ 4 2 7 1 9 1 - 5 6 2

No postretirement survivor benefits ....... 1 1 2 () 7 1 1 2 () 1 1 1

1 An annuity that provides income during the lifetime of both the retiree and the

surviving spouse. The accrued pension will usually be actuarially reduced at

retirement because of the longer time that payments are expected to be made. 

Employees and their spouses are required to waive the spouse annuity in writing if

they desire either a pension during the employee’s lifetime only or another option

offered by the plan, such as guarantee of payment for a specified period.

2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

68
Table 54. Defined benefit plans: Preretirement survivor benefits, all private industry workers, National Compensation Survey, 2003

Survivor benefit All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With preretirement survivor benefits1 .... 96 95 97 97 97 96 96 96 98 95

Equivalent to joint-and-survivor

annuity2 ............................................ 82 79 88 85 89 79 76 84 91 77

50 percent of employee’s

pension ........................................ 59 56 63 69 62 58 54 61 72 53

Other percent of employee’s

pension3 ....................................... 3 2 3 2 3 2 2 3 1 3

Employee choice of percent .......... 19 19 19 14 20 18 20 18 16 20

Percent of accrued benefit ................ 12 15 8 5 7 15 19 10 5 16

Other4 ................................................ 1 1 1 7 1 2 1 2 2 1

No preretirement survivor benefits ........ 2 3 1 5 () 2 2 2 2 1 3

Not determinable ................................... 2 2 2 3 1 2 2 2 1 2

1 Survivor annuity is based upon the benefit the employee would have received

if retirement had occurred on the date of death. 2 The spouse annuity is computed as if the employee had retired with a

joint-and-survivor annuity. That is, the accrued pension is first reduced because of

the longer time that payments were expected to be made to both the retiree and the

surviving spouse. The spouse’s share is then the specified percentage of the

reduced amount. 3 Other percentages range from 51 percent to 100 percent of the retiree’s

pension. 4 Includes annuity based on a dollar amount formula or a percentage of

earnings. 5 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

69
Table 55. Defined benefit plans: Vesting requirements, all private industry workers, National Compensation Survey, 2003

Vesting requirement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Immediate full vesting ............................ 5 4 6 2 9 3 1 () 6 8 3

Cliff vesting2 .......................................... 81 85 74 89 67 88 82 81 75 85

With full vesting:

 At any age3 .................................... 81 84 74 89 65 88 82 80 75 84

Less than 5 years ...................... 1 1 1 4 1 1 1 () 1 1 1

5 years ....................................... 77 81 70 83 65 83 76 77 66 83

10 years ..................................... 1 1 2 1 () - 2 5 1 () 3 1 ( )

Other ................................................. 1 1 1 () - 1 1 () - 1 - 1

Graded vesting4 .................................... 9 6 14 3 16 5 14 7 13 6

Not determinable ................................... 5 5 6 7 9 4 4 6 4 6

1 Less than 0.5 percent. 2 Under a cliff-vesting schedule, an employee is not entitled to any benefits

accrued under a pension plan until satisfying the requirement for 100-percent

vesting. 3 Includes other service requirements not shown separately. 4 Graded vesting schedules give an employee rights to a gradually increasing

share of pension benefits determined by years of service, eventually reaching

100-percent vesting status.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

70
Table 56. Defined benefit plans: Provisions for early receipt of deferred vested benefits, all private industry workers, National Compensation

Survey, 2003

Early retirement provision All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Immediate .............................................. 17 24 8 13 8 22 23 16 8 23

Early retirement ..................................... 66 60 75 76 71 64 59 69 72 63

Reduction same as early retirement .. 52 46 61 65 59 49 41 56 58 49

Reduction not the same as early

retirement ......................................... 7 7 8 2 6 7 10 6 9 6

Not determinable ............................... 7 7 6 9 6 8 8 7 5 8

Normal retirement .................................. 12 12 13 9 16 11 13 12 17 10

Not determinable ................................... 4 4 4 2 5 3 6 3 3 4

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

71
Table 57. Traditional defined benefit plans: Provisions for early receipt of deferred vested benefits, all private industry workers,

National Compensation Survey, 2003

Early retirement provision All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100

Immediate .............................................. 3 3 2 3 3 6 2 3 2

Early retirement ..................................... 79 77 81 76 81 74 81 76 81

Reduction same as early retirement .. 65 62 67 63 66 55 67 61 67

Reduction not the same as early

retirement ......................................... 9 10 9 7 10 13 8 10 8

Not determinable ............................... 6 5 5 7 5 5 6 5 6

Normal retirement .................................. 14 15 14 17 12 12 14 17 12

Not determinable ................................... 4 6 3 4 4 8 3 3 5

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet

publication criteria.

72
Table 58. Cash balance plans: Percentage basis of employer and interest rate contributions, all private industry

workers, National Compensation Survey, 2003

Basis of contributions All workers White collar

occupations

Service

producing

industries

Establishment size

Nonunion 1 to 99

workers

100 workers

or more

Employer contribution

Total ...................................................... 100 100 100 100 100 100

Flat percent ........................................... 13 12 10 - 17 13

Percent based on1 ................................. 87 87 89 100 81 87

Social Security wage base .............. 8 7 7 - 11 8

Age ................................................. 62 65 64 71 59 63

Service ............................................ 58 61 59 52 61 62

Earnings .......................................... 24 23 23 5 31 25

Not determinable ................................... 1 1 1 - 1 1

Interest rate contribution

Total ...................................................... 100 100 100 100 100 100

U.S. Government securities .................. 61 62 58 42 68 66

Flat percent ........................................... 21 18 23 45 12 15

Schedule of percents ............................. 2 3 3 - 3 3

Other ..................................................... 4 3 4 4 3 3

Not determinable ................................... 12 13 13 9 14 13

Average flat percent .............................. 4.6 5.0 5.2 - 4.6 4.9

1 The characteristics listed below are not mutually exclusive. For

example, a plan may be based on age and service.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this

category or data do not meet publication criteria.

73
Table 59. Defined contribution plans: Participation in types of plans with employer contributions, all private industry workers, National

Compensation Survey, 2003

Characteristics Savings

and thrift

Deferred

profit

sharing

Employee

stock

ownership

Money

purchase

pension

Stock

bonus

Simplified

employee

pension

Savings

incentive

match

plan

Other

Salary

reduction

with

employer

contributions

All workers ............................................. 70 21 5 11 1 ( ) 2 4 1 86

Worker characteristics

White collar ............................................ 69 21 6 12 1 ( ) 3 4 1 86

Blue collar .............................................. 69 26 3 8 1 ( ) 2 3 2 86

Service .................................................. 74 15 3 11 - 1 4 1 82

Full time ................................................. 70 22 5 11 1 ( ) 2 4 1 87

Part time ................................................ 65 17 6 12 1 () 3 6 1 ( ) 78

Union ..................................................... 70 12 2 21 - - 1 ( ) 1 78

Nonunion ............................................... 70 23 5 10 1 ( ) 3 5 1 87

Average wage less than $15 per hour ... 70 22 6 9 1 ( ) 1 5 1 85

Average wage $15 per hour or higher ... 70 21 4 12 1 ( ) 3 3 1 86

Establishment characteristics

Goods producing ................................... 71 25 3 9 1 ( ) 1 2 2 90

Service producing .................................. 69 20 6 12 1 ( ) 3 5 1 84

1 to 99 workers ...................................... 60 25 3 8 - 5 10 1 78

100 workers or more ............................. 76 19 6 13 1 ( ) 1 ( ) 1 ( ) 2 91

1 Less than 0.5 percent.

NOTE: Where applicable, dash indicates no employees in this category or data do not meet publication criteria.

74
Table 60. Savings and thrift plans: Summary of provisions, all private industry workers, National Compensation Survey, 2003

Provision All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Automatic enrollment feature ................ 5 5 6 1 7 3 2 6 3 5

Pretax contributions allowed ................. 97 98 96 98 97 98 97 98 95 98

Transfer/rollover contributions allowed .. 79 80 76 77 74 81 83 77 71 80

Employee choice of investments for

employee contributions ........................ 86 88 81 80 80 88 81 88 79 86

Employee choice of investments for

employer contributions ......................... 72 75 69 68 65 75 69 74 65 73

Immediate full vesting ............................ 21 21 22 12 20 21 19 22 18 21

NOTE: Where applicable, dash indicates no employees in this category or data do not meet publication criteria.

75
Table 61. Savings and thrift plans: Plan sponsor, all private industry workers, National Compensation

Survey, 2003

Characteristics Total Single employer Multiemployer

group

Employer

association

All workers ............................................. 100 99 1 1 ( )

Worker characteristics

White collar ............................................ 100 99 1 ( ) 1 ( )

Blue collar .............................................. 100 96 4 -

Service .................................................. 100 100 1 () -

Union ..................................................... 100 92 8 -

Nonunion ............................................... 100 99 1 ( ) 1 ( )

Establishment characteristics

Goods producing ................................... 100 96 4 -

Service producing .................................. 100 99 1 ( ) 1 ( )

1 to 99 workers ...................................... 100 99 1 () 1

100 workers or more ............................. 100 98 2 -

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in

this category or data do not meet publication criteria.

76
Table 62. Savings and thrift plans: Transfer and rollover provisions,1 all private industry workers, National Compensation Survey, 2003

Rollover availability All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Transfers/rollovers allowed ................... 79 80 76 77 74 81 83 77 71 80

Transfers/rollovers not allowed ............. 3 2 4 5 4 3 4 3 2 3

Not determinable ................................... 18 18 20 17 22 17 14 21 27 17

1 Participants are allowed to transfer/rollover contributions and earnings from a

previous employer’s plan.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

77
Table 63. Savings and thrift plans: Maximum employee contributions,1 all private industry workers, National Compensation Survey, 2003

Maximum employee

contribution

All

workers

Occupational group Industry Establishment size

Union Nonunion

Average

wage

less

than $15

per hour

Average

wage

$15 per

hour or

higher

White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ................................... 100 100 100 100 100 100 100 100 100 100 100 100

Percentage of employee

earnings ....................... 59 57 63 66 60 59 52 63 70 58 60 59

Less than 10

percent ..................... 1 1 1 4 1 1 - 2 2 () 1 1 1

10 percent .................. 2 2 2 2 () 2 2 2 2 2 2 2 2

11 percent .................. 2 ( ) 2 () - - - 2 () 1 - - 2 ( ) 2 ( ) 2 ( )

12 percent .................. 1 1 2 1 2 1 1 1 2 () 2 2 1

13-14 percent ............. 1 1 2 () - 1 2 ( ) 2 () 1 2 () 1 1 1

15 percent .................. 25 24 25 32 23 26 28 24 20 26 25 25

16 percent .................. 6 6 7 1 8 5 4 7 13 5 3 8

17 percent .................. 2 1 3 3 4 1 1 2 2 () 2 2 2

18 percent .................. 2 3 2 1 3 2 2 () 3 3 2 3 2

19 percent .................. 2 ( ) 2 () 1 - - 1 1 2 () 3 2 ( ) 2 () 1

20 percent .................. 7 6 9 10 9 6 2 10 12 6 9 6

Greater than 20

percent ..................... 11 11 11 14 6 13 11 12 17 11 13 11

Specified dollar

amount ......................... 1 1 1 2 () 2 2 ( ) 2 () 1 2 1 1 1

Up to Internal Revenue

Code limit ..................... 39 41 37 31 38 39 47 34 26 40 39 39

Not determinable ........... 1 1 2 () 2 1 1 2 () 1 2 1 1 1

Average3 maximum

contribution (percent of

earnings) .......................... 17.2 17.2 17.4 16.9 16.8 17.3 17.1 17.3 18.7 17.0 17.4 17.0

1 Includes contributions that are not matched by the employer. If maximum

contributions vary, such as by length of service, the highest possible contribution

was tabulated.

2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude workers

without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

78
Table 64. Savings and thrift plans: Method of determining employee pretax contribution, all private industry workers, National Compensation

Survey, 2003

Method of pretax contribution All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Pretax contributions allowed ............. 97 98 96 98 97 98 97 98 95 98

All contributions must be pretax .... 58 57 58 61 62 56 67 53 48 59

At option of employee, all

contributions ................................ 37 39 34 30 31 39 27 42 45 36

At option of employee, up to

specified amount .......................... 2 1 4 1 () 3 1 1 2 2 2

Initial contributions must be pretax;

additional contributions cannot be

pretax ........................................... 1 () 1 1 () - 1 ( ) 1 ( ) 1 ( ) 1 () - 1 ( )

Pretax allowed, options unknown .. 1 1 ( ) 1 () 6 1 () 1 2 1 () - 1

No pretax contributions allowed ........ 1 ( ) 1 ( ) 1 () - - 1 () 1 1 () - 1 ( )

Not determinable ............................... 2 2 4 2 3 2 3 2 5 2

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

79
Table 65. Savings and thrift plans: Maximum pretax employee contributions,1 all private industry workers, National Compensation Survey,

2003

Maximum pretax contribution All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Percent of employee earnings ............... 61 59 63 66 60 61 52 65 73 59

Less than 10 percent ......................... 2 1 1 4 1 2 2 () 2 1 2

10 percent ......................................... 2 3 2 1 2 2 2 2 2 2

12 percent ......................................... 1 1 2 1 3 1 1 1 2 () 1

13–14 percent ................................... 1 1 2 () - 1 2 ( ) 2 () 1 2 () 1

15 percent ......................................... 25 25 26 29 24 26 28 24 18 26

16 percent ......................................... 6 6 7 1 8 5 4 7 13 5

17 percent ......................................... 1 1 1 2 3 1 1 2 - 1

18 percent ......................................... 2 2 2 1 2 2 2 () 3 3 2

Greater than 18 percent .................... 19 17 21 24 16 20 14 21 34 17

Amount not determinable .................. 1 1 2 () 2 1 1 2 () 1 2 1

Specified dollar amount ......................... 1 1 1 2 () 2 2 ( ) 2 () 1 2 1

Up to Internal Revenue Code limit ........ 38 40 36 27 38 38 45 34 25 39

Option unknown .................................... 1 2 ( ) 2 () 6 2 () 1 2 2 () - 1

Average3 maximum pretax contribution

(percent of earnings) ............................ 17.0 17.0 17.1 16.9 16.6 17.2 17.1 17.0 18.7 16.8

1 Includes contributions that are not matched by the employer. If maximum

contributions vary, such as by length of service, the highest possible contribution

was tabulated.

2 Less than 0.5 percent. 3 The average is presented for all covered workers; averages exclude workers

without the plan provision.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

80
Table 66. Savings and thrift plans: Method of employer matching contributions, all private industry workers, National

Compensation Survey, 2003

Characteristics Total Specified

matching

percent1

Varies by

service

Varies by

amount of

contribution

Varies by

profit level Other Notdeterminable

All workers ............................................. 100 67 3 11 2 13 4

Worker characteristics

White collar ............................................ 100 69 3 10 1 13 4

Blue collar .............................................. 100 67 3 13 2 12 4

Service .................................................. 100 57 3 11 7 21 2 ( )

Union ..................................................... 100 64 5 5 1 14 11

Nonunion ............................................... 100 68 3 11 2 13 3

Establishment characteristics

Goods producing ................................... 100 62 3 11 3 14 7

Service producing .................................. 100 69 3 10 2 13 3

1 to 99 workers ...................................... 100 63 3 14 3 15 2

100 workers or more ............................. 100 70 3 9 1 12 5

1 Plans in which the employer matches a specified percentage of

employee contributions. For example, the employer matches 50

percent of employee earnings up to 6 percent. 2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this category

or data do not meet publication criteria.

81
Table 67. Savings and thrift plans: Employee contributions by employer specified matching percentage, all private industry workers,

National Compensation Survey, 2003

Specified matching percentage

and employee contribution

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ......................................... 100 100 100 100 100 100 100 100 100 100

Less than 2 percent ............ 1 1 () 2 1 () 1 1 1 1 () - 1

2 percent ............................ 5 4 8 12 8 5 5 6 7 5

3 percent ............................ 11 10 13 23 9 12 15 9 8 12

4 percent ............................ 18 18 19 14 15 19 19 17 14 18

5 percent ............................ 14 17 8 7 9 15 7 17 3 15

6 percent ............................ 41 42 40 36 42 41 39 42 62 39

Greater than 6 percent ....... 9 8 11 4 17 6 11 7 6 9

1–49 percent employer match

 Total employee contribution ... 18 16 25 6 27 15 23 15 16 18

Less than 2 percent ............ 1 ( ) 1 () - 1 () - 1 () - 1 () - 1 ( )

2 percent ............................ 1 ( ) 1 () 1 1 () 1 1 () - 1 - 1

3 percent ............................ 1 1 1 () 1 1 1 () 1 1 ( ) 1 () 1

4 percent ............................ 3 3 5 1 2 3 5 2 2 3

5 percent ............................ 2 2 3 1 5 2 2 2 - 3

6 percent ............................ 9 8 14 3 18 6 10 9 12 9

Greater than 6 percent ....... 2 2 3 1 () 1 3 5 1 2 2

50 percent employer match

 Total employee contribution ... 35 35 31 39 43 32 37 34 33 35

2 percent ............................ 2 1 5 4 6 1 2 2 7 2

3 percent ............................ 3 3 3 2 5 2 5 2 1 3

4 percent ............................ 7 8 6 7 5 8 9 6 2 8

5 percent ............................ 2 2 2 4 1 () 3 2 3 1 () 3

6 percent ............................ 16 18 11 19 17 16 13 18 22 16

Greater than 6 percent ....... 4 4 4 3 10 2 6 3 1 4

51–99 percent employer match

 Total employee contribution ... 11 10 16 1 ( ) 7 12 11 10 32 8

3 percent ............................ 1 1 () 2 1 () - 1 2 1 ( ) 1 () 1

4 percent ............................ 1 1 () 1 1 () 2 1 () - 1 3 1 ( )

5 percent ............................ 2 2 1 - - 2 1 () 3 2 2

6 percent ............................ 6 5 10 - 2 7 9 5 25 4

Greater than 6 percent ....... 1 1 2 - 2 1 - 2 2 1

100 percent employer match

 Total employee contribution ... 36 37 27 51 23 40 27 40 19 38

Less than 2 percent ............ 1 1 () 2 - 1 1 1 1 () - 1

2 percent ............................ 3 2 2 8 1 3 3 3 1 3

3 percent ............................ 7 6 7 20 3 9 8 7 6 7

4 percent ............................ 7 7 8 6 6 7 5 8 8 7

5 percent ............................ 7 10 1 2 4 8 3 9 1 () 8

6 percent ............................ 9 10 5 14 4 11 7 10 3 10

Greater than 6 percent ....... 1 1 1 1 3 1 () - 2 1 1

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet

publication criteria.

82
Table 68. Savings and thrift plans: Investment choices, all private industry workers, National Compensation Survey, 2003

Investment choice All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Employee contributions

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Total with investment choice allowed1 .. 86 88 81 80 80 88 81 88 79 86

Company stock .................................. 29 32 24 20 20 32 17 35 38 27

Other common stock fund ................. 46 49 43 31 37 49 32 54 54 45

Fixed interest securities or

investments ...................................... 44 46 42 38 37 47 31 52 57 43

Diversified investments ..................... 48 49 46 46 40 51 37 54 51 48

Other2 ................................................ 15 16 14 9 8 17 13 16 17 14

Not determinable ............................... 3 3 2 - 5 2 3 2 4 2

No choice of investment ........................ 2 2 2 4 2 2 4 1 - 2

Not determinable ................................... 13 10 17 16 19 10 15 11 21 11

Employer contributions

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

Total with investment choice allowed1 .. 72 75 69 68 65 75 69 74 65 73

Company stock .................................. 21 23 19 19 17 23 12 27 25 21

Other common stock fund ................. 37 39 34 31 30 40 25 44 40 37

Fixed interest securities or

investments ...................................... 36 38 35 30 31 38 24 43 43 35

Diversified investments ..................... 40 40 37 42 34 42 31 45 37 40

Other2 ................................................ 9 9 10 3 7 9 6 10 8 9

Not determinable ............................... 2 2 2 - 2 2 3 () 2 4 1

No choice of investment ........................ 11 12 10 9 9 12 10 11 13 11

Not determinable ................................... 17 14 21 23 26 13 20 15 22 16

1 Sums of individual items exceed totals because multiple choices are available

to many employees. 2 Includes purchase of U.S. Government securities, life insurance, annuities,

real estate, mortgage, and deposits in credit unions or savings accounts. 3 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where

applicable, dash indicates no employees in this category or data do not meet

publication criteria.

83
Table 69. Savings and thrift plans: Eligibility requirements, all private industry workers, National Compensation Survey, 2003

Eligibility requirement All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100 100 100

With minimum age or service

requirement .......................................... 80 79 80 93 70 84 88 76 72 81

Service requirement only ................... 31 34 28 17 25 33 31 31 35 30

3 months or less ............................ 10 10 12 2 12 9 10 10 6 10

6 months ........................................ 4 5 2 5 1 5 6 3 2 4

1 year ............................................ 16 18 13 10 12 18 16 17 26 15

Greater than 1 year ....................... 1 1 1 ( ) 1 () - 1 - 1 1 () 1

Age 21 ............................................... 39 36 36 68 28 43 46 35 28 40

No service requirement ................. 2 3 1 2 1 () 3 3 2 1 () 2

1–11 months .................................. 9 7 10 20 10 9 10 9 13 9

1 year ............................................ 28 26 25 46 18 31 34 24 15 29

Greater than 1 year ....................... 1 ( ) 1 () - 1 () - 1 () - 1 ( ) 1 ( ) 1 ( )

Other than age 21 ............................. 10 8 17 8 18 8 11 10 8 11

No service requirement ................. 1 1 1 ( ) 1 ( ) 1 () 1 1 1 1 () 1

1–11 months .................................. 4 3 6 1 () 6 3 4 4 4 4

1 year ............................................ 5 3 10 7 11 3 6 5 4 6

No minimum age or service

requirement .......................................... 15 17 14 5 20 13 9 18 16 15

Not determinable ................................... 5 4 7 2 9 3 2 6 12 4

Average service requirement (in

months) ................................................ 9.1 9.1 8.7 9.6 8.3 9.3 9.1 9.0 9.1 9.1

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

84
Table 70. Savings and thrift plans: Automatic enrollment requirements, all private industry workers, National Compensation Survey, 2003

Automatic enrollment

requirement

All

workers

Occupational group Industry Establishment size

Union Nonunion White

collar

Blue

collar Service Goodsproducing

Service

producing

1 to 99

workers

100

workers or

more

Total ...................................... 100 100 100 100 100 100 100 100 100 100

Default method based on

percentage ........................... 4 4 5 1 7 3 1 5 3 4

0.01–1.99 ...................... 1 ( ) 1 ( ) 1 ( ) 1 () - 1 () - 1 () 1 1 ( )

2.00–2.99 ...................... 1 1 2 1 () 3 1 ( ) 1 () 1 - 1

3.00–3.99 ...................... 2 2 2 1 () 3 2 1 3 2 2

4.00 or greater ............... 1 () 1 1 ( ) 1 () 1 1 ( ) 1 () 1 - 1 ( )

Method not determinable ...... 1 1 1 - 1 1 1 1 1 () 1

Not required .......................... 91 92 87 91 85 93 94 89 85 91

Not determinable ................... 5 3 7 8 8 4 4 5 12 4

Average percentage .............. 2.8 3.0 2.6 1.9 2.9 2.7 3.0 2.8 2.6 2.9

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data do not meet publication

criteria.

85
Table 71. Savings and thrift plans: Vesting provisions, all private industry workers, National Compensation

Survey, 2003

Characteristics Total Immediate

full vesting Cliff vesting1 Gradedvesting2

Not

determinable

All workers ............................................. 100 21 18 54 8

Worker characteristics

White collar ............................................ 100 21 20 51 8

Blue collar .............................................. 100 22 15 55 9

Service .................................................. 100 12 8 76 4

Union ..................................................... 100 18 27 48 7

Nonunion ............................................... 100 21 17 55 8

Establishment characteristics

Goods producing ................................... 100 20 15 55 11

Service producing .................................. 100 21 19 54 7

1 to 99 workers ...................................... 100 19 16 55 11

100 workers or more ............................. 100 22 19 53 6

1 Under cliff vesting, an employee is not entitled to any

benefits until satisfying requirements for 100 percent vesting. 2 Under graded vesting, an employee’s rights to benefits

increase with length of service, eventually reaching 100

percent.

NOTE: Because of rounding, sums of individual items may not

equal totals. Where applicable, dash indicates no employees in

this category or data do not meet publication criteria.

86
Table 72. Deferred profit-sharing plans: Employer contribution, all private industry workers,

National Compensation Survey, 2003

Characteristics Total Based on

stated formula

No stated

formula

Not

determinable

All workers ............................................. 100 65 30 5

Worker characteristics

White collar ............................................ 100 63 33 5

Blue collar .............................................. 100 67 26 7

Nonunion ............................................... 100 64 31 6

Establishment characteristics

Goods producing ................................... 100 60 30 10

Service producing .................................. 100 66 30 3

1 to 99 workers ...................................... 100 57 35 8

100 workers or more ............................. 100 71 26 2

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no

employees in this category or data do not meet publication criteria.

87
Table 73. Deferred profit-sharing plans: Allocation of employer contributions to individual

employee accounts, all private industry workers, National Compensation Survey, 2003

Characteristics Total Proportional

to earnings

Other

allocation

formula1

Not

determinable

All workers ............................................. 100 60 28 12

Worker characteristics

White collar ............................................ 100 57 29 14

Blue collar .............................................. 100 66 25 9

Nonunion ............................................... 100 62 26 12

Establishment characteristics

Goods producing ................................... 100 63 29 8

Service producing .................................. 100 59 27 14

1 to 99 workers ...................................... 100 63 24 13

100 workers or more ............................. 100 58 31 11

1 Includes other allocation formulas such as plans

based on employee contributions, employee earnings

and service, or shares distributed equally.

NOTE: Because of rounding, sums of individual items

may not equal totals. Where applicable, dash

indicates no employees in this category or data do not

meet publication criteria.

88
Table 74. Deferred profit-sharing plans: Eligibility requirements, all private industry workers, National Compensation

Survey, 2003

Eligibility requirement All

workers

Occupational group Industry Establishment size

Nonunion White

collar

Blue

collar

Goods

producing

Service

producing

1-99

workers

100

workers

or more

Total ...................................................... 100 100 100 100 100 100 100 100

With minimum age or service

requirement .......................................... 85 85 83 77 89 96 75 87

Service requirement only ................... 22 28 11 15 25 23 21 24

3 months or less ............................ 4 6 1 () 3 4 5 3 4

6 months ........................................ 1 2 1 () - 2 1 2 1

1 year ............................................ 17 20 10 12 19 17 17 18

Greater than 1 year ....................... 1 ( ) 1 ( ) 1 ( ) 1 () - - 1 ( ) 1 ( )

Age 21 ............................................... 50 49 50 31 58 55 44 50

1–11 months .................................. 9 8 11 13 7 12 6 8

1 year ............................................ 40 40 40 18 49 43 37 41

Greater than 1 year ....................... 1 1 - - 1 1 1 1

Other than age 21 ............................. 13 8 22 31 6 17 10 14

1–11 months .................................. 3 2 3 7 1 1 4 3

1 year ............................................ 11 6 19 24 5 16 6 11

No minimum age or service

requirement .......................................... 7 4 14 19 2 4 11 5

Not determinable ................................... 8 10 3 4 9 1 ( ) 14 8

Average service requirement (in

months) ................................................ 10.7 10.7 10.8 9.7 11.1 10.7 10.8 10.8

1 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal totals. Where applicable, dash indicates no employees in this category or data

do not meet publication criteria.

89
Table 75. Money purchase pension plans: Employer contributions, all private industry workers, National

Compensation Survey, 2003

Employer contribution All workers

Whitecollar

occupations

Serviceproducing

industries

Establishment size

Nonunion 1 to 99

workers

100 workers

or more

Total ...................................................... 100 100 100 100 100 100

Fixed percentage of earnings ............ 67 68 70 66 68 71

Less than 3 percent ....................... 8 5 6 8 8 7

3.00–5.99 ...................................... 35 41 37 46 31 39

6.00–8.99 ...................................... 14 12 15 5 18 13

9.00–11.99 .................................... 7 9 9 4 8 9

12.00 percent or greater ................ 4 1 3 4 3 3

Percentage varies by earnings .......... 4 5 5 - 6 4

Dollar amount per hour worked ......... 8 5 5 20 2 5

Other1 ................................................ 18 21 20 4 24 19

Not determinable ............................... 3 2 ( ) 2 ( ) 10 2 () 2

1 Includes other plans where the percentage of employer

contributions varies by age, service, or a combination of age and

service.

2 Less than 0.5 percent.

NOTE: Because of rounding, sums of individual items may not equal

totals. Where applicable, dash indicates no employees in this

category or data do not meet publication criteria.

90
91

The National Compensation Survey (NCS) health and

retirement series provides information on detailed provisions of medical care, prescription drug, dental, vision, defined benefit, and defined contribution plans. The

portion of the NCS sample from which estimates on employee

benefits are made covers all private sector establishments in

the United States, with the exception of farms and private

households.

Scope of survey

The 2003 NCS data on provisions of healthcare and retirement plans were obtained from 3,030 private industry establishments representing approximately 103 million workers; of

this number, over 79 million were full-time workers, and the

remainder—nearly 24 million—were part-time workers. The

NCS uses the establishment’s definitions of full- and parttime status. For purposes of this survey, an establishment is

an economic unit that produces goods or services, a central

administrative office, or an auxiliary unit providing support

services to a company. The establishment usually is at a

single physical location.

Industry groups

Detailed industries are classified into two broad groups:

Goods producing. These industries include mining, construction, and manufacturing.

Service producing. These industries include transportation,

communications, and public utilities; wholesale trade; retail

trade; finance, insurance, and real estate; and services.

Occupational groups

Narrowly defined occupations selected for study are classified into one of the following three broad occupational

groups.

White collar. This group includes professional, technical,

executive, administrative, managerial, and related occupations; clerical and administrative support occupations; and

sales occupations.

Blue collar. This group includes precision production, craft,

and repair occupations; machine operators and inspectors;

transportation and moving occupations; and handlers,

equipment cleaners, helpers, and laborers.

Service occupations. Included in this group are protective

service, food service, health service, cleaning and building

service, and personal service occupations.

Excluded from the survey are self-employed persons, proprietors, major stockholders, members of a corporate board

who are not otherwise officers of the corporation, volunteers, unpaid workers, family members who are paid token

wages, the permanently disabled, partners in unincorporated

firms, and U.S. citizens working overseas.

Definition of terms

Full-time worker. A full-time worker is any employee that the

employer considers to be full time.

Part-time worker. A part-time worker is any employee that

the employer considers to be part time.

Union worker. An employee is a union worker if all of the

following conditions apply to his or her occupation:

• A labor organization is recognized as the bargaining

agent for all workers in the occupation.

• Wage and salary rates are determined through collective bargaining or negotiations.

• Settlement terms, which must include earnings provisions and may include benefit provisions, are embodied in a signed, mutually binding collective bargaining

agreement.

Nonunion worker. An employee in an occupation not meeting the conditions for union coverage is considered a nonunion worker.

Calculation details

Averages for occupations within an establishment were used

to produce estimates for worker groups with average hourly

pay below $15 and for those averaging $15 and above. Individual workers can fall into an earnings category different

from the average for an occupation and establishment into

which they are classified.

The calculations are not based on actual decisions regarding coverage made by employees within the occupations. For example, in an occupation in which 5 single employees and 5 married employees are participating in a medical plan, the calculations for this table use all 10 employees

in both single and family-coverage computations; the calculations are not based on the assumption that the 5 single

employees have single coverage or that the 5 married employees have family coverage. Rather, the deductible calcuAppendix A. Technical Note
92

lations are based on the assumption that all 10 employees

have identical coverage.

Benefit areas

BLS requests that, for sampled occupations, establishments

provide data on the incidence (defined as the rate of access

to or participation in) and selected details of each of the

following benefit areas: Paid leave; short- and long-term disability benefits; medical, dental, and vision care; prescription drug coverage; life insurance; defined benefit pensions;

and defined contribution plans. Data also are collected on

the incidence of certain other benefits, such as travel accident insurance, nonproduction cash bonuses, childcare,

adoption assistance, long-term-care insurance, flexible workplaces, wellness programs, fitness centers, job-related and

non-job-related educational assistance, and subsidized commuting. Data on incidence and key provisions (such as medical plan premiums for example) are published separately from

data on detailed provisions included in this publication.

BLS field economists also ask respondents to provide

Summary Plan Provision documents for defined benefit pensions; defined contribution plans; and medical, prescription

drug, dental, and vision care plans. BLS analyzes these plans

in Washington to garner the required data on plan provisions. The data in this publication provide the results of this

analysis.

Sample design and data collection

The sample for this survey was selected on the basis of a

three-stage design. The first stage involved the selection of

areas. The NCS sample consists of 152 metropolitan areas

and nonmetropolitan areas that represent the Nation’s 326

Metropolitan Statistical Areas (as defined by the Office of

Management and Budget in 1994) and the remaining portions of the 50 States. Metropolitan areas are either Metropolitan Statistical Areas (MSAs) or Consolidated Metropolitan Statistical Areas (CMSAs), as defined by the Office of

Management and Budget. Nonmetropolitan areas are counties that do not fit the metropolitan area definitions.

In the second stage, the sample of establishments was

drawn from a sampling frame based on State Unemployment

Insurance reports within sampled areas. Each sampling frame

is stratified by sampling cell. A sampling cell consists of an

area or a group of areas by industry. Each sampled establishment was selected within a sampling cell with a probability

proportional to its employment. This technique allows larger

establishments to have a greater chance of being selected

for the sample. Weights were applied to each establishment

when the data were tabulated so that each establishment

represents units in the economy similar to those not selected

for collection.

The third stage of sample selection was a probability

sample of occupations within a sampled establishment. Identifying the occupations for which data were to be collected

involved a four-step process:

1. Probability-proportional-to-size selection of establishment jobs.

2. Classification of jobs into occupations based on the

Census of Population system.

3. Characterization of jobs as full time versus part time,

union versus nonunion, and time versus incentive.

4. Determination of the level of work of each job.

BLS field economists visited sampled establishments or

contacted them by telephone to collect data for the survey.

To reduce the reporting burden, field economists asked respondents to provide Summary Plan Provision documents

for health and retirement plans.

Data calculation

Tabulations in this bulletin show the percentage of all employees who receive specified benefits, as well as information on the provisions of many of these benefits. To present

provision data, tabulations generally indicate the percentage of all employees receiving a benefit (participants) who

are covered by specified features. For example, a tabulation

may show the percentage of workers with medical care benefits who participate in a prepaid plan.

The majority of tables in the bulletin exhibit the percentage of all employees who have access to or are participating

in a particular benefit plan, or the percentage covered by a

specific provision. In addition, average benefit provisions,

such as the average annual deductible in healthcare plans,

are presented. In some cases, tabulations indicate both the

percentage of employees with a given provision and the

average value of that provision. For example, tabulations

indicate the percentage of employees in indemnity plans with

overall limits who must pay selected deductibles (such as

$200, $250, and $300 per year), as well as the average deductible. All tabulations of averages include only those employees actually covered by the provision being averaged.

Survey estimation methods

The survey design uses an estimator that assigns the inverse of each sample unit’s probability of selection as a weight

to the unit’s data at each stage of sample selection. Three

weight-adjustment factors are applied to the data. The first

factor accounts for establishment nonresponse and the second factor for occupational nonresponse. The third,

poststratification, factor is introduced to adjust the estimated

employment totals to actual counts of employment by industry for the survey reference date.

The general form of the estimator for a population total Y

is

∑ ∑ = =

= i o

j ij

ij ij

i

n

i i

i i

p

Y f

p

f f Y

1 1

2 1
93

where

n = number of responding sample establishments;

oi = occupation sample size selected from the ith establishment;

Yij = value for the characteristics of the jth selected occupation in the ith selected establishment;

pi = probability of including the ith establishment in the

sample;

pij = probability of including the jth occupation in the

sample of occupations from the ith establishment;

f 1i= weight adjustment factor for nonresponse for the

ith establishment;

f

ij = weight adjustment factor for nonresponse for the

jth occupation in the ith establishment;

f 2i= weight adjustment factor for poststratification totals

for the ith establishment.

Appropriate employment or establishment totals are used

to calculate the proportion, mean, or percentage that is desired.

Reliability of estimates

The statistics in this bulletin are estimates derived from a

sample of usable occupation quotes selected from the responding establishments. They are not tabulations based

on data from all employees in private establishments within

the scope of the survey. Consequently, the data are subject

to sampling and nonsampling errors.

Sampling errors are the differences that can arise between

results derived from a sample and those computed from observations of all units in the population being studied. When

probability techniques are used to select a sample, statistical

measures called “standard errors” can be calculated to measure possible sampling errors. No estimates of sampling error were calculated for this survey.

Nonsampling errors also affect survey results. They can be

attributed to many sources: Inability to obtain information

about all establishments in the sample; definitional difficulties; differences in the interpretation of questions; inability

or unwillingness of respondents to provide correct information; mistakes in recording or coding data; and other errors

of collection, response, processing, coverage, and estimation for missing data.

Computer edits of the data and professional review of

both individual and summarized data reduce the nonsampling

errors in recording, coding, and processing the data. However, to the extent that the characteristics of nonrespondents

are not the same as those of respondents, nonsampling errors are introduced in the development of estimates.
Table A-1. Number of establishments and occupational observations studied and estimated

number of workers within the scope of the survey, all private industry workers, National

Compensation Survey, 2003

Characteristics

Number of

establishments

studied

Number of

occupational

observations

Estimated number

of workers1

Total ...................................................... 3,030 17,273 103,121,548

Worker characteristics

White-collar occupations ....................... – 10,356 53,418,512

Blue-collar occupations ......................... – 4,771 30,188,280

Service occupations .............................. – 2,146 19,514,756

Full time ................................................. – 14,430 79,285,662

Part time ................................................ – 2,843 23,835,885

Union ..................................................... – 2,349 11,026,514

Nonion ................................................... – 14,924 92,095,034

Average wage less than $15 per hour ... – 8,637 60,125,210

Average wage $15 per hour or more ..... – 8,636 42,996,338

Establishment characteristics

Goods-producing industries .................. 713 4,127 22,720,659

Service-producing industries ................. 2,317 13,146 80,400,888

1 to 99 workers ...................................... 1,333 5,453 55,759,131

100 workers or more ............................. 1,697 11,820 47,362,416

Geographic areas

Metropolitan areas ................................. 2,425 14,085 85,884,975

Nonmetropolitan areas .......................... 605 3,188 17,236,572

New England ......................................... 175 1,033 5,449,205

Middle Atlantic ....................................... 387 2,209 13,752,857

East North Central ................................. 561 3,260 17,489,356

West North Central ................................ 276 1,486 9,272,359

South Atlantic ........................................ 534 3,054 17,949,486

East South Central ................................ 171 953 5,617,726

West South Central ............................... 344 2,005 11,068,657

Mountain ................................................ 210 1,210 6,120,857

Pacific .................................................... 372 2,063 16,401,045

1 Employment estimates are not as precise as

those developed from other BLS surveys with larger

samples and designed specifically for employment

estimates. The employment estimates in this table are

presented only to indicate the approximate size of

various classifications to the whole private economy.

NOTE: Because of rounding, sums of individual items

may not equal totals. Dashes indicate data not

available since establishment counts are not estimated

for worker characteristics.

94
95

Data for the 2003 National Compensation Survey benefits series were collected from December2002 to April 2004, reflecting an average reference

period of 2003. Respondents were asked for the most current

information as of the time of data collection.

The following summary is a composite of establishment

responses to the survey:

Establishments Number

In sample 4,468

Out of business or out of scope 446

Unable or unwilling to respond 992

Responding fully or partially 3,030

The responding establishments yielded 17,273 occupational observations (quotes) for which data were collected.

For establishments unable or unwilling to provide the

minimum amount of usable data, a weight adjustment is made

on the basis of the sample unit employment. This technique

assumes that the mean value of the nonrespondents equals

the mean value of the respondents at some “detailed” cell

level. These cells are defined in a manner that groups together establishments that are homogeneous with respect to

the characteristics of interest. In most cases, the cells are the

same as those used for sample selection.

For establishments unable or unwilling to provide data

for a specific occupation, a similar cell-level approach is used

to make adjustments to the sampled occupation weights in

responding establishments. The characteristics of interest

include the major occupation group of the unreported occupations.

Imputation procedures were used for missing items, such

as participation values, plan provisions, and employee

Appendix B. Survey Response

and employer medical premium values, within responding

occupational observations (quotes).

Four procedures were used to adjust for missing data

from partial and full refusals. Each of these participant values is imputed by selecting a similar plan from another establishment.

First, the percentage of plan participants was imputed in

cases where that number was not reported. Each of these

participant values was imputed by selecting a similar plan

from another occupational observation with usable participation data.

Second, when not available, plan provisions were imputed

by selecting a usable plan from another occupational observation with similar plan characteristics. Provisions from the

selected plan then were used to represent the missing data.

The following tabulation gives the participation imputation

percentages for the various benefit areas:

Benefit area Imputation percentage

Defined benefit 53

Defined contribution 56

Medical care 59

Dental benefits 60

Vision benefits 60

Prescription drugs 59

Finally, imputations for employee and employer medical

premiums were made in cases where one or both of the premium values were not reported for a particular plan. One or

both of the premiums were imputed by selecting usable premium values from another occupational observation with

similar plan characteristics.