Exhibit 4.7: Distribution of Covered Workers Facing PPO In-Network Copayments for Physician Office Visits, 2004-2005

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Exhibit 4.7: Distribution of Covered Workers Facing PPO In-Network Copayments for Physician Office Visits, 2004-2005

More than three-quarters (80%) of covered workers enrolled in PPOs were required to pay copayments for physician office visits with in-network providers in 2005 (see Exhibit 4.6). Most workers who face a copayment pay either $15 or $20 per visit, with almost one in four workers paying $15 (25%). Fewer than one in fifty covered workers (<1%) paid $5 per visit.

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*Distribution is statistically different from previous year shown at p<.05.

‡In calculating the distribution of copayments across all plan types, the copayments applicable to in-network services were used for PPO plans.

Note: The distribution of copayments for physician office visits does not include covered workers who do not have a copayment.

Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits: 2004-2005. From Exhibit 7.8, at http://www.kff.org/insurance/7315/sections/ehbs05-7-8.cfm.

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Trends and Indicators in the Changing Health Care Marketplace
Information provided by the Health Care Marketplace Project.
Publication Number: 7031
Information Updated: 04/26/06