Approximately what percentage of total covered health insurance expenses does out-of-network health care account for?

Study for the Certified Employee Benefit Specialist (CEBS) Group Benefits Associate (GBA) 2 Test. Engage with flashcards and multiple choice questions, each with hints and explanations. Prepare effectively for your exam!

Out-of-network health care usually accounts for approximately 10% of total covered health insurance expenses. This figure reflects the common scenario in which most insured individuals primarily utilize in-network providers due to higher coverage levels and lower out-of-pocket costs related to in-network services. While this percentage can vary depending on the specific health plan and its structure, 10% is a widely accepted average in the industry based on data trends observed in health care utilization.

The choice of 10% highlights the typical reliance on in-network services by insured individuals, as opting for out-of-network care generally leads to higher costs and is less frequently utilized. This can be attributed to both patient preference for affordability and the design of many insurance plans that incentivize using in-network providers for comprehensive coverage.

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