There are regional differences in health plan rates and adoption, but voluntary benefit adoption throughout the country is on the rise, according to Benefitfocus Inc.'s report, "State of Employee Benefits 2018 – Regional Edition." Health plans from preferred provider organizations are the most popular among U.S. employees, according to anonymous employee benefit election data from 540 employers on the BENEFITFOCUS Platform representing 1,281,447 individual consumers. On average, 48 percent choose PPOs while 35 percent choose high deductible health plans, though HDHP offering rates are on the rise, especially in the Midwest and West. Regardless of region, voluntary benefit election is also growing, but gradually, according to the report. Employees are more likely to select just one voluntary accident, critical illness and/or hospital indemnity benefit plan than they are to enroll in multiple plans of this type. "In today's employment environment, where meeting consumer preferences is key, attractive benefits can make the difference between whether a prospective employee accepts a job offer or not," says Benefitfocus CEO Ray August. "This regional data helps employers understand how they stack up against others in their area and how benefit offerings and elections are trending, so they can be more competitive in their own offerings." Here are some notable differences between the regions: The West leads in HSA contributions, corresponding with rising HDHP offerings; since 2016, HDHP offering rates have increased 76 percent in the West. Employers in the West also offer the most choice in voluntary benefits, such as accident, critical illness and/or hospital indemnity insurance. The Midwest leads in HDHP offering and adoption rates. HDHPs are most prevalent in the Midwest, where 70 percent of employers offer them alongside traditional health plans, up from 46 percent in 2016. Employees in the Midwest pay the lowest PPO premiums in the country, at less than $1,500 annually for single coverage. Employees in the Northeast pay the highest premiums, both for PPOs ($1,692 for single coverage) and HDHPs ($1,237). The average employer HSA contribution (single coverage) has increased 10 percent year over year. The South leads in voluntary benefit choice growth, but workers pay the highest deductibles: 28 percent higher than the nationwide average for PPOs and 11 percent higher than the nationwide average for HDHPs. Since 2016, there's been a 138 percent increase in the share of employers offering at least three voluntary benefits, giving Southern employees a greater opportunity to supplement their core medical coverage.