# Group health insurance statistics for 2026

Source: https://www.getprescience.com/guides/group-health-insurance-statistics
Author: Aditya Jain, MD, Cofounder and COO, Prescience
Published: 2026-10-29
Updated: 2026-10-29
Cite as: Aditya Jain, MD. "Group health insurance statistics for 2026." Prescience, October 29, 2026. https://www.getprescience.com/guides/group-health-insurance-statistics

Average employer health insurance premiums reached $9,325 for single coverage and $26,993 for family coverage in 2025, up 5% and 6% in a year, according to KFF. Workers paid $1,440 and $6,850 of that. These are the numbers I use when I talk to founders about health benefits, organized by topic, each with its source: premiums over time, deductibles, who offers coverage, funding, GLP-1s and where costs are heading.

- **Average family premium:** $26,993
- **Average single premium:** $9,325
- **Workers in self-funded plans:** 67%
- **2027 group medical trend:** 9.0%

## Key statistics at a glance

- **$26,993:** average annual family premium for employer coverage, 2025 (KFF).
- **$9,325:** average annual single premium, 2025 (KFF).
- **$6,850:** what the average worker pays toward family coverage each year; **$8,889** at small firms (KFF).
- **$1,886:** 2025 single deductible among workers with a general deductible; **$2,631** at firms with 10–199 workers (KFF).
- **59%:** share of firms with 10–199 workers offering health benefits, vs. **97%** of larger firms (KFF).
- **53.8%:** share of Americans with employment-based coverage in 2024 (Census).
- **9.0%:** PwC's projected group medical cost trend for 2027.

## Premiums in 2025

**Average annual premiums, 2025 (KFF Employer Health Benefits Survey)**

| Group | Single | Family |
| --- | --- | --- |
| All covered workers | **$9,325** | **$26,993** |
| Firms with 10–199 workers | $9,211 | $26,054 |
| Firms with 200+ workers | $9,361 | $27,280 |
| PPO plans | $9,818 | $28,272 |
| High-deductible plans with a savings option | $8,620 | $25,379 |
| Firms where 35%+ of workers are 50 or older | $9,599 | $27,699 |
| Firms where 35%+ of workers earn $80,000+ | $9,600 | $27,957 |

KFF reports similar single premiums across firm sizes but lower family premiums at small firms in this survey. These are weighted averages of covered workers, not quotes for an otherwise identical group. Network, benefit design and enrollment mix differ across categories.

_Chart: Bar chart of average monthly employer health premiums in 2025: $777 single with $657 paid by the employer, and $2,249 family with $1,679 paid by the employer._

## Premiums over time

**Originally published annual premium estimates; 2015–2024 include firms with 3–9 workers, while 2025 does not**

| Year | Single | Family | Family growth that year |
| --- | --- | --- | --- |
| 2015 | $6,251 | $17,545 | 4% |
| 2020 | $7,470 | $21,342 | 4% |
| 2024 | $8,951 | $25,572 | 7% |
| 2025 | $9,325 | $26,993 | 6% |

- KFF's 2025 report puts five-year family premium growth at **26%**, compared with **28.6%** wage growth and **23.5%** inflation.
- It reports ten-year family premium growth of **53%**, compared with **35.8%** inflation.
- Do not recompute those trend percentages by dividing the original older reports in the table. KFF adjusts historical comparisons to the 2025 survey population of firms with at least ten workers.
- Keep both the survey year and population definition with any chart copied into a budget presentation. Rounded figures also need not reproduce every published percentage exactly.

## What workers pay

**Worker contributions, 2025 (KFF)**

| Measure | All firms | Small firms (10–199) | Large firms (200+) |
| --- | --- | --- | --- |
| Share of family premium paid by worker | 26% | 36% | 23% |
| Family contribution per year | $6,850 | $8,889 | $6,227 |
| Covered workers paying $12,000+ for family coverage | 11% | 28% | n/a |
| Covered workers whose employer pays full single premium | n/a | 29% | 7% |
| Worker pays over half the family premium | n/a | 29% | 5% |

Across all firms, workers contribute **16%** of single premiums ($1,440 a year) and **26%** of family premiums ($6,850). Small firms split the extremes: they're more likely to pay all of the single premium and more likely to leave families paying most of theirs.

## Deductibles, out-of-pocket limits and plan types

**KFF 2025: deductible averages exclude workers without a general deductible**

| Measure | Figure |
| --- | --- |
| Average general deductible | **$1,886** |
| At small firms (10–199) | $2,631 |
| At large firms (200+) | $1,670 |
| Growth over 5 years / 10 years | +17% / +43% |
| Covered workers with a deductible of $2,000+ | 34% (53% at small firms, 28% at large) |
| Out-of-pocket limit of $2,000 or less | 12% of covered workers in plans with an out-of-pocket maximum |
| Out-of-pocket limit above $6,000 | 21% of covered workers in plans with an out-of-pocket maximum |

**Enrollment by plan type, 2025 (KFF)**

| Plan type | Share of covered workers |
| --- | --- |
| PPO | 46% |
| High-deductible plan with savings option | 33% |
| HMO | 12% |
| POS | 9% |
| Conventional (indemnity) | under 1% |

## Who offers coverage, by firm size

**Share of firms offering health benefits, 2025 (KFF)**

| Firm size | Offer rate |
| --- | --- |
| 10–24 workers | 51% |
| 25–49 workers | 64% |
| 50–199 workers | 89% |
| All 10–199 | 59% |
| 200–999 workers | 96% |
| 1,000+ workers | over 99% |
| All firms with 10+ workers | 61% (65% in 2024) |

Offer rates describe firms that offer coverage to at least some workers, not universal enrollment. They do not tell you whether a particular employee is eligible, can afford the contribution or uses another source of coverage. Do not combine firm-level offer rates with establishment-level measures from other surveys without checking definitions and the underlying year.

> **Offering health insurance sets a small company apart:** KFF found that 51% of firms with 10–24 workers offered health benefits in 2025. That statement does not cover firms below ten workers. Use it as context for a benefits decision, not as proof that your offer will win a particular candidate.

## How many people have employer coverage

- **53.8%** of Americans had employment-based coverage for some or all of 2024, the most common type, ahead of Medicare (19.1%), Medicaid (17.6%) and direct-purchase coverage (10.7%) (Census).
- **8.0%** lacked health insurance throughout 2024 in the Census CPS ASEC measure. That annual measure is different from being uninsured on a particular day.
- At firms that offer coverage, **80%** of workers are eligible, **76%** of those eligible enroll, and **61%** of all workers end up covered (KFF, 2025).
- Across all firms, **55%** of workers are covered by their own employer's plan, down from 57% a year earlier (KFF).
- **91%** of workers are employed by a firm that offers coverage to at least some workers (KFF).

## Who enrolls when coverage is offered

At offering firms where at least 35% of workers were age 26 or younger, KFF found 39% of workers covered by their employer, versus 64% at other offering firms. At firms where at least 35% earned $37,000 or less, the comparison was 43% versus 64%. These associations do not prove why workers declined coverage or predict enrollment at a particular startup.

Among offering firms, reported own-employer coverage was 72% for public-sector workers, 59% at private for-profit firms and 60% at nonprofits. These figures should not be presented as coverage rates for all workers in each sector, including firms that offer no health benefits.

## The numbers that matter most for small businesses

Small-firm averages highlight different contribution and cost-sharing choices. For family coverage, the premium average was $26,054 at firms with 10–199 workers and $27,280 at larger firms, while worker shares averaged 36% and 23%. Do not multiply those average percentages by the average premiums and label the result the published worker dollar contribution.

I would compare a proposed benefit with these benchmarks across several dimensions. A lower employer contribution may leave families paying more even when total premiums are similar. A deductible average alone does not summarize the whole policy. See [employer contributions](https://www.getprescience.com/guides/how-much-do-employers-pay-for-health-insurance) and [average premium cost](https://www.getprescience.com/guides/average-employee-health-insurance-cost) for examples using explicit assumptions.

## Funding models

- **67%** of covered workers are in self-funded plans; **80%** at firms with 200 or more workers.
- At firms with 10–199 workers: **27%** self-funded and **37%** level-funded.

_Chart: 2025 covered-worker shares in self-funded plans: 67% at all firms with 10+ workers, 80% at firms with 200+ workers and 27% at firms with 10–199 workers._

These survey categories overlap. KFF reports 51% of small-firm covered workers in either a level-funded or self-insured plan; adding 27% and 37% to get 64% would be wrong. Its questions account for respondents who describe level-funded coverage as insured or self-funded. The legal funding arrangement and the respondent's label are not always identical.

The funding shares do not establish that self-funding causes lower deductibles. Employers select their benefit designs separately, and the survey does not isolate a causal effect of financing on employee cost sharing. Compare the actual deductible, copays and maximum in each proposal.

## GLP-1 coverage

**KFF 2025: among firms offering health benefits, reported GLP-1 weight-loss coverage**

| Firm size | Cover for weight loss |
| --- | --- |
| 200–999 workers | 16% |
| 1,000–4,999 workers | 30% |
| 5,000+ workers | 43% (28% in 2024) |

- Among firms with at least 5,000 workers that covered these medicines for weight loss, 59% reported use above expectations and 66% reported a significant effect on prescription-drug spending. Those percentages do not describe all large employers.
- Coverage depends on the exact drug, indication and policy. A diabetes benefit does not establish obesity-treatment coverage. See [GLP-1 coverage decisions](https://www.getprescience.com/guides/should-our-health-plan-cover-glp1s).

## The individual market (relevant to ICHRA)

- Individual-market data describe a different market from employer coverage. Check plan availability by employee location before evaluating an ICHRA.
- A plan-count network share is not an enrollment-weighted share of people. Neither establishes whether an employee's doctor participates.
- Compare premium before assistance, premium after assistance and cost sharing separately. A national premium-change percentage cannot determine a specific employee's net cost.
- Marketplace plan counts and employer enrollment measure different things. Do not treat the chart percentages as employee enrollment shares or as a forecast of the plans available in a particular ZIP code. Confirm current choices using CMS files and the actual policies.

_Chart: CMS 2026 federal-platform plan-county offerings: HMO 44,390 (46%), EPO 32,100 (33%), PPO 14,174 (15%), POS 6,418 (7%), out of 97,082 rows. Rounded shares total 101%; these are not unique nationwide plan or enrollment shares._

_Chart: Marketplace plan selections: bronze rose from 30% in 2025 to 40% in 2026; silver fell from 57% to 43%. These are aggregate selections, not the same individuals switching._

## Where costs are heading

**Projections for employer health costs**

| Projection | 2026 | 2027 |
| --- | --- | --- |
| PwC group medical cost trend | 9.0% (restated in 2027 report) | 9.0% |
| PwC individual market trend | 8.5% (restated in 2027 report) | 8.5% |
| Mercer employer cost per employee | 6.7% | 8.2% after plan changes (11% with none) |

The September 2026 Marsh release on Mercer's site reports preliminary employer expectations, not realized 2027 spending. PwC's medical trend measures expected cost growth before individual employers' specific benefit decisions. Treat both as scenarios for planning rather than direct renewal forecasts. PwC revised its earlier 2026 group estimate upward from 8.5% to 9.0%.

## What the averages mean for a 20-person company

**Applying national averages to one small employer**

Illustrative budgeting exercise, not a quote. Fourteen single and six family enrollees use KFF's 2025 small-firm premium averages, $9,211 and $26,054. Assume the employer pays all single premiums and exactly 64% of each family premium. Apply an arbitrary 8.2% sensitivity increase once to the entire premium total; this is not a forecast translating 2025 directly into 2027.

- Single premiums: 14 × $9,211: $128,954
- Family premiums: 6 × $26,054: $156,324
- Total annual premium: $285,278
- Paid by families (36%): $56,277
- Paid by the company: $229,001
- Company cost per employee: $11,450
- Total premium after one hypothetical 8.2% increase: $308,671

The assumed employer cost is $229,001.36 and the family contribution total is $56,276.64, rounded in the lines above. Each family pays $9,379.44 annually under this formula. That differs from KFF's published $8,889 average because average shares and average dollars are separate measures. The sensitivity raises total premium by $23,392.80 before deciding who pays the increase.

> **Prescience Diamond: A company health plan with an effective $0 deductible.** These averages are what a quote has to beat. Our quotes usually come in 10–20% below comparable fully insured coverage, with an effective $0 deductible instead of the $2,631 small-firm average.
> - **An effective $0 deductible** and simple copays shown before a visit
> - **A broad national PPO network,** plus providers we contract with directly
> - **24/7 physician-led care navigation** that books visits and explains costs
> - **Usually 10–20% below comparable fully insured coverage,** fixed in your quote, with no admin fees
> Best for teams of about 15 or more that want one great group plan. [Get a Diamond quote](https://www.getprescience.com/get-started?p=Employer&product=diamond)

## How to read these numbers

- **Check the denominator.** KFF premium averages weight covered workers, while offer rates describe firms. Neither is automatically an average over every employee in the economy.
- **The 2025 KFF survey excludes firms with 3–9 workers,** so it says little about the smallest companies.
- **Keep household and employer surveys separate.** Census counts people and coverage during the year; KFF surveys employers. People may have more than one coverage type, so Census percentages need not sum to 100%.
- **Projections are not renewals.** PwC and Mercer describe market averages. Your renewal also depends on aging, plan changes and how your plan is priced. See [why did our health insurance renewal go up](https://www.getprescience.com/guides/why-did-our-health-insurance-renewal-go-up).

## Turn statistics into a decision without overstating them

I start a comparison by writing down the question. A company setting its premium contribution needs contribution and enrollment data. A family choosing a plan needs covered service costs, annual payroll deductions and the relevant maximum. A chart about the percentage of employers offering benefits does not answer either question on its own. Select the measure that matches the decision before choosing a statistic because its number looks compelling.

For a budget, make a column for measured facts and another for assumptions. Put the survey year next to every external number. Replace provisional premiums with written quotes when they arrive, and preserve the original census so you can explain any difference. Keep scenarios for family enrollment separate from scenarios for premium growth. That allows a reviewer to see whether the company is buying richer benefits, covering more people or paying more for comparable coverage.

For a presentation, retain uncertainty and definitions even when shortening the slide. Do not label the small-firm deductible as what every employee pays, or the national employer premium as the employee payroll deduction. Avoid ranking individual insurers from employer-level averages. The strongest use of these statistics is to identify questions for the actual proposal, then document the answers from the policy and quote.

**Replace the benchmark with your team's proposal**

These statistics describe populations, not the people on your census. Use them as a reference, then compare written coverage and costs for your actual employee locations and family tiers.

[Price coverage for my team](https://www.getprescience.com/quote)

[Model an employer budget](https://www.getprescience.com/tools/employer-health-insurance-cost-calculator)

## Frequently asked questions

**What is the average cost of employer health insurance in 2026?**

The verified KFF figures cited here are 2025 survey results: $9,325 single and $26,993 family annually. They are not measured 2026 premiums. Obtain current quotes rather than multiplying them by a different survey's cost forecast.

**What percentage of employers self-fund?**

KFF's 67% figure is the share of covered workers, not employers. At small firms, 27% are reported in self-funded plans and 37% in level-funded plans, with overlap; KFF gives 51% in either category.

**How fast are health insurance costs rising?**

KFF reported 6% family premium growth in 2025. PwC's 2027 report gives 9.0% group medical trend for both restated 2026 and projected 2027. These are different measures from an individual policy renewal.

**What percentage of small businesses offer health insurance?**

KFF reported 59% among firms with 10–199 workers and 51% among those with 10–24 workers in 2025. These estimates do not include firms below ten workers.

**How much do employees pay for health insurance?**

On average $1,440 a year for single coverage and $6,850 for family coverage in 2025. At small firms the family figure is $8,889.

**What is the average deductible for employer health insurance?**

KFF's 2025 single deductible average was $1,886 among covered workers whose plans had a general deductible: $2,631 at small firms and $1,670 at large firms.

**How many Americans have employer-sponsored health insurance?**

53.8% of the population had employment-based coverage for some or all of 2024, according to the Census Bureau.

**How many employers cover GLP-1s for weight loss?**

Among firms offering health benefits, KFF reported weight-loss coverage at 43% of firms with 5,000 or more workers and 16% of those with 200–999 workers in 2025. This does not establish coverage at a particular employer.

## Sources

- [KFF, 2026 Marketplace plan selections and deductibles](https://www.kff.org/affordable-care-act/what-we-know-so-far-about-2026-aca-marketplace-enrollment-premiums-and-deductibles/)
- [KFF, 2025 Employer Health Benefits Survey](https://www.kff.org/health-costs/2025-employer-health-benefits-survey/)
- [KFF, 2024 Employer Health Benefits Survey](https://www.kff.org/health-costs/2024-employer-health-benefits-survey/)
- [KFF, 2020 Employer Health Benefits Survey](https://www.kff.org/health-costs/2020-employer-health-benefits-survey/)
- [KFF, 2015 Employer Health Benefits Survey](https://www.kff.org/health-costs/2015-employer-health-benefits-survey/)
- [U.S. Census Bureau, Health Insurance Coverage in the United States: 2024](https://www.census.gov/library/publications/2025/demo/p60-288.html)
- [PwC, Medical cost trend 2027 (including restated 2026 trend)](https://www.pwc.com/us/en/industries/health-industries/library/assets/pwc-behind-the-numbers-2027.pdf)
- [Mercer, Employers expect health benefit costs to jump in 2027 (September 2026)](https://www.mercer.com/en-us/about/newsroom/employers-expect-health-benefit-costs-to-jump-in-2027/)
- [CMS, 2026 Marketplace enrollment data](https://www.cms.gov/data-research/statistics-trends-reports/marketplace-products/2026-marketplace-open-enrollment-period-public-use-files)