Updated for the KFF 2026 survey. KFF published the 2026 Employer Health Benefits Survey on October 22, 2026, and every survey figure on this page now comes from it. Changes from 2025 are the ones KFF reports. The 2025 figures remain in the 2025 report.
Premiums and worker contributions, 2026
The KFF 2026 Employer Health Benefits Survey reports employer coverage at firms with 10 or more employees. Premium and contribution averages describe covered workers, not all employees or all employers.
| 2026 average | Single coverage | Family coverage |
|---|---|---|
| Annual premium | $9,804 | $28,303 |
| Change from 2025 | 5% | 5% |
| Worker contribution | $1,672 | $7,471 |
| Worker share of premium | 18% | 27% |
The 5% rise in family premiums outpaced wage growth (3.7%) and inflation (2.7%), as KFF reports them. Over five years the three are close: family premiums rose 28%, against 26.9% for wages and 24.4% for inflation. Workers' dollars rose faster than the premium: the average family contribution is up 9%, or $621, from $6,850 in 2025. KFF describes the contribution percentages as similar to 2025.
Source: KFF 2026, cost of health insurance and worker contributions. The average contribution percentages are survey estimates; dividing the average contribution dollars by the average premium dollars does not reproduce an average of individual contribution percentages.
How employers answered projected cost increases
Costs were projected to rise sharply for 2026, and KFF asked offering firms what they did about it in their largest plan. Among large firms (200 or more workers):
- 44% raised the share of the premium workers pay.
- 21% raised deductibles or other cost sharing for most services.
- 16% changed insurers or plan administrators.
- 14% raised cost sharing for specific services, and 10% added utilization management such as prior authorization.
- 7% moved to a plan with a tiered or narrower network.
Across all firms, 18% raised the worker share of premiums, including 66% of employers with 5,000 or more workers. Heading into 2027, KFF notes that forecasts again project premium increases approaching double digits, which is the context most January 1, 2027 renewals will arrive in.
Small firms and large firms are different markets
National averages hide the gap that matters most in small-group work. Single premiums are similar across firm sizes and family premiums run somewhat lower at small firms, but small employers pass far more of the family premium to workers and use higher deductibles.
| KFF 2026 | 10 to 199 workers | 200+ workers |
|---|---|---|
| Average single premium | $9,593 | $9,865 |
| Average family premium | $27,288 | $28,592 |
| Worker contribution, family | $9,687 | $6,840 |
| Worker share of family premium | 37% | 25% |
| Average single deductible (among workers with a deductible) | $2,624 | $1,772 |
| Covered workers with a single deductible of $2,000+ | 55% | 33% |
| Firms offering health benefits | 66% | 98% |
| Covered workers in self-funded plans | 25% | 85% |
Small-firm workers also face more extreme contribution splits. 29% of covered workers at small firms are in a plan where the employer pays the whole single premium, against 5% at large firms, yet 32% must pay more than half of the family premium, against 6%. At small firms, 31% of covered workers face a family contribution of $12,000 or more.
Worked example: turn a benchmark into a renewal discussion
For a fictional employer with 50 workers, assume an employee-only monthly premium of $750 today and $825 at renewal, with the employer paying 75% of that tier’s premium and 26 benefit deductions per year. These are invented inputs, not a carrier quote or a Planlined product result.
| Measure | Current | Renewal |
|---|---|---|
| Monthly premium | $750.00 | $825.00 |
| Annual premium (monthly × 12) | $9,000.00 | $9,900.00 |
| Employer annual cost (75%) | $6,750.00 | $7,425.00 |
| Employee monthly cost (25%) | $187.50 | $206.25 |
| Employee cost per paycheck (26 deductions) | $86.54 | $95.19 |
The renewal raises this contract’s annual premium by $900, or 10%. Its $9,900 annual premium is $307, about 3.2%, above KFF’s $9,593 average single premium for covered workers at firms with 10 to 199 workers. Use the full workforce of 50 to select that firm-size band, rather than the number enrolled. Compare single coverage with single coverage and annual premiums with annual premiums.
This is context for a discussion, not a target rate or evidence of overpricing. KFF’s average spans different plans and employers; it does not adjust this example for location, workforce, benefits or networks. A renewal offer may be for a different plan year from the 2026 survey. Review those differences before recommending a change.
Follow the KFF benchmarking method, check a different pay schedule in the paycheck deduction calculator, then use the editable employer decision worksheet to compare your quotes and budget. For a separate actual product export, inspect the fictional medical proposal and its source checks.
Funding differs just as sharply. 71% of all covered workers are in self-funded plans: 85% at large firms and 25% at small ones. Separately, 38% of covered workers at firms with 10 to 199 workers are in level-funded plans, similar to 2025. KFF points out that level-funded plans, unlike insured small-group plans, may use health status in rating and underwriting and are not required to cover all essential health benefits. If you are weighing that option for a smaller group, our level-funded plans explainer covers how the arrangement works.
To see what the carriers in a client's state actually returned under the medical loss ratio rules, use our MLR rebates by state and carrier data.
Plan design: PPOs lead; compare deductible populations
KFF 2026, employee cost-sharing, Figures 7.3, 7.5 and 7.9: the average single deductible is $1,955 among covered workers whose plans have a general annual deductible. Including workers without one, assigning them zero, gives $1,733. The plan-type and firm-size deductible amounts here use the first population.
From 2026 KFF reports HSA-qualified plans as their own plan type. High-deductible plans paired with an HRA, which it previously grouped with HSA plans, are now counted as PPOs, POS plans or HMOs, so these shares are not directly comparable with 2025.
| Plan type | Share of covered workers | Average single deductible, among workers with a deductible |
|---|---|---|
| PPO | 50% | $1,446 |
| HSA-qualified plan | 29% | $2,912 |
| HMO | 12% | $1,562 |
| POS | 8% | $1,902 |
Deductible figures are for workers in plans with a general annual deductible. Across all plans that average is $1,955 for single coverage in 2026, which KFF describes as similar to 2025 ($1,886); it is up 18% over five years. The share of covered workers facing a single deductible of $2,000 or more is 38%, similar to 2025 (34%). Office-visit copays average $27 for primary care and $46 for a specialist.
Among firms offering health benefits, 39% offer an HSA-qualified plan, up from 31% in 2025; large firms are more likely to (54% against 38%). Employer account funding is modest: workers in HSA-qualified plans receive an average employer HSA contribution of $713 for single and $1,346 for family coverage, and 39% of employers offering single coverage through these plans put nothing into the account. 8% of covered workers are in a plan offered with an HRA; KFF stopped collecting HRA contribution amounts in 2026.
Drugs, networks and access to care
- GLP-1 drugs for weight loss. 16% of firms with 200 to 999 workers, 29% with 1,000 to 4,999, and 33% with 5,000 or more cover GLP-1 agonists when used primarily for weight loss. Across all firms with 200 or more workers that is 18%, similar to 19% in 2025, and 12% of the large firms that do not cover them stopped within the last 12 months.
- Lower-cost drug channels. 33% of firms with 50 or more workers that offer drug coverage give enrollees access to lower-cost mail-order generics through a third-party vendor, and 11% limit some prescriptions to mail-order pharmacies only.
- IVF. 24% of firms with 200 to 999 workers, 38% with 1,000 to 4,999 and 47% with 5,000 or more cover IVF in their largest plan, directly or through a vendor.
- Mental health networks. 51% of offering firms call their largest plan's network "very broad", but only 22% say the same for mental health and substance use services.
- Prior authorization. 7% of offering firms with 200 or more workers say more services need prior authorization than a year ago; 2% say fewer.
Which benefits private-sector workers can get
KFF describes employers that offer coverage. The BLS National Compensation Survey instead counts every private industry worker, including part-time staff and those whose employer offers nothing, so its access rates run lower and give the wider view of the market.
| Benefit, March 2025 | Private industry workers with access |
|---|---|
| Medical care | 72% |
| Outpatient prescription drugs | 71% |
| Life insurance | 59% |
| Employee assistance program | 59% |
| Health care flexible spending account | 47% |
| Wellness programs | 46% |
| Dental care | 44% |
| Short-term disability | 44% |
| Health savings account | 41% |
| Long-term disability | 37% |
| Vision care | 29% |
What changes for 2026 and 2027
ACA affordability percentage
The affordability percentage has risen every year since 2024. A higher percentage means an employer can charge somewhat more for the lowest-cost self-only option before failing the test. Run your own contributions through the ACA affordability calculator.
| Plan year | Required contribution percentage | IRS source |
|---|---|---|
| 2024 | 8.39% | Rev. Proc. 2023-29 |
| 2025 | 9.02% | Rev. Proc. 2024-35 |
| 2026 | 9.96% | Rev. Proc. 2025-25 |
| 2027 | 10.22% | Rev. Proc. 2026-26 |
The employer shared responsibility amounts also moved. For 2026, Rev. Proc. 2025-26 sets the annual 4980H(a) amount at $3,340 per full-time employee and the 4980H(b) amount at $5,010 per employee who receives a premium tax credit. For 2027, Rev. Proc. 2026-22 raises them to $3,780 and $5,670.
HSA and HDHP limits
| Limit | 2025 | 2026 | 2027 |
|---|---|---|---|
| HSA contribution limit, self-only | $4,300 | $4,400 | $4,500 |
| HSA contribution limit, family | $8,550 | $8,750 | $9,000 |
| HDHP minimum deductible, self-only | $1,650 | $1,700 | $1,750 |
| HDHP minimum deductible, family | $3,300 | $3,400 | $3,500 |
| HDHP out-of-pocket maximum, self-only | $8,300 | $8,500 | $8,700 |
| HDHP out-of-pocket maximum, family | $16,600 | $17,000 | $17,400 |
Sources: Rev. Proc. 2024-25 for 2025, Rev. Proc. 2025-19 for 2026, which also raises the maximum excepted benefit HRA to $2,200 for plan years beginning in 2026, and Rev. Proc. 2026-24 for 2027.
Using these numbers on a renewal. The survey figures on this page are national averages. To set one client against them, layer them in as benchmark context in rate negotiation, then work the group's own figures in renewal analysis and contribution modeling. Terms such as HDHP, HSA, level-funded and self-funded are defined in the benefits glossary.
Check a specific offer with the ACA affordability calculator, then show the employee cost with the payroll deduction calculator. National averages do not establish affordability for an individual offer.
What this data cannot tell you
- 2027 premiums. The survey describes plans in force during 2026, with interviews from January to July. It is not a forecast, and carrier renewal projections for 2027 are not survey results. Compare a renewal against the employer size and population that match the group.
- Your client's market. These are national averages. KFF reports average family premiums of $31,378 in the Northeast and $26,702 in the South, and industry and workforce wages move them too.
- Very small employers. From 2025 KFF surveys firms with 10 or more workers, so its offer rates are not comparable with estimates it published earlier that included firms with 3 to 9 workers.
- Dental, vision and voluntary pricing. Neither survey on this page reports premiums for ancillary or voluntary lines.
Common questions
What is the average employer health insurance premium in 2026?
According to the KFF 2026 Employer Health Benefits Survey, published October 22, 2026, the average annual premium is $9,804 for single coverage and $28,303 for family coverage, both 5% higher than in 2025. Workers contribute an average of $1,672 toward single coverage and $7,471 toward family coverage; the family amount is up 9%, or $621, from 2025.
What is the ACA affordability percentage for 2026?
For plan years beginning in 2026, the IRS set the required contribution percentage at 9.96% in Rev. Proc. 2025-25, up from 9.02% in 2025 and 8.39% in 2024. For 2027 plan years it rises again, to 10.22%, under Rev. Proc. 2026-26. A higher percentage lets an employer charge somewhat more for self-only coverage before the offer is treated as unaffordable.
How many covered workers are enrolled in HSA-qualified plans?
KFF found that 29% of covered workers are enrolled in an HSA-qualified plan in 2026, the same as in 2025. PPOs remain the most common plan type, at 50% of covered workers. Among firms offering health benefits, 39% offer an HSA-qualified plan, up from 31% in 2025.
Source and method
Premiums, contributions, deductibles, plan enrollment, funding and employer practices: KFF, 2026 Employer Health Benefits Survey, published October 22, 2026, based on 1,937 interviews with non-federal public and private firms with 10 or more workers, fielded January to July 2026, and rechecked against the full report on November 6, 2026. Access rates: U.S. Bureau of Labor Statistics, National Compensation Survey, March 2025, private industry workers, retrieved from the BLS Public Data API on September 15, 2026. Affordability percentages, 4980H amounts and HSA limits: the IRS revenue procedures linked above; the 2027 procedures (2026-22, 2026-24 and 2026-26) were rechecked October 16, 2026. Planlined did not survey anyone for this page.