A family health plan through an employer now carries an average premium of $28,303 a year, and the worker’s own share of that bill has reached $7,471. For anyone who gets insurance through a job, those numbers shape take-home pay, the choice of a plan and even decisions about changing employers.
In this article we will discuss what KFF found in its 2026 survey, how the costs split between workers and companies, and how to read your own benefits options before enrollment closes.
The Headline Numbers From the 2026 Survey
KFF released its 2026 Employer Health Benefits Survey on 22 October. It is an annual look at what American employers offer, what the coverage costs and how that cost is shared. The average annual premium for family coverage was $28,303, up 5 percent, or about $1,310, from 2025. Single coverage averaged $9,804, also up 5 percent.
Workers paid on average $7,471 toward family coverage, which is 27 percent of the premium, and that contribution rose 9 percent, or $621. For single coverage, workers paid $1,672, or 18 percent of the premium. Subtracting the worker contribution from the total premium gives an employer share of about $20,832 for family coverage; that is simple arithmetic from the survey’s figures.
| Item | Family coverage | Single coverage |
| Average annual premium | $28,303 | $9,804 |
| Change in premium from 2025 | Up 5 percent | Up 5 percent |
| Average worker contribution | $7,471 | $1,672 |
| Worker share of the premium | 27 percent | 18 percent |
| Employer share (simple arithmetic) | About $20,832 | Not given in this summary |
It helps to translate the annual numbers into paychecks. Spread over 26 biweekly pay periods, the $7,471 family contribution works out to roughly $287 per paycheck, and over 12 months it is about $623 a month; both are simple arithmetic from the survey figure, and your actual deduction depends on your employer’s pay schedule and plan. That money comes out before you see your pay, which is why many workers underestimate how much they spend on coverage until they add up a year of stubs.
The premium itself is the price of keeping the plan open for a year, not the cost of any particular medical service. It is shared between the employer and the employee, and the employee’s portion is only one part of what they will spend, since deductibles, copays and coinsurance come on top when care is used.
Two points of context help. First, this is a United States story. Employer-sponsored insurance is a feature of the American system, where many people under 65 with private coverage get it through work. In countries with national health systems, such as the United Kingdom and Canada, the same workplace conversation looks very different. Second, these are averages. A worker at a small business and a worker at a large corporation can face very different costs, and so can people in different regions or industries.
Workers’ Share Is Growing Faster Than the Premium Itself
The most interesting line in the survey is not the 5 percent rise in the total premium. It is that the worker’s family contribution rose 9 percent, nearly twice as fast. Over the same period, according to KFF, wages rose 3.7 percent and general inflation was 2.7 percent, with KFF noting that inflation has been higher in recent months. As simple arithmetic, the worker contribution rose about 5.3 percentage points faster than wages.
The employer’s roughly $20,832 never appears on a paycheck, but it is part of what a worker costs the company. Economists often argue that over time, higher benefit costs can hold back wage growth, because a company deciding how much to spend on each employee has a total budget. The survey cannot prove that link for any one employer, yet it is a reasonable lens when a raise looks small. When you compare job offers, a plan that costs an employee less in contributions can be worth as much as a higher salary.
Who Absorbed the Increase
Another piece of arithmetic is revealing. The total family premium rose by about $1,310 and the worker contribution rose by $621, which means workers covered roughly 47 percent of the increase while paying 27 percent of the premium. That is a rough calculation from rounded numbers, but the pattern is clear: when costs go up, a larger share than usual landed on employees. This is the reason many people feel their paycheck is stretching less far even when they receive a raise.
The survey figures do not by themselves explain why premiums keep rising, and KFF’s full report is the place to look for its analysis. Commonly discussed pressures include the prices that hospitals and providers charge, spending on prescription drugs and heavier use of care, but each employer faces its own mix, and that is general background and not a finding of this survey.
How Employers Responded
KFF found that 18 percent of all firms raised the share of premiums paid by workers in response to projected cost increases, and that figure climbs to 44 percent among large firms. Employers have a limited set of tools when costs rise. They can absorb the increase and cut profit or other spending, shift cost to employees through higher contributions, raise deductibles, narrow networks or drop benefits. The survey suggests that large employers lean toward shifting costs, while the share among all firms is much lower, which suggests many smaller ones have not yet passed the increase along.
For workers, the lesson is to look at the payroll deduction as well as the plan’s headline features. A plan that looks similar to last year’s can cost more out of each paycheck, and a raise of a few percent can disappear into a contribution that rose faster.
Deductibles Hold Steady While the Monthly Bill Climbs
The average deductible for single coverage among covered workers in plans that have one was $1,955, which KFF described as similar to the previous year. The size of the employer matters: the average was $2,624 at smaller firms and $1,772 at larger firms. A deductible is the amount you pay for covered care before the plan starts sharing costs, with some services, such as preventive visits, often covered before the deductible applies.
Why a Steady Deductible Still Hurts
A flat deductible may sound like good news, but it only shows that one dial has not moved. Premiums, which are paid whether or not you use care, rose. So the total a worker could pay in a year, premiums plus the cost of reaching the deductible, went up even though the deductible itself did not. Families who rarely use care feel it mainly through the paycheck, while families with an expensive year feel it at the pharmacy and the hospital billing office.
Plans with high deductibles are often paired with lower premiums, and they are the type that can be combined with a health savings account. They suit some people well and strain others, especially people who need regular care early in the year. Many plans cover preventive services, such as routine screenings, before the deductible, but the list of covered services varies, so check the summary of benefits before relying on that.
The Gap Between Small and Large Employers
The difference between $2,624 and $1,772 is large enough to change how a person weighs a job offer. Smaller employers often have less bargaining power with insurers and may offer fewer plan options, so employees there can face higher deductibles. That does not make every small employer a poor choice, since some compensate with higher pay, but it does mean you should ask about the full benefits package. The deductible deserves to be a question in the interview as well as in the enrollment guide.
As an illustration with invented round numbers, imagine a worker whose annual share of the premium is $3,000 and whose deductible is $2,000. If the worker has a year with major care, the total before the plan begins to share costs is $5,000, and that is before any coinsurance or copays. A leaner plan with a $1,000 premium share and a $4,000 deductible reaches the same $5,000 total, yet it costs far less in a quiet year and far more in a bad one, so the two plans only compare fairly once you also count the out-of-pocket maximum and your own likely use of care.
More Firms Offer Coverage, but Employers Are Uneasy
The survey found that 67 percent of firms with 10 or more workers offer health benefits, compared with 61 percent the year before. At the worker level, 92 percent of workers are at a firm that offers coverage to at least some of its workers. As simple arithmetic, the share of those larger firms offering coverage rose by 6 percentage points, which is a visible change in one year. KFF’s own report is the place to see how it interprets the shift, and readers should avoid reading too much into a single year’s survey result.
The words “at least some of its workers” matter. A company can offer coverage to full-time employees only, or require a waiting period before it begins, so being at an offering firm is not the same as being eligible. If you are part time, new to a job or a contractor, read the eligibility section of the benefits guide before assuming anything.
If you are weighing a job change, treat benefits as part of the offer. Ask for the plan documents, not only the headline premium, and compare the employee contribution for the tier you would use, the deductible, and the network for the doctors you see. A slightly lower salary with a far cheaper plan can leave you better off than a bigger paycheck with a costly one, and it is a calculation recruiters will often help with if you ask.
Despite the growth in offering, employers are not happy about the bill. Only 17 percent of firms said they are very satisfied with the overall cost of care, while 29 percent are dissatisfied or very dissatisfied. That is a striking measure of frustration in a market where companies are still offering the benefit, and it suggests the pressure on plans, contributions and networks will continue. Employers rarely abandon coverage entirely, because it helps with hiring and retention, but they will keep adjusting the design.
Weight-Loss Drug Coverage Depends on Company Size
KFF also asked about coverage of GLP-1 drugs for weight loss. Among firms with 200 or more workers, 18 percent cover them, compared with 19 percent last year. The share rises sharply with size, as the table shows.
| Firm size | Share covering GLP-1 drugs for weight loss |
| 200 or more workers (all) | 18 percent |
| 200 to 999 workers | 16 percent |
| 1,000 to 4,999 workers | 29 percent |
| 5,000 or more workers | 33 percent |
Why Coverage Varies so Much
GLP-1 medications are a class of drugs that was developed for diabetes and is now widely used for weight management. Coverage for diabetes and coverage for weight loss are separate questions, and a plan can cover one and exclude the other. Employers weigh the cost of the drugs against the possible long-term health benefits, and the larger a company is, the more it can spread risk and negotiate. Smaller firms can find a single expensive prescription meaningful in a way a very large payroll does not.
Employers decide on this coverage for reasons that are not always about price. Some worry about paying for a medication that people may take for a long time, some about fairness across employees, and some about whether a drug’s benefits will show up within the years a worker stays at the company. None of these arguments is settled, which is why the share of employers covering the drugs has stayed fairly close to last year’s and varies so much by size.
What to Check in Your Plan
If this matters to you, do not rely on rumor or a coworker’s experience. Look in the plan’s formulary, which is the list of covered drugs, and read the notes on restrictions. Many plans require prior authorization, meaning the insurer must approve the prescription first, and some set conditions such as a body mass index threshold or participation in a lifestyle program. Ask HR or the insurer in writing whether weight-loss use is covered, and keep the answer. Coverage can change from one plan year to the next, so check again at each open enrollment.
If your plan does not cover these drugs, talk with your prescriber about alternatives and ask the insurer whether an exception process exists. Be cautious about online sellers offering these medications without a prescription or at prices that seem too good to be true, since counterfeit and unsafe products are a documented risk with any popular drug. Only fill prescriptions through licensed pharmacies.
Networks Look Broad Until Mental Health Care Enters the Picture
Employers were generally positive about provider access: 89 percent called their largest plan’s provider network broad. But only 64 percent said so for mental health and substance use services. A 25-point gap, which is simple arithmetic from the two figures, tells you that finding a therapist or a treatment program through a workplace plan can be harder than finding a primary care doctor.
The gap matters because mental health needs are often ongoing. A person who sees a therapist weekly feels a network limit much more than someone who visits a primary care doctor once a year, and the cost of going out of network repeats with every session. The survey figure reflects employers’ own view of their networks, not a patient’s experience, so it is a signal to investigate rather than a measure of how hard care is to find in your area.
Check the Directory, Then Call
A provider directory is a starting point, and it is sometimes out of date. Directories can list clinicians who have stopped accepting new patients or who left the network, which is why people sometimes call them inaccurate. Before booking a first appointment, call the office and ask whether it participates in your specific plan, not only with the insurer’s name. Then confirm with the insurer, and write down the date and the name of the person you spoke with.
Know Your Options if the Network Is Thin
If the network lacks a suitable provider, ask the insurer about out-of-network benefits, the process for requesting an exception when no in-network provider is available, and any telehealth options. Many employers also provide an employee assistance program that offers a few counseling sessions at no cost, and it is worth asking HR whether yours does. Out-of-network care can cost much more, and a separate and often higher deductible may apply, so request cost estimates before treatment begins.
Reading Your Benefits Guide Before Open Enrollment Closes
Benefit guides are written to satisfy legal requirements, not to be pleasant, and the main comparison pages are often buried. Look first for the summary of benefits and coverage, a standardized document that plans provide so that options can be compared on common terms. If you can only read one page per plan, make it that one.
Open enrollment dates differ by employer, so check yours with HR. The materials can be dense, but most of the confusion comes down to a few terms. The table below puts them side by side.
| Term | What it means | Why it matters |
| Premium | What you pay each pay period to have the plan | Your fixed cost, whether or not you use care |
| Deductible | What you pay for covered care before the plan shares costs | Sets the cost of a bad year |
| Copay | A flat fee for a service such as a visit | Predictable for routine care |
| Coinsurance | Your percentage of the bill after the deductible | Can add up on expensive treatment |
| Out-of-pocket maximum | The most you pay for covered in-network care in a year | Your worst-case exposure |
Compare Total Cost, Not Just the Premium
The cheapest premium rarely means the cheapest year. Estimate three scenarios for each plan: a quiet year, a moderate year with a few visits and prescriptions, and a bad year in which you reach the out-of-pocket maximum. Add the annual premium to each estimate and compare.
Someone with a chronic condition or a planned procedure often comes out ahead with a pricier premium and a lower deductible, while a healthy single adult may do better with a lean plan.
HSA and FSA Basics
A health savings account lets you set aside pre-tax money for medical costs, and it is generally available only when you are enrolled in a qualifying high-deductible health plan. The balance typically stays with you and can roll over from year to year.
A flexible spending account is also funded with pre-tax pay, but it is usually tied to your employer and often has a use-it-or-lose-it rule, though some plans allow a limited carryover or grace period. The annual limits are set by the tax authorities and change, so check the current figures with the IRS or your plan administrator. This is general information and not tax advice.
Look Beyond the Plan Itself
Check which extras come with each option, such as telehealth visits, wellness programs, a nurse line or discounts on gym memberships. These rarely decide a choice, but they can break a tie. Also note whether the employer contributes money to a health savings account for those who enroll in a high-deductible plan, since that contribution lowers the true cost of that option.
Spouse and Dependent Rules
If a spouse has access to coverage through another employer, compare the two. Some employers charge a surcharge for covering a spouse who has other options, or exclude spouses who could be covered elsewhere. Look at the cost of adding dependents too, since the jump from single to family coverage can be large, as the survey averages show.
A reasonable schedule is to read the materials the day they arrive, list your questions that evening, and ask HR or the insurer within the first week. Leave a few days before the deadline for forms, because enrollment systems get busy, and take screenshots or save confirmation emails after you submit. If you miss the window, many plans allow changes only after a qualifying life event, such as marriage, birth of a child or loss of other coverage, so a missed deadline can lock in a choice for a year.
Final Thoughts: Questions Worth Taking to HR
Start by asking for the total employee cost of each plan option for each coverage tier, along with the deductible and out-of-pocket maximum. Ask whether the employer plans to change the share of the premium that employees pay, and how that has moved over recent years. These questions are reasonable, and they signal that you are comparing carefully.
Then move to the practical issues. Confirm that your doctors, your therapist and your usual hospital are in the network, and look up your regular prescriptions on the formulary. Ask what happens if a medication is subject to prior authorization, and whether weight-loss drugs are covered if that matters to your family. Find out whether there is an employee assistance program, a telehealth service or a nurse line that costs nothing.
Finally, build a small cushion for the cost that insurance does not remove. Even a good plan leaves a deductible or a coinsurance bill, and an emergency fund that can cover your out-of-pocket maximum is a sensible target if you can reach it over time. For personal medical, legal or tax questions, a licensed professional or a benefits counselor is the right person to ask.
Frequently Asked Questions
How Much Does Employer Family Health Coverage Cost in 2026?
According to the KFF survey, the average annual premium for family coverage is $28,303, up 5 percent. Single coverage averages $9,804.
How Much of the Premium Do Workers Pay?
Workers pay on average $7,471 toward family coverage, which is 27 percent of the premium. For single coverage they pay $1,672, or 18 percent.
Is the Average Deductible Going Up?
KFF reported an average single-coverage deductible of $1,955 among covered workers in plans with a deductible, similar to last year. It was $2,624 at smaller firms and $1,772 at larger firms.
Is GLP-1 Weight-Loss Coverage Common Among Employers?
Not at most of them. KFF found that 18 percent of firms with 200 or more workers cover them, and the share is higher at the largest firms, at 33 percent of those with 5,000 or more workers.
Should I Choose the Plan With the Lowest Premium?
Not automatically. Compare the premium, deductible and out-of-pocket maximum under a quiet year and a bad year, and check that your doctors and prescriptions are covered.
When Is Open Enrollment for Employer Health Plans?
The dates are set by each employer, so ask HR for yours. Many companies hold enrollment in the fall, but do not assume your schedule matches anyone else’s.