Employer-sponsored insurance covers almost 157 million people under the age of 65. Each year, the KFF conducts a survey to examine trends in employer-sponsored health benefits. The survey sampled private firms and nonfederal government employers with 10 or more employees. KFF completed interviews with 1,937 firms between January and July 2026.
This article summarizes the main points of the 2026 Employer Health Benefits Survey.
Health Insurance Premiums
In 2026, the average premiums for employer-sponsored health insurance were $9,804 for single coverage and $28,303 for family coverage. The average single and family premiums increased by 5% each over the last year, the same as the previous year for single coverage (5%) and slightly lower than the previous year for family coverage (6%).
Additionally, the 2026 KFF report notes an increase of 3.7% in workers’ wages and inflation of 2.7%. The average premium for family coverage has risen 28% over the last five years, compared with a 26.9% increase in workers’ wages and a 24.4% rise in inflation.
Premiums under a health savings account (HSA)-qualified high deductible health plans (HDHPs) were still lower than the average premium. HSA-qualified plans’ annual premiums for single and family coverages were $8,989 and $26,450, respectively. Beginning in 2026, HSA-qualified plans are reported as a separate plan type, and HDHPs paired with a health reimbursement arrangement (HRA) are now classified as preferred provider organization (PPO), point-of-service (POS) or health maintenance organization (HMO) plans.
Conversely, on average, the premiums for workers enrolled in PPO plans were higher than those for other plans. The average PPO premium was $10,272 for single coverage and $29,522 for family coverage in 2026.
Premiums also varied by firm size and region. Family premiums averaged $27,288 at small firms (10-199 workers) and $28,592 at large firms. In the Northeast, premiums averaged $10,806 for single coverage and $31,378 for family coverage, compared with $9,272 and $26,702 in the South.
Worker Contributions
In 2026, the average worker contribution toward premiums was 18% for single coverage and 27% for family coverage, similar to 2025’s percentages. In terms of dollar amounts, workers contributed $1,672 and $7,471 toward their premiums for single coverage and family coverage in 2026, respectively. These numbers were higher than in 2025.
Contributions differed sharply by firm size. Workers at small firms paid 37% of the family premium on average, compared with 25% at large firms, which works out to $9,687 versus $6,840. Overall, 13% of covered workers (31% at small firms) pay $12,000 or more for family coverage.
Plan Enrollment
KFF changed how it classifies plans this year, so plan type shares are not directly comparable to prior years. The following were the most common plan types in 2026:
- PPOs: 50% of workers covered
- HSA-qualified plans: 29% of workers covered
- HMOs: 12% of workers covered
- POS plans: 8% of workers covered
- Conventional (indemnity) plans: less than 1% of workers covered
Self-Funding
In the past few years, self-funded plans have become more popular. Many large organizations self-fund or pay for some or all health services for their workers directly from their own funds rather than purchase health insurance. In 2026, 71% of covered workers—including 25% at small firms and 85% in large firms—were enrolled in self-funded plans. The percentage of covered workers in self-funded plans in 2026 was higher than in 2025 (71% and 67%, respectively).
Level funded arrangements combine self-funded plans with stop-loss. In 2026, 38% of covered workers in small firms are covered by a level funded plan, similar to 2025.
Employee Cost Sharing
Most workers must pay a share of their health care costs, and the average deductible for single coverage was $1,955 in 2026, similar to last year’s number. The average annual deductible has increased 18% over the last five years and 34% over the past decade. Small firms averaged $2,624, and large firms averaged $1,772.
In 2026, 38% of covered workers were in a plan with a general annual deductible of $2,000 or more for single coverage, up from 34% last year. This percentage has increased by 31% over the last five years, and 63% over the past decade. The share was 55% at small firms and 33% at large firms.
Beyond deductibles, most workers cover some portion of the costs of their health care services. For example, 60% of covered workers had coinsurance, 11% had a copay for hospital admissions, and 10% had both requirements. The average hospital admission coinsurance rate was 20% in 2026, while the average payment amount was $317. Office visits carried average copays of $27 for primary care and $46 for specialists, and the average outpatient surgery copay was $205.
In addition, nearly all workers were covered by a plan with an out-of-pocket maximum (OOPM), but the costs varied considerably. Among covered workers with single coverage, 14% had an OOPM of less than $2,000, and 24% had an OOPM above $6,000.
Availability of Employer-sponsored Coverage
In 2006, 67% of firms with 10 or more workers offer health benefits to at least some of their workers, up from 61% last year. Large firms (those with 200 or more workers) are much more likely than smaller firms to offer health benefits (98% of firms with 200-999 workers and more than 99% of firms with 1,000 or more workers).
Although the vast majority of workers are employed by firms offering health benefits, many aren’t covered by their employers. Some are not eligible to enroll, while others choose not to for various reasons. Overall, 80% of workers were eligible for health benefits at firms that offered coverage, and 74% of eligible workers accepted the organization’s offer. That works out to be 59% of workers at firms that offer health benefits enrolling in coverage, similar to the 61% in 2025.
Among firms that offer health benefits and firms that do not, 55% of all workers were covered by health plans offered by their employer, similar to last year’s percentage. Among workers at firms that offer health benefits, coverage was lower for those at firms with many younger workers (44% of workers covered, compared with 62% at other firms) and at firms with many lower-wage workers (47% of workers covered, compared with 61% at other firms).
GLP-1 Drug Coverage for Weight Loss
Glucagon-like peptide 1 (GLP-1) receptor agonists have grown in popularity due to their effectiveness in helping individuals with Type 2 diabetes and for weight loss. In the 2026 survey, 16% of firms with 200-999 workers, 29% of firms with 1,000-4,999 workers, and 33% of firms with 5,000 or more workers reported covering GLP-1s when used primarily for weight loss. The percentage of firms with 5,000 or more workers that cover GLP-1 agonists for weight loss in 2026 is lower than in 2025 (33% and 43%, respectively). Of these firms covering GLP-1s, 40% required a specific condition or had a requirement for coverage. These included meeting with a professional (dietitian, case manager or therapist) or enrolling in a lifestyle or weight-loss program. The requirement rate was 59% among firms with 5,000 or more workers.
Among firms covering GLP-1s for weight loss, 29% overall said that coverage had a “significant” impact on their plans’ prescription drug spending, including 21% of firms with 200-999 workers and 61% of firms with 5,000 or more workers.
Coverage growth stalled in 2026. Among firms with 200 or more workers, 18% covered GLP-1s for weight loss, down slightly from 19% last year. Among firms that do not cover them, 12% said they stopped coverage within the past year, and 79% said they are not likely to start covering them in the next 12 months.
Whether and how to provide GLP-1 coverage is likely to remain an important topic for employers and workers in the foreseeable future.
Other Benefit Trends
Among firms with 200 or more workers, 24% of those with 200-999 workers, 38% of those with 1,000-4,999 workers, and 47% of those with 5,000 or more workers cover in vitro fertilization. Among firms with 50 or more workers, 33% offer lower-cost mail-order generics through third parties such as Mark Cuban Cost Plus, SingleCare or GoodRx.
Conclusion
As expected, the average annual premiums for both single and family coverage increased in 2026 due to key cost drivers, and this was similar to the rate of growth over the past two years. Furthermore, forecasts project premium increases approaching double digits for 2027.
Employers should begin identifying tools and resources to manage rising costs and explore cost-sharing strategies. Because shifting more costs to workers could raise new affordability concerns, employers should weigh those strategies against their effect on employees.