Employer-sponsored health insurance premiums and worker contributions have shifted significantly over the past two decades. The Employer Health Benefits Survey, conducted annually since 1999, tracks these costs for private and non-federal public employers with ten or more employees. The latest data, covering the 2026 survey, reveals how the balance of responsibility between companies and workers has evolved, particularly regarding family coverage costs and wage-related thresholds.
Costs for Family Coverage
The survey documents the full per-person cost of coverage, which includes both the employer’s share and the amount workers pay. These figures vary by firm size, industry, and funding structure. Firms offering self-funded plans assume direct financial risk for medical claims, often contracting with third-party administrators to manage administrative tasks. For companies with multiple plan types, premiums are calculated as a weighted average, potentially including data from both self-funded and fully insured plans.
Geographic and industry classifications are based on a firm’s primary location and Standard Industrial Classification code. To ensure national representativeness, the data is weighted to the number of covered workers and adjusted for employee counts within specific categories. However, estimates for smaller sub-populations carry more uncertainty, sometimes resulting in “Not Sufficient Data” (NSD) designations when fewer firms participate.
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Wage Thresholds and Worker Earnings
Defining which firms are considered “higher-wage” or “lower-wage” has changed over time. Since 2013, thresholds are based on the 25th and 75th percentiles of national earnings reported by the Bureau of Labor Statistics. These cutoffs are adjusted for inflation and rounded to the nearest thousand. In 2026, a lower-wage firm is one where at least 35% of workers earn $38,000 or less, while a higher-wage firm employs at least 35% of workers making $82,000 or more.
For many years, particularly between 2001 and 2012, the specific wage cutoffs were not available for publication. During those periods, the survey instrument sometimes omitted questions regarding lower-wage workers to reduce respondent burden. The latest data suggests that wage gaps are widening, with the upper percentile rising steadily while the lower percentile has also increased significantly, reflecting broader economic shifts in compensation.
Worker Contributions Over Time
Worker contributions are the portion of the premium paid by employees. While the full cost of family coverage continues to climb, the specific percentage or dollar amount contributed by the average worker has varied based on the specific year and firm characteristics. The survey provides standard errors to help analysts determine whether differences between groups are statistically significant.
