Workers are paying an average of $7,471 annually toward premiums for employer-sponsored family health benefits, a 9% increase from 2025, according to the annual benchmark health benefits survey by KFF. This increase translates to $621 more per year.
The burden of family premiums falls harder on workers at small firms with less than 200 workers, who contribute $9,687 annually toward family coverage, $2,847 more than workers in large firms.
Family Health Coverage Costs
Total annual premiums for family coverage now average $28,303, up 5% or $1,310 from 2025. In contrast, wages rose 3.7% and general inflation rose 2.7% over the same period.
Since 2021, family premiums and workers’ contributions have increased at similar rates, 28% and 26%, respectively, comparable to the increase in wages, 27%, and inflation, 24%, over the same period.
Employer Responses to Rising Health Costs
Among large firms, most increased costs for workers to address higher projected health costs, including increasing the share of premium that workers pay, 44%, and increasing deductibles or other cost-sharing for most services, 21%.
KFF President and CEO Drew Altman noted that the 9% increase in worker-paid family premiums in 2026 adds to concerns about healthcare costs, alongside discussions about Affordable Care Act and Medicaid cuts.
Almost 157 million Americans under 65 rely on employer-sponsored coverage, and the 28th annual national survey of over 1,900 employers provides a detailed picture of the trends affecting it.
Average deductibles near $2,000, with covered workers at small firms facing much larger average deductibles, $2,624, compared to workers at larger firms, $1,772. Furthermore, among workers who face an annual deductible for single coverage, the average this year stands at $1,955, similar to the $1,886 average in 2025.
Only about one in five large firms cover GLP-1 drugs for weight loss, often with restrictions, and most report a significant or moderate impact on prescription drug spending. Additionally, few employers who don’t cover the drugs for weight loss say that they are either very or somewhat likely to begin offering them in the next year, with only 1% saying they are very likely and 13% saying they are somewhat likely.
A quarter of large firms provide coverage for in-vitro fertilization services, unchanged from 2024, and a third of employers offer access to lower-cost mail-order generic drugs. This includes 9% of employers who participate in an international prescription drug purchasing service to access discounted maintenance medications from outside the U.S.
Specifically, 49% of large firms say they get sufficient information about rebates and other payments paid by drug manufacturers to their insurer, administrator, or pharmacy benefit manager.
A quarter of employers offering health benefits provide health services through on-site or near-site clinics, treating both work-related and non-work-related conditions. These clinics are used by 24% of employers with at least 50 workers, and they often provide a range of services to employees.
Despite interest in Individual Coverage Health Reimbursement Arrangements, only about one in ten employers not offering health benefits use them to help workers purchase coverage through the Affordable Care Act Marketplaces. In fact, 11% of employers not offering health benefits are using ICHRAs to help workers purchase coverage, despite media and policy interest in this approach.
A third of employers with at least 50 workers offer enrollees access to lower-cost mail-order generic drugs through vendors such as GoodRx, Single-Care, or Mark Cuban Cost Plus. This can help reduce prescription drug costs for employees, and 33% of employers are taking advantage of this option.
