The cost of a family health plan at work climbed past $28,000 this year, and workers are covering a bigger slice of it than they did a year ago.
The average annual premium for employer-sponsored family coverage reached $28,303 in 2026, up 5%, or $1,310, from 2025, according to KFF’s 2026 Employer Health Benefits Survey, released Thursday. Workers’ own share rose faster. Covered employees now pay an average of $7,471 a year toward family premiums, up 9%, or $621.
Both numbers outran paychecks. Wages rose 3.7% over the same period and general inflation was 2.7%, though KFF noted that inflation has been running hotter in recent months.
“We have been hearing a lot about Affordable Care Act and Medicaid cuts. Now add a 9% increase in what workers with employer coverage paid toward family premiums in 2026 to the reasons voters are so concerned about their health care costs,” KFF President and CEO Drew Altman said in a statement released with the survey.
The survey is the 28th edition of KFF’s annual benchmark. It drew on more than 1,900 employers with at least 10 workers and covers the plans that insure almost 157 million Americans under 65.
How much do single and family plans cost in 2026?
Average premiums came in at $9,804 for single coverage and $28,303 for family coverage, each up 5% from last year. On average, workers paid 18% of the single premium and 27% of the family premium, about the same shares as in 2025.
Geography matters. Family premiums were highest in the Northeast, at $31,378 on average, and lowest in the South, at $26,702. Workers in PPO plans paid more than average, while people in HSA-qualified high-deductible plans had lower premiums: $8,989 for single coverage and $26,450 for family coverage.
Over the longer run the picture is less dramatic than this year’s jump in worker contributions suggests. Since 2021, family premiums have risen 28% and worker contributions 26%, roughly in line with wage growth of 27% and inflation of 24% over the same five years.
Why are small-business workers hit hardest?
The gap between small and large employers is the survey’s sharpest finding. Workers at firms with fewer than 200 employees contribute an average of $9,687 a year toward family coverage. That is $2,847 more than workers at larger companies pay.
Small firms tend to pass along a bigger share of the bill. Their workers pay 37% of the family premium on average, compared with 25% at large firms. Nearly a third, 31%, of covered workers at small firms are in plans where their family contribution is $12,000 a year or more.
Deductibles follow the same pattern. The average single-coverage deductible was $1,955, close to last year’s $1,886, but workers at small firms faced an average of $2,624 against $1,772 at large firms. More than half of covered workers at small firms, 55%, have a deductible of $2,000 or more, compared with 33% at larger firms.
How are employers responding to rising costs?
Most large employers shifted at least some of the cost onto workers. Among firms with 200 or more employees, 44% said they raised the share of the premium that workers pay, and 21% raised deductibles or other cost sharing for most services.
Some employers are also working around their pharmacy benefit managers. A third of employers with at least 50 workers now offer access to lower-cost mail-order generics through outside vendors such as Mark Cuban Cost Plus, GoodRx or SingleCare, and 9% use an international drug purchasing service for maintenance medications. Only 49% of large firms said they get enough information about the rebates drugmakers pay to their insurer or PBM.
A quarter of employers with at least 50 workers contract with on-site or near-site clinics. Employer frustration with plan administration has been building on other fronts too, including the recent push by large employers to bring electronic prior authorization to self-funded plans.
Are employers covering GLP-1 weight-loss drugs?
Mostly not. Only 18% of large firms cover GLP-1 drugs such as Wegovy and Zepbound specifically for weight loss, and those that do often attach conditions, like joining a lifestyle program or seeing a clinician first.
Coverage is expensive for those that offer it. Among large firms covering the drugs for weight loss, 29% said it had a significant effect on their prescription drug spending and 27% said the effect was moderate. Among those that don’t cover them, just 1% said they were very likely and 13% somewhat likely to add coverage in the next year. The cost of new medicines is a growing pressure point, as HNC reported in its look at new drug launch prices.
The survey also found that 27% of large firms cover in vitro fertilization, unchanged from 2024.
What does this mean for 2027?
More increases are likely. KFF said early forecasts for 2027 point to premium increases approaching double digits. This year’s 5% rise was more modest than many projections had suggested, but how quickly higher medical spending shows up in premiums is still uncertain.
The share of firms with 10 or more workers that offer health benefits rose to 67% from 61% last year, though KFF cautioned that the figure moves around because most firms are small. Among companies that don’t offer coverage, about 11% use individual coverage health reimbursement arrangements, or ICHRAs, to help workers buy their own plans.
For workers, the takeaway is simple. Open enrollment season is the time to compare the premium, the deductible and the out-of-pocket maximum together, because a cheaper paycheck deduction can mean a much bigger bill at the doctor’s office.
Key takeaways
- Average family premiums for employer coverage hit $28,303 in 2026, up 5%, according to KFF’s annual survey released Oct. 22, 2026.
- Workers’ share of family premiums rose 9% to $7,471, faster than wages (3.7%) or inflation (2.7%).
- Workers at small firms pay $9,687 a year on average for family coverage, $2,847 more than at large firms, and face higher deductibles.
- Only 18% of large firms cover GLP-1 drugs for weight loss, and early forecasts point to near double-digit premium increases in 2027.
Frequently asked questions
How much does employer family health insurance cost in 2026?
The average annual premium for employer-sponsored family coverage is $28,303 in 2026, according to KFF. Workers pay an average of $7,471 of that, and employers pay the rest.
How much did health insurance premiums go up in 2026?
Average family and single premiums each rose 5% from 2025. The amount workers contribute toward family coverage rose faster, by 9%, or $621.
Why do small-business employees pay more for health insurance?
Small firms tend to pass a larger share of the premium to workers. Workers at firms with fewer than 200 employees pay 37% of the family premium on average, compared with 25% at large firms, and they face higher average deductibles.
Do employer health plans cover GLP-1 drugs for weight loss?
Only 18% of large firms cover GLP-1 drugs specifically for weight loss in 2026, often with conditions such as a lifestyle program. Few employers that don’t cover them plan to start in the next year.
