Workers Now Pay $7,471 a Year for Family Coverage, Up 9 Percent. Here Is What KFF's 2026 Survey Means for Your Front Desk.
KFF's 2026 Employer Health Benefits Survey, released Oct. 22, puts the average family premium at $28,303, up 5 percent, and the worker share at $7,471, up 9 percent. The average single deductible held near $1,955.
Idea in Brief
The News
KFF's 2026 Employer Health Benefits Survey, released Oct. 22, found family premiums averaged $28,303, up 5 percent, while the worker contribution rose 9 percent to $7,471.
The Numbers
The average single deductible was $1,955, similar to last year, and 38 percent of covered workers had a single deductible of $2,000 or more; at small firms it was 55 percent.
The Move
Tighten cost estimates and point-of-service collection for high-deductible patients, re-verify coverage early in the plan year and confirm GLP-1 coverage before prescribing for weight loss.
Workers with employer family coverage now pay an average of $7,471 a year toward their premiums, up 9 percent, or $621, from 2025, according to KFF's 2026 Employer Health Benefits Survey, released Oct. 22.
The total family premium averaged $28,303, up 5 percent. This is the 28th annual edition of the survey by KFF, the nonprofit health policy research organization, and it is based on 1,937 interviews with private and non-federal public employers with 10 or more workers. Employer-sponsored insurance covers almost 157 million people under age 65, KFF reports, so these numbers describe the coverage many of your working-age patients carry. Across firms that offer benefits and firms that do not, 55 percent of workers are covered by a health plan offered by their own employer, the same as last year.
How much did premiums rise in 2026?
Average premiums rose 5 percent for both single and family coverage, to $9,804 and $28,303, according to the survey's summary of findings. Over the same period, workers' wages rose 3.7 percent and inflation was 2.7 percent, KFF said. The average family premium has risen 28 percent since 2021 and 55 percent since 2016.
How much more are workers paying?
Workers' contributions rose faster than premiums. The average worker contribution was $1,672 for single coverage, up from $1,440, and $7,471 for family coverage, up from $6,850. On average, workers paid 18 percent of the single premium and 27 percent of the family premium, which KFF describes as similar to 2025. Over the last five years, the average worker contribution for single coverage has risen 29 percent.
Firm size matters. Covered workers at firms with fewer than 200 employees contributed an average of $9,687 for family coverage, compared with $6,840 at larger firms, and paid a much larger share of the family premium, 37 percent versus 25 percent. Thirty-two percent of covered workers at smaller firms are in a plan where they must pay more than half of the family premium, compared with 6 percent at larger firms.
The premium is the number employers announce. The contribution and the deductible are the numbers patients bring to the front desk.
Clinical Pearls
- Average annual premiums in 2026 are $9,804 for single coverage and $28,303 for family coverage, each up 5 percent; wages rose 3.7 percent and inflation was 2.7 percent.
- Workers contribute $1,672 a year for single coverage and $7,471 for family coverage, up from $1,440 and $6,850.
- At firms with fewer than 200 workers, the average family contribution is $9,687, compared with $6,840 at larger firms.
- The average single deductible is $1,955, and 55 percent of covered workers at small firms are in a plan with a single deductible of $2,000 or more.
- Among firms with 200 or more workers, 7 percent say more services need prior authorization than last year and 70 percent say about the same.
- Eighteen percent of firms with 200 or more workers cover GLP-1 agonists primarily for weight loss, rising to 33 percent at firms with 5,000 or more workers.
What happened to deductibles?
Deductibles held roughly steady this year. Among covered workers in a plan with a general annual deductible, the average single-coverage deductible was $1,955, similar to $1,886 last year, according to the full report. The average was $2,624 at smaller firms and $1,772 at larger firms, and it has risen 18 percent over five years.
Thirty-eight percent of covered workers were in a plan with a single-coverage deductible of $2,000 or more, which KFF describes as similar to the 34 percent last year. At smaller firms, 55 percent of covered workers were in such a plan, compared with 33 percent at larger firms.
Are employers adding prior authorization?
Most large employers say no. Among firms with 200 or more workers, 7 percent said the number of services subject to prior authorization in their largest plan was higher than last year, 2 percent said lower, 70 percent said about the same and 21 percent did not know. Firms with 1,000 or more workers were more likely than firms with 200 to 999 workers to report an increase, 12 percent versus 6 percent.
Among firms that reported an increase, 48 percent said prior authorization was added to more services to help control overall cost growth. These are employers' answers about their own plans; the survey does not measure how often individual requests are reviewed or denied. A separate federal effort to extend electronic prior authorization to self-funded employer plans was announced Oct. 21, as we report today.
How are employers responding to rising costs?
Shifting more of the premium to workers was the most common response. In 2026, 18 percent of employers, including 66 percent of employers with 5,000 or more workers, said they increased the share of premiums paid by workers in response to anticipated premium increases. Among large firms, 44 percent raised the worker share, 21 percent raised deductibles or other cost sharing for most services, 16 percent changed insurers or plan administrators, 14 percent raised cost sharing for specific services and 10 percent added utilization management, such as prior authorization, for some services.
Do employers cover GLP-1 drugs for weight loss?
A minority of large employers do. Among firms with 200 or more workers, 18 percent cover glucagon-like peptide-1 (GLP-1) agonists when used primarily for weight loss, similar to 19 percent last year. Coverage rises with size: 16 percent of firms with 200 to 999 workers, 29 percent of firms with 1,000 to 4,999 workers and 33 percent of firms with 5,000 or more.
What should practices do now?
Three checks follow from the numbers. First, review cost estimates and point-of-service collection for patients in high-deductible plans; more than half of covered workers at small firms have a single deductible of $2,000 or more. Second, re-verify coverage at the first visit of the plan year, since 16 percent of large firms changed insurers or plan administrators in response to costs. Third, confirm GLP-1 coverage before prescribing for weight loss, because most employers in the survey do not cover it.
Reported, fact-checked and edited by The Script Pad's editorial staff.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
