Workers’ annual contributions for family health insurance rose 9% in 2026, reaching an average of $7,471.
Total family premiums, including employers’ payments, averaged $28,303 — increasing faster than wages and inflation.
Employees at smaller businesses face substantially higher family premium contributions and deductibles than those at larger firms.
Americans who get health insurance through work are seeing more of their paychecks go toward coverage, according to KFF’s (Kaiser Family Foundation) 2026 Employer Health Benefits Survey.
Workers contributed an average of $7,471 toward family premiums this year, an increase of $621 from 2025. Including the employer’s portion, annual family premiums reached $28,303, up 5%. That exceeded wage growth of 3.7% and general inflation of 2.7% over the comparison period.
The employee contribution works out to roughly $623 a month — before deductibles, copayments and other charges for using medical services.
The burden is particularly heavy at smaller businesses. Workers at firms with 10 to 199 employees contributed an average of $9,687 annually for family coverage, compared with $6,840 at larger employers. That is a difference of nearly $2,850 a year.
Passing on rising costs
Employers are responding to rising expenses by shifting some costs to employees. Among firms with at least 200 workers that offer health benefits, 44% increased workers’ share of premiums in response to projected cost increases. Another 21% increased deductibles or other cost sharing for most services.
Premiums are only part of the financial exposure. Among workers whose individual coverage includes a general annual deductible, the average deductible was $1,955. At smaller firms, it averaged $2,624, compared with $1,772 at larger firms.
Overall, 38% of covered workers were enrolled in plans with individual deductibles of at least $2,000.
The survey also found limited coverage for GLP-1 medications prescribed primarily for weight loss. Among employers with at least 200 workers offering health benefits, 18% covered those drugs. Of those covering them, 40% required participation in a lifestyle program or meetings with a dietitian, case manager or therapist.
It’s wise to shop around
For workers reviewing benefits during open enrollment, the findings underscore the value of comparing total potential spending. A lower payroll deduction can come with a larger deductible or higher charges when care is needed.
Employees can use each plan’s benefit summary to compare premiums, deductibles, prescription coverage and out-of-pocket limits, while checking whether their doctors and hospitals participate. Couples with access to two workplace plans should also compare the cost of covering everyone together with enrolling separately.
KFF’s survey included 1,937 interviews with private and nonfederal public employers. Employer-sponsored insurance covers almost 157 million Americans younger than 65.