Group Health Broker Benchmarks
Employer Cost-Sharing Benchmarks by Firm Size (2026)
What employers pay versus what workers contribute, by coverage tier and firm size, from the KFF Employer Health Benefits Survey. The contribution-strategy table for every renewal conversation.
Every renewal conversation eventually lands on the split: how much of the premium the employer absorbs and how much lands in the employee’s paycheck. The KFF survey benchmarks that split every year, and the small-firm versus large-firm gap is the most useful number in it, because it tells a broker exactly where a client sits against market and how much repricing room exists before employees feel it.
Table 1: The average split, 2025
| Coverage | Worker pays | Employer pays | Worker share |
|---|---|---|---|
| Single ($9,325 premium) | $1,440 | $7,885 | 16% |
| Family ($26,993 premium) | $6,850 | $20,143 | 26% |
Table 2: The small-firm penalty
| Firm size | Avg. family contribution | Workers paying $12,000+ |
|---|---|---|
| 10–199 workers | $8,889 | 28% |
| 200+ workers | $6,227 | — |
| All covered workers | $6,850 | 11% |
This is the sharpest number in the survey for a small-group broker: workers at small firms pay $2,662 more per year for family coverage than workers at large firms, and 28% of small-firm workers pay over $12,000. That gap is the recruiting-disadvantage story that sells plan redesign, level funding, and contribution restructuring to small employers competing for talent.
Table 3: Plan mix behind the split
| Plan type | Enrollment share | Contribution note |
|---|---|---|
| PPO | 46% | Highest premiums, richest networks |
| HDHP/SO | 33% | Lower premium; HSA/HRA funding common |
| HMO | 12% | Network trade-off |
| POS | 9% | Hybrid |
Table 4: The renewal-strategy levers
| Lever | What it moves | Watch-out |
|---|---|---|
| Contribution percentage shift | Employer cost ↔ employee paycheck | Retention/recruiting optics |
| PPO → HDHP/SO migration | ~$2,900/yr family premium savings | Deductible exposure; pair with HSA seed |
| Tiered contribution design | Targets family-tier pain | Discrimination testing |
| Funding change (level-funded) | Refund upside, mandate relief | Census underwriting |
| Ancillary rebalance | Perceived richness at low cost | See our ancillary benchmark |
Frequently asked questions
- What percentage of health premiums do employees pay?
- On average, 16% for single coverage and 26% for family coverage (KFF 2025): $1,440 and $6,850 per year respectively, with employers absorbing the remainder.
- Do small-firm employees pay more?
- Substantially. Average family contribution at firms with 10–199 workers is $8,889 versus $6,227 at larger firms, and 28% of small-firm workers pay over $12,000 a year for family coverage.
- What is the standard employer contribution strategy?
- Most employers cover the large majority of single premiums (workers pay 16% on average) and a smaller share of dependent costs (workers pay 26% of family premiums), with tiered designs used to target where the contribution dollars matter most.
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Sources & methodology
- All contribution and premium figures: KFF, 2025 Employer Health Benefits Survey, October 2025 (worker contributions 16%/26%; $1,440/$6,850; small-firm family contribution $8,889 vs. $6,227; 28% of small-firm workers over $12,000; plan-type enrollment mix).
- PPO–HDHP savings figure: KFF 2025 plan-type premium averages.
- Note on figures: Tables 1–3 are KFF primary survey data. Table 4 is standard renewal practice, presented directionally.