Group Health Broker Benchmarks
Group Health Premium Benchmarks by Plan Type and Firm Size (2026)
The premium numbers a broker quotes every day, assembled from the KFF Employer Health Benefits Survey: average single and family premiums, by plan type and firm size, with the five-year trend. The definitive primary source, made usable.
The KFF Employer Health Benefits Survey is the benchmark the entire industry quotes: it covers the employer-sponsored coverage of 154 million Americans. The problem is the report is dense. Below are the numbers a broker actually uses in a renewal or prospecting conversation, tabled cleanly, with the trend context that frames every rate discussion.
Table 1: Average annual premiums, 2025
| Coverage | Average premium | YoY change | Monthly equivalent |
|---|---|---|---|
| Single coverage | $9,325 | +5% | ~$777/mo |
| Family coverage | $26,993 | +6% | ~$2,249/mo |
Table 2: Premiums by plan type
| Plan type | Single | Family | Enrollment share |
|---|---|---|---|
| PPO | $9,818 | $28,272 | 46% |
| HDHP/SO | $8,620 | $25,379 | 33% |
| HMO | — | — | 12% |
| POS | — | — | 9% |
The PPO-to-HDHP spread is the broker’s most usable number: moving a family from PPO to HDHP/SO saves roughly $2,900 a year in premium ($28,272 vs. $25,379) before contribution strategy. With 46% of covered workers still on PPOs, that spread is the standing plan-design conversation in nearly half the market.
Table 3: The trend context
| Measure | 1-year | 5-year |
|---|---|---|
| Family premium growth | +6% | +24–26% |
| Workers’ wages | +4% | +26–28% |
| Inflation | +2.7% | +23–28.6% |
Table 4: What’s coming
| Driver | Signal |
|---|---|
| Small-group & individual rate filings | Insurers requesting double-digit increases |
| GLP-1 coverage expansion | 43% of 5,000+ firms cover for weight loss (up YoY) |
| Prescription drug costs | Top employer-cited premium driver |
| Hospital prices & tariffs | KFF flags sharper employer premium growth ahead |
For a broker, Table 4 is the prospecting script: double-digit small-group filings mean every renewal conversation next cycle starts with sticker shock, which is precisely when employers take broker-of-record calls. The agencies that grow through a hard market are the ones in front of that conversation early with plan-design and funding alternatives.
Frequently asked questions
- What is the average group health premium in 2026?
- Per the KFF 2025 survey, average annual premiums are $9,325 for single coverage (~$777/month) and $26,993 for family (~$2,249/month), up 5% and 6% respectively, with double-digit small-group increases requested for the next cycle.
- How much cheaper are HDHPs than PPOs?
- About $1,200/year on single coverage ($8,620 vs. $9,818) and $2,900/year on family ($25,379 vs. $28,272), before employer contribution strategy or HSA funding.
- Are premiums rising faster than wages?
- Roughly in line over five years (premiums +24–26% vs. wages +26–28%), but the 2025 increase (5–6%) outpaced both wages (4%) and inflation (2.7%), and next cycle’s filings point steeper.
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Sources & methodology
- All premium, plan-type, and trend figures: KFF, 2025 Employer Health Benefits Survey (Annual Survey and Summary of Findings), October 2025. The EHBS covers employer-sponsored coverage of 154 million Americans and is the industry’s standard primary source.
- Forward pressure: KFF 2025 release commentary (double-digit small-group filings; GLP-1 coverage; drug-price drivers).
- Note on figures: all Table 1–3 figures are KFF primary survey data. This page restates them in broker-usable form; verify current-year figures at kff.org when the 2026 survey publishes.