Workers pay more for family health coverage at smaller firms

Smaller firms had lower average family health premiums but higher employee contributions in KFF’s 2026 employer survey, released October 22.

At firms with 10 to 199 workers, annual family premiums averaged $27,288, compared with $28,592 at firms with 200 or more. Covered workers’ average contributions were $9,687 and $6,840, respectively. These national figures cover private and nonfederal public employers across industries. KFF defines family coverage as coverage for a family of four.

Federal data measure another part of a benefits offer: access and enrollment.

In March 2026, 87% of full-time private-industry workers had access to medical benefits and 58% participated. For part-time workers, those figures were 23% and 11%, according to Bureau of Labor Statistics data.

Participation measures enrollment across all workers in each group. Take-up measures enrollment among those with access. BLS reported take-up rates of 67% for full-time workers and 47% for part-time workers. That means fewer than half of part-time workers with access enrolled, even though that group was already a minority of all part-time workers.