What small-business health insurance costs, according to official surveys

Two official benchmarks, and why they differ

There is no single official average. Two widely used sources publish averages each year, and they do not measure the same set of firms.

The KFF 2026 Employer Health Benefits Survey, published October 22, 2026, interviews non-federal public and private employers with 10 or more workers. In that survey, "smaller firms" means firms with 10 to 199 workers. KFF reports that the average annual premium for employer-sponsored coverage in 2026 is $9,804 for single coverage and $28,303 for family coverage, each about 5% higher than in 2025. For covered workers at smaller firms, the average annual premium is $9,593 for single coverage and $27,288 for family coverage. At larger firms (200 or more workers), those averages are $9,865 and $28,592. Divided by 12, those smaller-firm averages are about $799 a month (single) and about $2,274 a month (family).

The federal Medical Expenditure Panel Survey — Insurance Component (MEPS-IC), sponsored by AHRQ and fielded by the Census Bureau, uses a different cut: private-sector establishments, split at fewer than 50 employees versus 50 or more. That break is closer to the ACA applicable large employer line and to the core group Ares advises. In the 2025 MEPS-IC tables — the latest complete official release as of this writing — the average total annual premium at firms with fewer than 50 employees was $9,034 for single coverage (Table I.C.1) and $24,176 for family coverage (Table I.D.1). At firms with 50 or more employees, those averages were $9,024 and $26,602. The all-firm national averages were $9,025 (single) and $26,281 (family). Divided by 12, the under-50 averages are about $753 a month (single) and about $2,015 a month (family).

Use both numbers, and keep the labels attached. KFF is more recent (plan year 2026) and includes public employers, but it starts at 10 workers and groups "small" up to 199 employees. MEPS-IC includes the smallest private firms and splits at 50, the more useful cut for a 2-to-50-employee company, but its latest official tables describe 2025. Neither figure is a quote for your firm.

What employees typically contribute

The premium is the total amount paid for the coverage, whether the employer pays it, the employee pays it, or they share it. The employee's share is a separate, and at smaller firms often larger, part of the story.

KFF reports that, in 2026, covered workers contribute 18% of the premium for single coverage and 27% for family coverage on average. The single-coverage contribution rates are similar at smaller and larger firms (16% vs. 18%). The family contribution rate is much higher at smaller firms: 37%, compared with 25% at larger firms. In dollars, the average annual worker contribution is $1,672 for single coverage and $7,471 for family coverage. For family coverage, covered workers at smaller firms contribute $9,687 a year on average, compared with $6,840 at larger firms — about $807 a month ($9,687 ÷ 12).

KFF also reports that 29% of covered workers at smaller firms are in a plan where the employer pays the entire single premium (5% at larger firms), while 32% must contribute more than half of the family premium (6% at larger firms). Thirty-one percent of covered workers at smaller firms are in a plan with a worker contribution of $12,000 or more for family coverage.

MEPS-IC 2025 tells a consistent story in a different sample. At firms with fewer than 50 employees, the average employee contribution was $1,924 a year for single coverage (Table I.C.2) and $7,760 a year for family coverage (Table I.D.2). At firms with 50 or more employees, those averages were $1,796 and $7,246. Divided by 12, the under-50 contributions are about $160 a month (single) and about $647 a month (family).

A contribution is a design choice. Many smaller employers pay a larger share — sometimes all — of the employee-only premium and a smaller share of dependent coverage. That pattern shows up in both surveys, and it is one of the items we will set with you on a proposal.

Deductibles and other cost-sharing

Premium is only one part of what coverage costs. KFF reports that, among covered workers in a plan with a general annual deductible in 2026, the average deductible for single coverage is $1,955. At smaller firms the average is $2,624; at larger firms it is $1,772. Fifty-five percent of covered workers at smaller firms are in a plan with a general annual deductible of $2,000 or more for single coverage, compared with 33% at larger firms.

Those are survey averages, not a recommendation to raise or lower a deductible. A high-deductible plan that is HSA-qualified is a distinct design with its own IRS rules; its average KFF premiums are lower than the overall average ($8,989 single and $26,450 family). A PPO in the same survey has a higher-than-average premium ($10,272 single and $29,522 family). Metal tiers describe how expected allowed costs are shared; they are not a quality rating. See small-group metal tiers and how to compare group health plans.

Offer rates, and what an average does not include

An average premium is calculated among employers that offer coverage and, in these surveys, among workers who are enrolled. It does not describe firms that do not offer a plan.

KFF reports that, in 2026, 67% of firms with 10 or more workers offer health benefits, compared with 98% of firms with 200 to 999 workers and more than 99% of firms with 1,000 or more workers. MEPS-IC 2025 shows a wider gap at the under-50 cut: 32.1% of private-sector establishments at firms with fewer than 50 employees offered health insurance, compared with 94.8% at firms with 50 or more (Table I.A.2). In Florida the under-50 offer rate was 22.8%. Many small Florida firms are shopping for a first plan, not only renewing one.

Premiums also vary by place

KFF reports lower-than-average 2026 premiums in the South ($9,272 single and $26,702 family) and higher-than-average premiums in the Northeast ($10,806 and $31,378). MEPS-IC publishes state-level averages. For 2025, at private-sector firms with fewer than 50 employees, average annual single premiums included $9,742 in Florida, $8,737 in Texas, $9,149 in California, and $11,804 in New York (Table II.C.1). Family premiums at the same firm size included $24,957 in Florida, $21,949 in Texas, $23,389 in California, and $30,351 in New York (Table II.D.1). Those are still averages for enrolled employees at establishments that offer coverage, not a city-level quote.

Florida employers can also use Tampa Bay employer benefits and the local group-health pages in this update. Employers with people in other states can start with the Texas, California, or New York pages, or with multi-state workforces.

What actually builds your quote

Survey averages are a starting point for budgeting. A proposal is built from the roster, the states where people work, the plan design, and the contribution you set. In most states a small-group plan is issued for 1 to 50 employees; California, New York, and Vermont use 1 to 100. See group coverage for 2, 5, or 10 employees. Fully insured small-group products are approved state by state. In Florida, the Department of Financial Services publishes the 2026 small-group ACA marketers, with county-level availability at the Office of Insurance Regulation.

Network type, deductible, out-of-pocket maximum, and metal tier change both the premium and what employees pay when they use care. See group plan options. The funding structure matters as well: a fully insured small-group plan, a level-funded or self-funded design, an ICHRA or QSEHRA, SHOP coverage, or coverage arranged through a PEO. Eligible small employers who enroll through SHOP may also look at the Small Business Health Care Tax Credit. A Section 125 cafeteria plan is how employees often pay their share of eligible premiums with pre-tax wages when the Code allows it.

A company with fewer than 50 full-time employees, including full-time equivalents, is generally not an applicable large employer and is not required to offer health coverage. Many still do. See Do employers under 50 have to offer health insurance?.

How we use these figures in a proposal

When you request a proposal, we start with your census, not with a national average. We will put the designs that can be issued for your group on one recommendation, including the employer and employee shares, and we will use the official figures on this page only as context — not as a substitute for the quote.

To test a contribution split against the rates on a quote — with no default premiums or percentages — use the employer contribution calculator.