Employer spending on health benefits reached $1.2 trillion in 2022 for 155 million covered lives, while workers still averaged $6,575 a year toward single coverage premiums in 2023. That mix of rising employer commitments and steadily higher employee shares becomes especially telling when you compare small versus large firms and HMO versus HDHP/SO plans.
Key Takeaways
- Worker average monthly contribution for single coverage was $125 in 2023, up from $118 in 2022
- Employees contribute 17% ($1,401) annually to single coverage premiums on average in 2023
- For family coverage, average employee share is 29% ($6,575 yearly) in 2023
- Employer share of family premiums was 71% or $17,393 in 2023
- Large firms (200+ workers) contributed 86% to single premiums ($7,400 average) in 2023
- Total employer spending on health benefits reached $1.2 trillion in 2022 for 155 million covered lives
- In 2023, 53% of firms offering health insurance reported that their largest plan was a PPO, covering 82% of covered workers enrolled in those plans
- Among workers at small firms (3-199 workers), 65% of covered workers are enrolled in a PPO plan as of 2023, compared to 48% at large firms (200 or more workers)
- In 2023, 28% of covered workers were enrolled in HDHP/SOs with an average deductible of $2,017 for single coverage, up from 20% in 2014
- 86% of small firms (3-49 workers) offer health insurance in 2023, up from 69% in 2010
- 47% of firms with 3-9 workers offered coverage in 2023, compared to 95% for 5,000+ worker firms
- Offering rates among firms 50-199 workers reached 89% in 2023
- 91% of finance/insurance firms offer coverage, highest industry rate in 2023 KFF survey
- In education/health services, 82% of firms offer ESI, covering 15% of all covered workers in 2023
- Leisure/hospitality firms offer at 38% rate, lowest among industries in 2023
In 2023, workers paid more of health premiums, with families averaging $6,575 contributed.
Related reading
01 · Category
Employee Contributions18 stats
01
Worker average monthly contribution for single coverage was $125in 2023, up from $118 in 2022
02
Employees contribute 17% ($1,401) annually to single coverage premiums on average in 2023
03
For family coverage, average employee share is 29% ($6,575 yearly) in 2023
04
Small firm workers pay 23% of single premiums ($1,606 average) vs 16% ($1,242) at large firms in 2023
05
HDHP/SO enrollees pay 28% of premiums ($1,986 single) compared to 15% for HMOs in 2023
06
Average annual employee contribution to family HDHP/SOs was $6,217in 2023
07
Workers' family premium share rose from 23% in 2003 to 29% in 2023
08
56% of covered workers face contributions over $100 monthly for single coverage in 2023
09
Northeast employees pay highest family contributions at $7,200average in 2023
10
PPO plan family contributions averaged $6,800for employees in 2023
11
Employee contributions grew 111% since 2003, five times wage growth
12
42% of workers in small firms (3-199) have family contribution caps at 8.2% of income
13
Average biweekly employee deduction for family coverage was $252in 2023
14
Low-wage workers (<$54k household) pay 42% of income on family premiums in 2023
15
71% of covered workers have contributions that vary by salary in 2023
16
HMO enrollees pay lowest share at 14% ($1,166 single) in 2023
17
Average employee HSA contribution was $968for single coverage in employer-funded HSAs 2023
18
Family contribution averaged $500monthly for 25% of workers in 2023
Interpretation
Employee Contributions Interpretation
In a trend that feels less like shared responsibility and more like a slow-motion financial heist, employee contributions for health insurance have surged over 20 years, now forcing low-wage workers to hand over nearly half their income for family coverage while wages have barely budged.
02 · Category
Employer Contributions16 stats
01
Employer share of family premiums was 71% or $17,393 in 2023
02
Large firms (200+ workers) contributed 86% to single premiums ($7,400 average) in 2023
03
Total employer spending on health benefits reached $1.2 trillion in 2022 for 155 million covered lives
04
Employers covered 83% of single coverage premiums ($7,129 worker-paid $1,306) in 2023
05
In HDHP/SOs, employer contribution to family premiums averaged $14,986or 71% in 2023
06
Small firms contributed average $6,800to single premiums (83%) in 2023
07
Employer premium contributions grew 47% from 2013-2023, outpacing wages by 18%
08
82% of large firms contribute to HSAs for HDHP/SO enrollees in 2023, averaging $968 single
09
Employers in the South contributed least to family premiums at $16,200average in 2023
10
For PPOs, employers paid 72% of family premiums ($17,400) in 2023
11
Average employer contribution per covered worker for health benefits was $13,741in 2021
12
Firms with 500+ workers contributed 85% to single coverage in 2023
13
Employer spending on family coverage rose 5% nominally in 2023 to $17,393
14
76% of covered workers have employer contributions to retirement plans alongside health in 2023
15
Average employer-paid premium per enrollee was $15,400for state/local government workers in 2022
16
Employers offered premium reimbursement to 12% of HDHP/SO enrollees in 2023
Interpretation
Employer Contributions Interpretation
Employers are essentially running a trillion-dollar shadow healthcare system, lavishly subsidizing our premiums like overzealous fairy godparents while our paychecks gasp for air.
03 · Category
Employer-Sponsored Insurance Coverage20 stats
01
In 2023, 53% of firms offering health insurance reported that their largest plan was a PPO, covering 82% of covered workers enrolled in those plans
02
Among workers at small firms (3-199 workers), 65% of covered workers are enrolled in a PPO plan as of 2023, compared to 48% at large firms (200 or more workers)
03
In 2023, 28% of covered workers were enrolled in HDHP/SOs with an average deductible of $2,017 for single coverage, up from 20% in 2014
04
91% of covered workers have access to prescription drug coverage through their employer-sponsored plans in 2023
05
For family coverage in 2023, 73% of covered workers are in PPOs, 18% in HDHP/SOs, 5% in HMOs, and 3% in PPOs
06
Small firms (3-199 workers) saw 77% offering coverage to their workers in 2023, down from 81% in 2022
07
99% of large firms (200+ workers) offer health insurance to at least some workers in 2023
08
Among firms with 50-199 workers, 92% offer coverage, with 68% of those offering PPOs as the most common plan type
09
In 2023, 55% of covered workers have coverage through a self-insured plan, rising to 82% for firms with 5,000+ workers
10
24% of small employers (3-49 workers) offered insurance in 2023, compared to 94% of large firms (1,000+ workers)
11
Covered workers in HDHP/SOs account for 29% of enrollment in 2023, with an average out-of-pocket maximum of $4,716 for family coverage
12
196 million non-elderly Americans had employment-based coverage in 2022, representing 52.5% of the under-65 population
13
In 2022, 64.8% of workers aged 18-64 had employer-sponsored insurance, varying by income from 79% for highest quartile to 45% for lowest
14
Among full-time workers, 73% had ESI in 2022, dropping to 36% for part-time workers
15
89% of firms with 1,000+ workers offered HDHP/SOs in 2023, but only 15% of small firms (3-49) did
16
In 2023, 15% of covered workers were in HMOs, primarily in the West region at 23%
17
Self-insured plans covered 63% of covered workers in 2023, up from 55% in 2018
18
92% of covered workers have dental coverage offered by employers in 2023
19
Vision coverage is offered by 34% of small firms and 77% of large firms in 2023
20
68% of covered workers can choose from three or more plans in 2023
Interpretation
Employer-Sponsored Insurance Coverage Interpretation
While the nation's largest companies increasingly shield themselves with self-insurance and offload costs via high-deductible plans, the small business backbone of America is quietly crumbling, offering less coverage each year and leaving a stark two-tiered system where your job's size dictates your health security.
More related reading
04 · Category
Firm Size and Offering Rates21 stats
01
86% of small firms (3-49 workers) offer health insurance in 2023, up from 69% in 2010
02
47% of firms with 3-9 workers offered coverage in 2023, compared to 95% for 5,000+ worker firms
03
Offering rates among firms 50-199 workers reached 89% in 2023
04
99% of firms 200+ workers offer insurance, with 100% for 5,000+ in 2023
05
Small firms saw eligibility rates of 72% for offered plans in 2023
06
25% of workers in firms 3-49 are eligible for coverage where offered, lowest among sizes
07
Large firms (1,000+) have 78% enrollment rates among eligible workers in 2023
08
Offering rates dropped to 54% for firms 3-199 workers from pre-ACA levels but stabilized in 2023
09
92% of firms 50-99 workers offer coverage in 2023
10
Self-insuring is adopted by 90% of firms 5,000+ workers vs 12% of 3-199 in 2023
11
69% of workers employed by small firms (3-199) have access to ESI in 2023
12
Firms 200-999 workers have 97% offering rate, with 75% PPO dominant plans
13
Enrollment in small firm plans averages 55% of eligible workers in 2023
14
83% of very small firms (3-24 workers) cite cost as top reason for not offering in 2023
15
Large firms cover 67% of all ESI enrollees despite being 1% of firms in 2023
16
61% of firms 25-49 workers offer insurance, up 5% from 2022 in 2023 survey
17
HDHP/SO offering in small firms rose to 37% in 2023 from 25% in 2018
18
94% of firms 1,000-4,999 offer multiple plan choices in 2023
19
Worker access rates are 90% in large firms vs 48% in small firms 3-49 in 2023
20
72% of retail trade firms (small-heavy) offer coverage in 2023
21
Average premiums in manufacturing firms (often larger) were $9,200single in 2023
Interpretation
Firm Size and Offering Rates Interpretation
While small businesses have made a valiant, cost-stricken effort to join the health insurance party since 2010, the stark reality remains that coverage is still largely a privilege of corporate scale, where the giants not only offer tickets but can also afford to design the entire carnival themselves.
05 · Category
Industry-Specific Statistics15 stats
01
91% of finance/insurance firms offer coverage, highest industry rate in 2023 KFF survey
02
In education/health services, 82% of firms offer ESI, covering 15% of all covered workers in 2023
03
Leisure/hospitality firms offer at 38% rate, lowest among industries in 2023
04
Manufacturing firms have 78% offering rate, with 55% PPO enrollment in 2023
05
Wholesale/retail trade offering rate is 72%, but only 45% enrollment among eligible in 2023
06
Professional services firms offer at 85%, with average family premiums $25,200 in 2023
07
Construction industry offering rate 65%, heavily small-firm influenced in 2023
08
Transportation/communications/utilities have 88% offering, 65% self-insured in 2023
09
In agriculture/mining/logging, only 52% offer coverage in 2023 KFF data
10
Public administration firms offer 98%, with $15,400 average employer premium per enrollee in 2022 BLS data
11
Healthcare industry workers have 92% ESI coverage rate among full-time in 2022 Census
12
Finance sector average annual premium $24,500family in 2023, highest industry
13
Retail trade enrollment 52% of eligible, lowest due to part-time prevalence in 2023
14
Manufacturing HDHP/SO adoption 35%, above average in 2023
15
Hospitality worker ESI access only 32% in 2022 MEPS data
Interpretation
Industry-Specific Statistics Interpretation
While it's a statistical delight that those in finance are so well-covered, the stark reality is that your access to health insurance remains perilously tied to whether your job involves serving coffee, spreadsheets, or the public good.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Priya Chandrasekaran. (2026, February 13). Health Insurance Employment Statistics. Gitnux. https://gitnux.org/health-insurance-employment-statistics
MLA
Priya Chandrasekaran. "Health Insurance Employment Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/health-insurance-employment-statistics.
Chicago
Priya Chandrasekaran. 2026. "Health Insurance Employment Statistics." Gitnux. https://gitnux.org/health-insurance-employment-statistics.
Sources & references
6 datasets cited across this report · attribution is report-level