2026 KFF Survey Takeaways: Rising Worker Costs and a Gap in Provider Data

Key Takeaways

• The 2026 KFF Employer Health Benefits Survey shows what workers pay for family coverage rising nearly twice as fast as the cost of the coverage itself.
• Employers say they are happy with the quality of the doctors in their networks, yet few large employers are confident they can see what their plan pays those doctors.
• Large employers most often responded to rising costs in 2026 by asking workers to pay more, and far fewer changed how or where their employees get care.

Family coverage cost $28,303 on average in 2026, according to the KFF Employer Health Benefits Survey findings, and workers paid $7,471 of it. While the total rose 5% from 2025, the workers’ portion rose 9%, more than twice as fast as their wages.

KFF’s 28th annual survey of employer-sponsored health benefits, released in October, drew on 1,937 employers with 10 or more workers, interviewed from December 2025 through July 2026. While the premium figures will headline most of the news coverage, the findings that matter more for 2028 planning come later in the report. Nearly every employer says it’s happy with the quality of the doctors in its network, yet few large employers are confident they can see what their plan pays those doctors. And few large employers have tried changing which doctors their employees see, even though that could lower plan costs without asking workers to pay more.

The headline numbers from the 2026 Employer Health Benefits Survey

In the 2026 Employer Health Benefits Survey, while premium growth was steady, workers’ contributions grew much faster.

A worker’s contribution is their share of the premium, taken out of each paycheck. This year’s increase came through that paycheck deduction. Deductibles, which workers pay only when they use care, stayed about where they were in 2025. So the cost shift reached every covered worker, whether or not they saw a doctor this year.

Firm size makes a large difference in what a family pays. At firms with fewer than 200 workers, employees with family coverage pay $9,687 a year toward the premium on average, compared with $6,840 at larger firms. Nearly a third of those small-firm workers pay more than half the family premium themselves, compared with 6% at larger firms. So the national averages understate what families at small employers pay.

Where employers went looking for savings in 2026

When KFF asked firms with 200 or more workers how they responded to projected cost increases, the most common answer was asking workers to pay more.

Actions that shifted cost to workers or trimmed benefits

• 44% increased the share of the premium workers pay
• 21% increased deductibles or cost sharing for most services
• 14% increased cost sharing for specific services
• 4% tightened eligibility for certain benefits
  
  

Actions that changed the insurer, the rules, or the network

• 16% changed insurers or plan administrators
• 10% added utilization management, such as prior authorization
• 7% switched to a plan with a tiered or narrower network

Far more employers asked workers to pay more than changed the plan itself. That matters because most covered workers (71%) are in self-funded plans, including 85% of those at large firms. A self-funded employer pays claims directly, so its plan costs are the sum of what it pays doctors and hospitals. Raising contributions changes who pays that bill without making it any smaller. The bill itself keeps growing for structural reasons, from hospital prices to low-quality care, and cost-shifting does nothing about any of them.

Few employers are sure what they pay providers

The KFF employer health benefits survey findings show employers give the doctors in their networks high marks on quality. But when KFF asked firms with 200 or more workers whether their insurer or administrator gives them enough information to understand prices and how care is used, few said yes without hedging.

On prices, most of the other large employers chose the softer “agree,” and some didn’t know whether they could get that information at all. KFF didn’t ask at all whether employers can see how well each doctor’s patients do. So when nearly every employer rates provider quality highly, that rating reflects what employers believe, not what their data shows.

Employers seem to judge quality by how many doctors the network includes. Of all firms, 89% describe the network in their largest plan as very or somewhat broad, and only 7% of large firms moved to a tiered or narrower network this year. A long list of doctors reads as a good list of doctors, even though the list itself says nothing about how those doctors perform.

Many large employers say their claims data is easy to access, but claims alone don’t show how each doctor performs. That takes measuring, doctor by doctor, how closely they follow clinical guidelines and what their patients’ care costs over time. 

Why raising worker costs won’t balance 2028 budgets

The 2026 survey measures what employers already paid, and forecasts for 2027 are higher. Mercer’s preliminary 2026 survey projects employer health benefit costs will rise 8.2% on average in 2027, the highest increase since 2003, even after planned cost-cutting changes. Business Group on Health puts the median 2027 trend at 9.2% and notes that actual costs have come in above employer forecasts three years running. A 2028 budget built on this year’s 5% premium growth is likely to come in low, and the usual way of balancing it — asking workers to pay more — is reaching a breaking point.

Three points should shape how a benefits team plans for 2028.

1. Cost-shifting is reaching its limit. KFF notes that after decades in which workers’ share of the premium held steady, a shift toward higher contributions “could raise new affordability concerns.” An employer that raised contributions and deductibles in 2026 has less room to do it again, so rethinking the plan before the next renewal means looking at options other than raising what workers pay.
2. The data gap is the planning gap. Large employers already want to guide care toward better doctors. Guiding members to higher-quality care moved into their top three priorities in Mercer’s survey this year, up from fifth. But guiding care to better doctors takes data on individual doctors, and few large employers are sure they have it. That data has to come first, since without it, a benefits team can’t design a quality-based change or tell whether it worked.
3. Broad networks and quality are separate questions. A network can be broad and still hold doctors in the same specialty whose patients have very different outcomes and total costs. Even inside a single hospital system, the best-performing doctors deliver 70% less low-value care than their underperforming peers. A broad network can include both, and the network list alone won’t tell employees which is which.

Five steps to take before your 2028 renewal

A benefits team can work through these steps during 2028 planning, starting with the numbers it already has.

1. Benchmark the basics. Compare the plan’s premium, worker contribution, and deductible figures against the KFF averages for its firm size.
2. List what the plan has already changed. Check the actions taken over the last two renewals against KFF’s list and note which ones the plan hasn’t tried.
3. Audit the data the administrator can provide. Ask for prices paid to in-network providers, service use by provider type, and gaps in care, then record what actually arrives.
4. Score breadth and quality separately. When comparing carriers, networks, or vendors for 2028, treat network size and provider quality as two different things.
5. Set a quality baseline before renewal. Measure provider quality now, so next year’s decision has a starting point to compare against. The savings calculator offers a first estimate of what better doctor choices could be worth.

Confidence is not visibility

Employers report near-universal satisfaction with provider quality, yet few large employers are confident they can see what their plan pays those providers. Their most common 2026 changes decided who pays for care, not which doctors deliver it. The plans that control cost in 2028 will be the ones that guide care toward the best-performing doctors, not the ones that raise deductibles again. Garner measures cost and quality for each doctor in the network you already have and helps cover employees’ out-of-pocket costs when they choose one of those doctors, so savings don’t depend on raising what workers pay. Book a demo to see what that data looks like for your own network.

FAQs

What is the KFF Employer Health Benefits Survey?

The KFF Employer Health Benefits Survey is an annual study of the cost and design of employer-sponsored health coverage in the U.S. The 2026 edition, the 28th, surveyed 1,937 public and private employers with 10 or more workers between December 2025 and July 2026. It tracks premiums, worker contributions, deductibles, plan types, and funding, and it asks employers how they are responding to rising costs.

How much did employer health insurance premiums increase in 2026?

Average premiums rose 5% in 2026, to $9,804 for single coverage and $28,303 for family coverage. That outpaced wage growth of 3.7% and inflation of 2.7%. Worker contributions rose faster, as the average family contribution climbed 9% to $7,471 and the average single contribution climbed 16% to $1,672. So workers felt this year’s increase more than the headline premium number suggests.

What is the average deductible for employer health coverage in 2026?

The average general annual deductible for single coverage is $1,955 in 2026, similar to 2025. Most workers with single coverage (88%) have a general deductible. Deductibles are higher at firms with fewer than 200 workers, where they average $2,624, and 38% of all covered workers are in a plan with a single deductible of $2,000 or more.

How are employers responding to rising health care costs?

Large employers most often asked workers to pay more. Among firms with 200 or more workers, 44% raised the worker share of premiums and 21% raised deductibles or cost sharing for most services in 2026. Far fewer changed how or where care is delivered, with 10% adding utilization management and 7% moving to a tiered or narrower network.

Why do employers say they’re satisfied with provider quality?

KFF doesn’t ask employers why, but the survey’s network data points to breadth as a likely reason. Nearly all employers (95%) are satisfied with the quality of their network providers, and 89% describe their network as broad. Yet among firms with 200 or more workers, only 14% strongly agree they can understand the prices their plan pays providers, so for most employers, that satisfaction isn’t based on clear data about what providers charge.