2020 Employer Health Benefits Survey

Section 1: Cost of Health Insurance

In 2020, the average annual premiums are $7,470 for single coverage and $21,342 for family coverage. The average premium for single coverage increased by 4% since 2019 and the average premium for family coverage increased by 4%. The average family premium has increased 55% since 2010 and 22% since 2015.

This graphing tool allows users to look at changes in premiums and worker contributions for covered workers at different types of firms over time: https://www.kff.org/interactive/premiums-and-worker-contributions/

PREMIUMS FOR SINGLE AND FAMILY COVERAGE
  • The average premium for single coverage in 2020 is $7,470 per year. The average premium for family coverage is $21,342 per year [Figure 1.1].
  • The average annual premium for single coverage for covered workers in small firms ($7,483) is similar to the average premium for covered workers in large firms ($7,466). The average annual premium for family coverage for covered workers in small firms ($20,438) is lower than the average premium for covered workers in large firms ($21,691). [Figure 1.2].
  • The average annual premiums for covered workers in HDHP/SOs is lower for single coverage ($6,890) but similar for family coverage ($20,359) to the overall average premiums. The average premiums for covered workers enrolled in PPOs are higher for single ($7,880) and family coverage ($22,248) than the overall average premiums [Figure 1.1].
  • The average premiums for covered workers with single coverage are relatively high in the Northeast and relatively low in the South. The average premiums for covered workers with family coverage are relatively high in the Northeast and relatively low in the South and West [Figure 1.3].
  • The average premium for single coverage varies across industries. Compared to the average single premiums for covered workers in other industries, the average premiums for covered workers in the Manufacturing, Retail, and Agriculture/Mining/Construction categories are relatively low and the average premium for Health Care workers is relatively high [Figure 1.4].
  • The average premium for family coverage for covered workers in firms with a relatively large share of lower-wage workers (where at least 35% of the workers earn $26,000 annually or less) is lower than the average premium for covered workers in firms with a smaller share of lower-wage workers ($19,332 vs. $21,486) [Figure 1.6].
  • The average premium for single coverage for covered workers in firms with a relatively large share of older workers (where at least 35% of the workers are age 50 or older) is higher than the average premium for covered workers in firms with a smaller share of older workers ($7,665 vs. $7,288) [Figure 1.6].
  • The average premium for family coverage for covered workers in firms with a relatively large share of younger workers (where at least 35% of the workers are age 26 or younger) is lower than the average premium for covered workers in firms with a smaller share of younger workers ($19,893 vs. $21,441) [Figure 1.6].
  • Covered workers at private for-profit firms have lower average annual premiums than covered workers at public firms or private not-for-profit firms for single coverage [Figure 1.6].

Figure 1.1: Average Annual Premiums for Covered Workers, Single and Family Coverage, by Plan Type, 2020

Figure 1.1: Average Annual Premiums for Covered Workers, Single and Family Coverage, by Plan Type, 2020

Figure 1.2: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Firm Size, 2020

Figure 1.2: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Firm Size, 2020

Figure 1.3: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Region, 2020

Figure 1.3: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Region, 2020

Figure 1.4: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Industry, 2020

Figure 1.4: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Industry, 2020

Figure 1.5: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Characteristics, 2020

Figure 1.5: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Characteristics, 2020

Figure 1.6: Average Annual Premiums for Covered Workers, by Firm Characteristics and Firm Size, 2020

Figure 1.6: Average Annual Premiums for Covered Workers, by Firm Characteristics and Firm Size, 2020

PREMIUM DISTRIBUTION
  • There remains considerable variation in premiums for both single and family coverage.
    • Eighteen percent of covered workers are employed in a firm with a single premium at least 20% higher than the average single premium, while 17% of covered workers are in firms with a single premium less than 80% of the average single premium [Figure 1.7].
    • For family coverage, 18% of covered workers are employed in a firm with a family premium at least 20% higher than the average family premium, while 20% of covered workers are in firms with a family premium less than 80% of the average family premium [Figure 1.7].
  • Nine percent of covered workers are in a firm with an average annual premium of at least $10,000 for single coverage [Figure 1.8]. Ten percent of covered workers are in a firm with an average annual premium of at least $28,000 for family coverage [Figure 1.9].

Figure 1.7: Distribution of Annual Premiums for Single and Family Coverage Relative to the Average Annual Single or Family Premium, 2020

Figure 1.7: Distribution of Annual Premiums for Single and Family Coverage Relative to the Average Annual Single or Family Premium, 2020

Figure 1.8: Distribution of Annual Premiums for Covered Workers With Single Coverage, 2020

Figure 1.8: Distribution of Annual Premiums for Covered Workers With Single Coverage, 2020

Figure 1.9: Distribution of Annual Premiums for Covered Workers With Family Coverage, 2020

Figure 1.9: Distribution of Annual Premiums for Covered Workers With Family Coverage, 2020

PREMIUM CHANGES OVER TIME
  • The average premium for single coverage is 4% higher than the single premium last year, and the average premium for family coverage is 4% higher than the average family premium last year [Figure 1.10].
    • The average premium for single coverage has grown 20% since 2015, similar to the growth in the average premium for family coverage (22%) over the same period [Figure 1.10].
    • The average family premiums for both small and large firms have increased at similar rates since 2015 (23% for small firms and 21% for large firms). For small firms, the average family premium rose from $16,625 in 2015 to $20,438 in 2020. For large firms, the average family premium rose from $17,938 in 2015 to $21,691 in 2020 [Figures 1.11 and 1.12].
    • The $21,342 average family premium in 2020 is 22% higher than the average family premium in 2015 and 55% higher than the average family premium in 2010. The 22% family premium growth in the past five years is slower than the 27% growth between 2010 and 2015 [Figure 1.14].
    • The average family premiums for both small and large firms have increased at similar rates since 2010 (54% for small firms and 55% for large firms). For small firms, the average family premium rose from $13,250 in 2010 to $20,438 in 2020. For large firms, the average family premium rose from $14,038 in 2010 to $21,691 in 2020 [Figures 1.11 and 1.12].
  • For covered workers in large firms, over the past five years, the average family premium in firms that are fully insured has grown at a similar rate to the average family premium for covered workers in fully or partially self-funded firms (19% for fully insured plans and 21% for self-funded firms) [Figure 1.13].
  • Over the last five years, the average premium for family coverage has risen 22% percent, more than inflation (10%).

Figure 1.10: Average Annual Premiums for Single and Family Coverage, 1999-2020

Figure 1.10: Average Annual Premiums for Single and Family Coverage, 1999-2020

Figure 1.11: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Size, 1999-2020

Figure 1.11: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Size, 1999-2020

Figure 1.12: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Size, 1999-2020

Figure 1.12: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Size, 1999-2020

Figure 1.13: Among Workers in Large Firms, Average Annual Premiums for Family Coverage, by Funding Arrangement, 1999-2020

Figure 1.13: Among Workers in Large Firms, Average Annual Premiums for Family Coverage, by Funding Arrangement, 1999-2020

Figure 1.14: Cumulative Premium Increases, Inflation, and Earnings for Covered Workers With Family Coverage, 2000-2020

Figure 1.14: Cumulative Premium Increases, Inflation, and Earnings for Covered Workers With Family Coverage, 2000-2020

Survey Design and Methods Section 2: Health Benefits Offer Rates

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