2021 Employer Health Benefits Survey

Section 6: Worker and Employer Contributions for Premiums

Covered workers on average contribute 17% of the premium for single coverage and 28% of the premium for family coverage in 2021.14 The average monthly worker contributions are $108 for single coverage ($1,299 annually) and $497 for family coverage ($5,969 annually). The average contribution amount for family coverage is higher for covered workers in small firms (3-199 workers) than for covered workers in large firms (200 or more workers) ($7,710 vs. $5,269).

  • In 2021, covered workers on average contribute 17% of the premium for single coverage and 28% of the premium for family coverage. The average percentage contributed for single coverage has remained stable in recent years. The average percentage contributed for family coverage is similar to the percentage (27%) last year [Figure 6.1].15
    • Covered workers in small firms on average contribute a much higher percentage of the premium for family coverage than covered workers in large firms (37% vs. 24%) [Figure 6.2].
  • Workers with single coverage have an average contribution of $108 per month ($1,299 annually), and workers with family coverage have an average contribution of $497 per month ($5,969 annually) toward their health insurance premiums [Figure 6.3], [Figure 6.4], and [Figure 6.5].
    • The average worker contribution in HDHP/SOs for family coverage is lower than the overall average worker contribution for family coverage ($5,129 vs. $5,969) [Figure 6.6].
  • Worker contributions also differ by firm size.
    • Covered workers in small firms on average contribute significantly more annually for family coverage than covered workers in large firms ($7,710 vs. $5,269). The average contributions amounts for covered workers in small and large firms are similar for single coverage [Figure 6.7].

Figure 6.1: Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, 1999-2021

Figure 6.1: Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, 1999-2021

Figure 6.2: Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Firm Size, 2021

Figure 6.2: Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Firm Size, 2021

Figure 6.3: Average Monthly Worker Premium Contributions for Single and Family Coverage, 1999-2021

Figure 6.3: Average Monthly Worker Premium Contributions for Single and Family Coverage, 1999-2021

Figure 6.4: Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single Coverage, 1999-2021

Figure 6.4: Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single Coverage, 1999-2021

Figure 6.5: Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Family Coverage, 1999-2021

Figure 6.5: Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Family Coverage, 1999-2021

Figure 6.6: Average Annual Worker and Employer Premium Contributions and Total Premiums for Single and Family Coverage, by Plan Type, 2021

Figure 6.6: Average Annual Worker and Employer Premium Contributions and Total Premiums for Single and Family Coverage, by Plan Type, 2021

Figure 6.7: Average Annual Worker and Employer Premium Contributions and Total Premiums for Single and Family Coverage, by Firm Size, 2021

Figure 6.7: Average Annual Worker and Employer Premium Contributions and Total Premiums for Single and Family Coverage, by Firm Size, 2021

Figure 6.8: Average Annual Worker and Employer Premium Contributions and Total Premiums for Single Coverage, by Plan Type and Firm Size, 2021

Figure 6.8: Average Annual Worker and Employer Premium Contributions and Total Premiums for Single Coverage, by Plan Type and Firm Size, 2021

Figure 6.9: Average Annual Employer and Worker Premium Contributions and Total Premiums for Family Coverage, by Plan Type and Firm Size, 2021

Figure 6.9: Average Annual Employer and Worker Premium Contributions and Total Premiums for Family Coverage, by Plan Type and Firm Size, 2021

DISTRIBUTIONS OF WORKER CONTRIBUTIONS TO THE PREMIUM
  • About nine-tenths of covered workers are in a plan where the employer contributes at least half of the premium for both single and family coverage.
    • Twelve percent of covered workers are in a plan where the employer pays the entire premium for single coverage, while only 4% of covered workers are in a plan where the employer pays the entire premium for family coverage [Figure 6.10].
  • Covered workers in small firms are much more likely than covered workers in large firms to be in a plan where the employer pays the entire premium.
    • Twenty-nine percent of covered workers in small firms have an employer that pays the full premium for single coverage, compared to 5% of covered workers in large firms [Figure 6.10].
    • For family coverage, 10% of covered workers in small firms have an employer that pays the full premium, compared to 1% of covered workers in large firms [Figure 6.10].
  • Thirteen percent of covered workers are in a plan with a worker contribution of more than half of the premium for family coverage [Figure 6.10].
    • Thirty-one percent of covered workers in small firms work in a firm where the worker contribution for family coverage is more than 50% of the premium, a much higher percentage than the 5% of covered workers in large firms [Figure 6.10].
    • Small shares of covered workers in small firms (3%) and large firms (1%) must pay more than 50% of the premium for single coverage [Figure 6.10].
  • There is substantial variation among workers in both small and large firms in the dollar amounts they must contribute.
    • Among covered workers in small firms, 34% have a contribution for single coverage of less than $500, while 20% have a contribution of $2,000 or more [Figure 6.13]. For family coverage, 13% have a contribution of less than $1,500, while 27% have a contribution of $10,500 or more [Figure 6.14].
    • Among covered workers in large firms, 12% have a contribution for single coverage of less than $500, while 16% have a contribution of $2,000 or more [Figure 6.13]. For family coverage, only 3% have a contribution of less than $1,500, while 5% have a contribution of $10,500 or more [Figure 6.14].

Figure 6.10: Distribution of Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Firm Size, 2021

Figure 6.10: Distribution of Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Firm Size, 2021

Figure 6.11: Distribution of Percentage of Premium Paid by Covered Workers for Single Coverage, 2002-2021

Figure 6.11: Distribution of Percentage of Premium Paid by Covered Workers for Single Coverage, 2002-2021

Figure 6.12: Distribution of Percentage of Premium Paid by Covered Workers for Family Coverage, 2002-2021

Figure 6.12: Distribution of Percentage of Premium Paid by Covered Workers for Family Coverage, 2002-2021

Figure 6.13: Distribution of Worker Contributions for Single Coverage, by Firm Size, 2021

Figure 6.13: Distribution of Worker Contributions for Single Coverage, by Firm Size, 2021

Figure 6.14: Distribution of Worker Contributions for Family Coverage, by Firm Size, 2021

Figure 6.14: Distribution of Worker Contributions for Family Coverage, by Firm Size, 2021

DIFFERENCES BY FIRM CHARACTERISTICS
  • The percentage of the premium paid by covered workers varies by firm characteristics.
    • Covered workers in private, for-profit firms have relatively high premium contribution rates for single (20%) and family (30%) coverage. Covered workers in public firms and have relatively low premium contributions for single (11%) and family (23%) coverage. The average single coverage contribution rate for covered workers in private not-for-profit firms (16%) is also relatively low [Figure 6.17].
    • Covered workers in firms with a relatively large share of lower-wage workers (where at least 35% of workers earn $28,000 a year or less) have a higher average contribution rate for family coverage than those in firms with a smaller share of lower-wage workers (35% vs. 27%) [Figure 6.17].
    • Covered workers in firms with a relatively large share of higher-wage workers (where at least 35% earn $66,000 or more annually) have a lower average contribution rate for family coverage than those in firms with a smaller share of higher-wage workers (24% vs. 32%) [Figure 6.17].
    • Covered workers in firms with a relatively large share of younger workers (where at least 35% of workers are age 26 or younger) have higher average contribution rates for single coverage (23% vs. 17%) and for family coverage (35% vs. 28%) than those in firms with a smaller share of younger workers [Figure 6.17].
    • Covered workers in firms that have at least some union workers have a lower average contribution rate for family coverage (20% vs. 33%) than those in firms without any union workers [Figure 6.17].
    • Among covered workers in large firms, those that are in partially or completely self-funded plans on average have a lower average contribution rate for family coverage than workers in firms that are fully-insured (23% vs. 30%) [Figure 6.19].16

Figure 6.15: Distribution of the Percentage of Total Premium Paid by Covered Workers for Single and Family Coverage, by Firm Wage Level, 2021

Figure 6.15: Distribution of the Percentage of Total Premium Paid by Covered Workers for Single and Family Coverage, by Firm Wage Level, 2021

Figure 6.16: Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single and Family Coverage, by Firm Wage Level, 2021

Figure 6.16: Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single and Family Coverage, by Firm Wage Level, 2021

Figure 6.17: Average Annual Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Firm Characteristics, 2021

Figure 6.17: Average Annual Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Firm Characteristics, 2021

Figure 6.18: Average Percentage of Family Premium Paid by Covered Workers, by Firm Characteristics, 2021

Figure 6.18: Average Percentage of Family Premium Paid by Covered Workers, by Firm Characteristics, 2021

Figure 6.19: Average Percentage of Premium Paid by Covered Workers, by Firm Characteristics and Size, 2021

Figure 6.19: Average Percentage of Premium Paid by Covered Workers, by Firm Characteristics and Size, 2021

DIFFERENCES BY REGION AND INDUSTRY
  • The average worker contribution rate for single coverage is relatively high in Northeast (20%) and relatively low in the West (14%) [Figure 6.20].
  • The average worker contribution rate for family coverage is relatively low in the Northeast (24%) and the Midwest (25%) and relatively high in the South (33%) [Figure 6.20].
  • There is considerable variation in average worker contribution rates across industries for single and family coverage [Figure 6.21].

Figure 6.20: Average Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type and Region, 2021

Figure 6.20: Average Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type and Region, 2021

Figure 6.21: Average Percentage of Premium Paid by Covered Workers, by Industry, 2021

Figure 6.21: Average Percentage of Premium Paid by Covered Workers, by Industry, 2021

CHANGES OVER TIME
  • The average worker contributions in 2021 for single coverage ($1,299) and for family coverage ($5,969) are similar to the average contribution levels last year [Figures 6.4 and 6.5].
  • The average worker contributions for single and family coverage have increased over the last five years (15% and 13%, respectively) and over the last 10 years (41% and 45%, respectively) [Figures 6.4 and 6.5].

Figure 6.22: Average Annual Worker Contributions for Covered Workers With Single Coverage, by Firm Size, 1999-2021

Figure 6.22: Average Annual Worker Contributions for Covered Workers With Single Coverage, by Firm Size, 1999-2021

Figure 6.23: Average Annual Worker Contributions for Covered Workers With Family Coverage, by Firm Size, 1999-2021

Figure 6.23: Average Annual Worker Contributions for Covered Workers With Family Coverage, by Firm Size, 1999-2021

Figure 6.24: Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Firm Size, 1999-2021

Figure 6.24: Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Firm Size, 1999-2021

Figure 6.25: Among Large Firms, Average Annual Worker Contributions for Covered Workers With Family Coverage, by Firm Wage Level, 1999-2021

Figure 6.25: Among Large Firms, Average Annual Worker Contributions for Covered Workers With Family Coverage, by Firm Wage Level, 1999-2021


  1. Estimates for premiums, worker contributions to premiums, and employer contributions to premiums presented in Section 6 do not include contributions made by the employer to Health Savings Accounts (HSAs) or Health Reimbursement Arrangements (HRAs). See Section 8 for estimates of employer contributions to HSAs and HRAs.↩︎
  2. The average percentage contribution is calculated as a weighted average of all a firm’s plan types and may not necessarily equal the average worker contribution divided by the average premium.↩︎
  3. For definitions of self-funded and fully-insured plans, see the introduction to Section 10.↩︎
Section 5: Market Shares of Health Plans Section 7: Employee Cost Sharing

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