Key Findings for Small & Mid-Sized Companies
This dashboard summarizes the 2024 KFF Employer Health Benefits Survey, with a particular focus on insights relevant to small and mid-sized companies (generally less than 500 employees). The following cards highlight critical top-line metrics, revealing ongoing trends in healthcare costs and coverage within this segment.
Avg. Family Premium (Small Firms)
$25,167
+24% since 2019
Avg. Single Premium (Small Firms)
$9,131
+25% since 2019
Avg. Family Contribution (Small Firms)
$7,947
(33% of premium)
Avg. Single Contribution (Small Firms)
$1,204
(14% of premium)
Understanding Firm Sizes in This Survey:
Throughout this dashboard, "Small Firms" refer to companies with **3 to 199 workers**, while "Large Firms" refer to companies with **200 or more workers**. This distinction is based on the survey's methodology and helps highlight differences in health benefit trends across company sizes.
The Cost of Coverage
Healthcare premiums continue their steady climb, often outpacing growth in wages and general inflation. This section explores long-term cost trends and breaks down how these expenses are shared between employers and their workers, with an emphasis on small and mid-sized companies.
Family Premium Growth vs. Economy (All Firms)
Over the last two decades, the growth in family health insurance premiums has consistently outpaced increases in workers' earnings and overall inflation, highlighting the growing burden of healthcare costs for all firms, including smaller ones.
Who Pays for Coverage? Worker vs. Employer Contributions
While employers cover the majority of premium costs, the portion paid by workers varies significantly, especially between small and large firms. The default view shows contributions for small firms, but you can compare with larger firms.
The Plan Landscape
The types of health plans employers offer have evolved significantly. This section examines the current market share of different plan types and the prevalence of self-funding, with a focus on trends relevant to small and mid-sized companies.
Health Plan Enrollment Over Time
For small firms, PPO plans remain the most common, but HDHP/SOs (High-Deductible Health Plans with Savings Options) have seen notable growth, reflecting a shift in plan preferences. Use the toggles to compare enrollment trends across different firm sizes.
Prevalence of Self-Funded Plans
While self-funding is more common among large firms, a significant portion of covered workers in small firms are now in self-funded or level-funded plans, indicating a growing trend in this segment. Use the toggles to compare prevalence across different firm sizes.
Why Small Firms Don't Offer Health Benefits
Small businesses face distinct challenges when it comes to providing health insurance. This chart highlights the most frequently cited reasons for not offering health benefits among small firms.
The Employee Experience: Cost Sharing
Beyond premiums, employees face out-of-pocket costs like deductibles and copayments. This section details the prevalence of these costs and how they have trended over time, impacting workers' financial exposure, particularly within small and mid-sized companies.
The Rise of High Deductibles
The percentage of covered workers with a high annual deductible of $2,000 or more for single coverage has grown significantly, with small firms showing a higher prevalence. The default view highlights this trend for small firms.
Emerging Trends in Benefits
The benefits landscape is constantly changing. While some emerging trends data is predominantly collected from larger firms, understanding these developments is crucial for anticipating future directions in the broader benefits market. This section covers new drug classes, mental health support, and family-building services.
Coverage of GLP-1s for Weight Loss (Large Firms)
Coverage for GLP-1 agonist drugs (e.g., Ozempic, Wegovy) for weight loss is still limited, with larger firms (200+ employees) more likely to offer it. Many firms that do cover these drugs have conditions, like lifestyle program enrollment.
Provider Network Adequacy (All Firms)
Employers perceive their provider networks for mental health services as significantly less broad than their general medical networks. You can compare the perceptions of small vs. large firms.
Wellness Programs Offered (All Firms)
Employers are actively investing in employee well-being through various health promotion and wellness programs. See how small and large firms compare in offering these initiatives.
Coverage for Family Building & Other Services (Large Firms)
Large firms (200+ employees) are increasingly offering benefits to support family building and other specific needs, though coverage is not yet universal. Data for these specific benefits is primarily available for larger firms.
37%
Cover Fertility Medications
27%
Cover In-Vitro Fertilization (IVF)
13%
Cover Adoption Services
29%
Cover Abortion in Most Circumstances
24%
Cover Gender-Affirming Hormone Therapy
5%
Offer Travel Benefits for Abortion Care