2018 Employer Health Benefits Survey
Section 1: Cost of Health Insurance
The average annual premiums in 2018 are $6,896 for single coverage and $19,616 for family coverage. The average premium for single coverage increased by 3% since 2017 and the average premium for family coverage increased by 5%. The average family premium has increased 55% since 2008 and 20% since 2013. The average family premium for covered workers in small firms (3-199 workers) ($18,739) is significantly lower than average family premiums for workers in large firms (200 or more workers) ($19,972).
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 2018 is $6,896 per year. The average premium for family coverage is $19,616 per year [Figure 1.1].
- The average annual premium for family coverage for covered workers in small firms ($18,739) is lower than the average premium for covered workers in large firms ($19,972) [Figure 1.2].
- The average annual premiums for covered workers in HDHP/SOs are lower for single coverage ($6,459) and family coverage ($18,602) than overall average premiums. The average premiums for covered workers enrolled in PPOs are higher for single ($7,149) and family coverage ($20,324) than the overall plan average [Figure 1.1].
- The average premium for covered workers with single coverage is higher in the Northeast ($7,172) than in all other regions. Compared to the average premium for family coverage for covered workers in other regions, the average family premium for covered workers in the Northeast ($20,697) is higher and the average family premium for covered workers in the South is lower ($19,057) [Figure 1.3].
- The average premiums for covered workers vary across industries. The average premiums for covered workers in the Agriculture/Mining/Construction industry category are relatively lower for single ($6,241) and family ($17,417) coverage [Figure 1.4].
- The average premiums 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) are higher than the average premiums for covered workers in firms with a smaller share of older workers ($7,288 vs. $6,560 for single coverage and $20,463 vs. $18,887 for family coverage) [Figure 1.6].
- The average premiums for covered workers in firms with at least some union workers are higher than the average premiums for covered workers in firms without union workers for family coverage ($20,333 vs. $19,234) [Figure 1.5].
- Premiums also vary by type of firm ownership. For both single and family coverage, covered workers at private for-profit firms have lower average annual premiums than covered workers at public firms or private not-for-profit firms [Figure 1.6].
Figure 1.1: Average Annual Premiums for Covered Workers, Single and Family Coverage, by Plan Type, 2018
Figure 1.2: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Firm Size, 2018
Figure 1.3: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Region, 2018
Figure 1.4: Average Monthly and Annual Premiums for Covered Workers, by Plan Type and Industry, 2018
Figure 1.5: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Characteristics, 2018
Figure 1.6: Average Annual Premiums for Covered Workers, by Firm Characteristics and Firm Size, 2018
PREMIUM DISTRIBUTION
- There is considerable variation in premiums for both single and family coverage.
- Sixteen 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, 17% of covered workers are employed in a firm with a family premium at least 20% higher than the average family premium, while 19% of covered workers are in firms with a family premium less than 80% of the average family premium [Figure 1.7].
- Five percent of covered workers are in a firm with an average annual premium of at least $10,000 for single coverage [Figure 1.8]. Eight percent of covered workers are in a firm with an average annual premium of at least $26,000 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, 2018
Figure 1.8: Distribution of Annual Premiums for Covered Workers With Single Coverage, 2018
Figure 1.9: Distribution of Annual Premiums for Covered Workers With Family Coverage, 2018
PREMIUM CHANGES OVER TIME
- The average premium for single coverage is 3% higher than the single premium last year, and the average premium for family coverage is 5% higher than the average family premium last year.
- The average premium for single coverage has grown 17% since 2013 and the average premium for family coverage has grown 20% over the same period.
- The average family premiums for both small and large firms have increased at similar rates since 2013 (20% for small firms and 19% for large firms). For small firms, the average family premium rose from $15,581 in 2013 to $18,739 in 2018. For large firms, the average family premium rose from $16,715 in 2013 to $19,972 in 2018 [Figures 1.11 and 1.12].
- The $19,616 average family premium in 2018 is 20% higher than the average family premium in 2013 and 55% higher than the average family premium in 2008. The 20% family premium growth in the past five years is smaller than the 29% growth between 2008 and 2013, or the 40% premium growth between 2003 and 2008 [Figure 1.13].
- The average family premiums for both small and large firms have increased at similar rates since 2008 (55% for small firms and 54% for large firms). For small firms, the average family premium rose from $12,091 in 2008 to $18,739 in 2018. For large firms, the average family premium rose from $12,973 in 2008 to $19,972 in 2018 [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 20% for self-funded firms) [Figure 1.14].
Figure 1.10: Average Annual Premiums for Single and Family Coverage, 1999-2018
Figure 1.11: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Size, 1999-2018
Figure 1.12: Average Annual Premiums for Covered Workers With Family Coverage, by Firm Size, 1999-2018
Figure 1.13: Cumulative Premium Increases, Inflation, and Earnings for Covered Workers With Family Coverage, 2003-2018
Figure 1.14: Among Workers In Large Firms, Average Annual Premiums for Family Coverage, by Funding Arrangement, 1999-2018