Employer Health Insurance Participation Statistics 2026: Access, Enrollment, and Worker Costs

Employer health insurance participation statistics measure several stages of coverage. Access means a worker can enroll in an employer plan. Participation means the worker enrolls. The take-up rate is the share of workers with access who participate. Premiums and employee contributions then describe cost, not participation.

Keeping those measures separate helps employers diagnose whether a problem is plan availability, affordability, eligibility, communication, or enrollment friction.

Health insurance statistics at a glance

Sources: KFF 2024 Employer Health Benefits Survey and BLS Employee Benefits in the United States.

Access, participation, and take-up

BLS publishes each measure because a worker can decline an available plan. A spouse's plan, public coverage, cost, plan design, waiting periods, or personal preference may affect enrollment. Participation among all workers will always be no greater than access.

Employers should calculate the measures consistently:

• access rate = workers with access / workers in scope
• participation rate = enrolled workers / workers in scope
• take-up rate = enrolled workers / workers with access

Define “in scope” before comparing business data with BLS. The survey's worker population and the company's eligibility population may differ.

Employer size and wages affect access

National Compensation Survey tables show higher medical-plan access and participation at larger private establishments. Higher-wage workers are also more likely to have access and participate than lower-wage workers. Full-time workers have much greater access than part-time workers.

These factors overlap. Establishment size alone does not explain the entire gap, and the tables do not show why a specific worker declined coverage. A useful internal analysis reviews work status, wage band, location, tenure, and plan tier while protecting employee privacy.

Premiums continue to be a major labor cost

KFF's 2024 Employer Health Benefits Survey reported average annual premiums of $8,951 for single coverage and $25,572 for family coverage. Covered workers contributed an average of 16% of the single premium and 25% of the family premium.

These are averages among surveyed employers with coverage, not quotes for a particular company. Geography, workforce age, employer size, funding arrangement, network, deductible, and benefit design can move a firm's cost far from the national average.

The employer's cost also extends beyond premium payments. Administration includes eligibility files, enrollment changes, carrier reconciliation, employee questions, notices, payroll deductions, continuation coverage, and correction of discrepancies.

Participation does not measure affordability by itself

A high take-up rate may coexist with substantial household cost. A low take-up rate may reflect access to other coverage rather than an unaffordable employer plan. Employers should combine participation data with worker contribution, deductible, out-of-pocket maximum, coverage tier, and employee feedback.

Useful measures include:

Small-employer considerations

Small employers face different pricing, administrative, and risk arrangements than large employers. The Affordable Care Act's employer shared-responsibility provisions generally apply to applicable large employers, but other federal and state rules can apply across employer sizes. Tax credits may be available to some qualifying small employers through the Small Business Health Options Program.

Eligibility and affordability calculations are legal and tax matters. Employers should verify current thresholds and rules through official sources and qualified advisers rather than relying on a dated article.

Benefits administration support

Routine work includes maintaining eligibility records, distributing approved materials, tracking enrollment windows, reconciling carrier files, and routing employee questions. A human resources virtual assistant can support documented administration. Plan selection, protected health information, legal notices, payroll authorization, and employee-specific benefit decisions require authorized HR, benefits, legal, and payroll owners.

Frequently asked questions

What is the difference between health-plan participation and take-up?

Participation is enrolled workers divided by all workers in the measured group. Take-up is enrolled workers divided only by workers who have access.

How much does employer health insurance cost?

KFF reported average 2024 annual premiums of $8,951 for single coverage and $25,572 for family coverage. Actual employer and employee costs vary widely.

Do workers pay part of the premium?

Usually, but arrangements vary. In KFF's 2024 survey, covered workers paid 16% of the single premium and 25% of the family premium on average.

Sources and methodology

1. BLS, Employee Benefits in the United States, March 2025. Medical-plan access, participation, and take-up tables.
2. BLS, National Compensation Survey: Employee Benefits. Detailed tables and methodology.
3. KFF, 2024 Employer Health Benefits Survey. Premium, contribution, plan, and employer survey data.
4. IRS, Questions and Answers on Employer Shared Responsibility Provisions. Federal employer-rule guidance.
5. HealthCare.gov, Small Business Health Options Program. Small-employer coverage information.
6. U.S. Department of Labor, Health Plans and Benefits. Employee-benefit compliance resources.

This article uses sources available on September 22, 2026. BLS estimates are worker-based and subject to sampling error. KFF premium figures are employer-survey averages, not rates guaranteed to any employer.