By the numbers
A health plan is harder to get right when you’re small.
Fewer small employers offer coverage, renewals keep climbing, and covered workers often pay more of the bill. Every number on this page names its source and the year it describes.
Three numbers
Hiring
55% vs 90%
of private-sector workers at worksites with fewer than 50 people can get a health plan through their job. At worksites with 500 or more, 90%.
Source: U.S. Bureau of Labor Statistics, Employee Benefits in the United States, Table 2, March 2026. Private industry, by worksite size.
Renewals
14%
is the median increase small-group insurers proposed for 2027. The middle half of insurers asked for 10% to 18%.
Source: Peterson-KFF Health System Tracker, small-group rate filings for 2027, proposed 2027 rates, published August 2026. Median of 295 insurers’ proposed rates in every state, not one employer’s renewal.
What workers pay
32% vs 6%
of covered workers at firms with 10 to 199 employees pay more than half of the family premium themselves. At larger firms, 6%.
10 to 199 workers32 in 100
200 or more6 in 100
Source: KFF Employer Health Benefits Survey, 2026. Covered workers, by firm size.
Who offers coverage
The smaller the business, the less likely it offers health benefits
A first plan puts you ahead of many businesses your size, and closer to the larger employers you hire against.
Source: KFF Employer Health Benefits Survey, 2026.
- California35%vs 95% at firms with 50 or more
- Texas28%vs 91% at firms with 50 or more
- United States32%vs 95% at firms with 50 or more
The two surveys count differently, businesses in one and workplaces in the other, so their numbers don’t compare directly. Texas moves a lot from one year to the next.
Who pays
At smaller firms, workers pay a bigger share of family coverage
How the average family premium splits between employer and worker, by firm size.
Firms with 10 to 199 workers
Employer 63%Worker 37%
Firms with 200 or more workers
Employer 75%Worker 25%
Source: KFF Employer Health Benefits Survey, 2026. Average contribution of covered workers; the employer pays the rest.
Reading the plan
Plenty of people with insurance find it hard to read
That is why we explain every plan in plain words, in English or Spanish, before anyone signs.
27%
of adults with job-based coverage say terms like deductible and coinsurance are hard to understand.
Source: KFF Survey of Consumer Experiences with Health Insurance, 2023.
37% vs 29%
of insured Hispanic adults find the statement their insurer sends after care, the explanation of benefits, hard to understand. Among insured White adults, 29%.
Source: KFF Survey of Consumer Experiences with Health Insurance, 2023.
Sources
Each figure links to its publisher.
- U.S. Bureau of Labor Statistics, Employee Benefits in the United States, Table 2Data: March 2026
- Peterson-KFF Health System Tracker, small-group rate filings for 2027Data: proposed 2027 rates, published August 2026
- KFF Employer Health Benefits SurveyData: 2026
- AHRQ Medical Expenditure Panel Survey, via KFF State Health FactsData: 2025
- KFF Survey of Consumer Experiences with Health InsuranceData: 2023
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