Employer Health Benefits Survey 2025: Key Health Benefit Trends For Employers
Premiums, cost sharing, and GLP-1 coverage all shifted this year. Here's what the latest employer-sponsored health insurance plan trends mean for benefits budgets ahead.
Employer-sponsored insurance covers 154 million people under age 65 in the United States. Each year, KFF conducts an employer health benefits annual survey to track how those plans are changing. This article summarizes the main findings from the 2025 Employer Health Benefits Survey and what they signal for the year ahead.
Health Insurance Premiums
In 2025, the average premium for employer-sponsored health insurance was $9,325 for single coverage and $26,993 for family coverage. Single and family premiums rose 5% and 6%, respectively, over the last year, a slightly slower pace than the previous year's 6% and 7% increases.
For context, the 2025 KFF report also found a 4% increase in workers' wages and inflation of 2.7%. Looking back further, the average family premium has climbed 24% over the last five years, compared with a 26% rise in wages and a 28.6% rise in inflation over the same period.
Plan type continues to shape what employers and workers pay. High deductible health plans with savings options (HDHP/SOs) carried lower than average premiums, at $8,620 for single coverage and $25,379 for family coverage. Preferred provider organization (PPO) plans ran higher than average, at $9,818 for single coverage and $28,272 for family coverage.
Worker Contributions
Workers' average share of the premium held steady in 2025 at 16% for single coverage and 26% for family coverage, similar to the year before. In dollar terms, that worked out to $1,440 for single coverage and $6,850 for family coverage, both slightly higher than 2024.
Plan Enrollment
Enrollment patterns changed little from last year. The most common plan types in 2025 were:
PPOs: 46% of covered workers
HDHP/SOs: 33% of covered workers
Health maintenance organizations (HMOs): 12% of covered workers
Point-of-service (POS) plans: 9% of covered workers
Conventional indemnity plans: less than 1% of covered workers
Self-Funding On The Rise
Self-funded plans, where an employer pays some or all health costs directly from its own funds rather than purchasing insurance, have grown more common in recent years. In 2025, 67% of covered workers were enrolled in self-funded plans, including 27% at small firms and 80% at large firms, holding steady from 2024.
Level funded arrangements, which combine self-funding with stop-loss coverage, also remained popular among small firms: 37% of their covered workers were in a level-funded plan in 2025, similar to the year before.
Employee Cost Sharing
Most workers still pay a meaningful share of their care costs. The average deductible for single coverage was $1,886 in 2025, in line with last year but up 17% over five years and 43% over the past decade. About 34% of covered workers had a general annual deductible of $2,000 or more for single coverage, a share that has grown 32% over five years and 77% over 10.
Beyond deductibles, 65% of covered workers had coinsurance, 11% had a copay for hospital admissions, and 8% had both. The average hospital admission coinsurance rate was 20%, with an average payment of $313. Nearly all workers had an out-of-pocket maximum, though the range was wide: 12% of workers with single coverage had a maximum under $2,000, while 21% had one above $6,000.
Availability Of Employer-Sponsored Coverage
Sixty-one percent of firms with 10 or more workers offered health benefits to at least some employees in 2025, similar to last year. Large firms, those with 200 or more workers, were far more likely to offer coverage than smaller firms, 97% compared with 59%.
Among workers at firms offering benefits, 80% were eligible to enroll, and 76% of those eligible took up the offer, meaning 61% of workers at these firms ultimately enrolled. Across all firms, whether or not they offer benefits, 55% of workers were covered by an employer-sponsored plan.
Health Promotion & Wellness Programs
Wellness programming remains more common at larger organizations. Health risk assessments were offered by 35% of small firms and 53% of large firms, and more than half of large firms offering the assessment used incentives or penalties to encourage completion.
Biometric screenings followed a similar pattern: 22% of small firms and 43% of large firms offered them, though the small-firm share jumped from 9% in 2024. General wellness programs, covering areas like smoking cessation, weight management, and lifestyle coaching, were offered by 56% of small firms and 83% of large firms.
GLP-1 Drug Coverage For Weight Loss
Glucagon-like peptide 1 (GLP-1) receptor agonists continued to gain ground in 2025. Among firms with 200 or more workers, coverage for GLP-1s used primarily for weight loss ranged from 16% of firms with 200 to 999 workers up to 43% of firms with 5,000 or more workers, up from 28% the year before at the largest firms. About a third of firms covering these drugs required participants to meet a specific condition, such as working with a dietitian or enrolling in a lifestyle program.
Utilization has outpaced expectations. Among firms covering GLP-1s for weight loss, 43% of those with 1,000 to 4,999 workers and 66% of those with 5,000 or more workers said the drugs had a significant impact on prescription spending. Some employers have responded by scaling back coverage, including tightening requirements even for GLP-1 use tied to Type 2 diabetes. Expect this to remain an active decision point for plan sponsors.
Employee Concerns About Health Plan Management
Large employers reported that workers are increasingly concerned about:
Affordability of cost sharing.
Scheduling timely appointments with providers.
Complexity of prior authorization requirements.
Finding in-network providers.
The number of denied claims.
What This Means For Employers
Rising premiums, growing deductibles, and expanding GLP-1 utilization all point to a benefits landscape that's getting more expensive to manage, and early projections suggest 2026 costs will climb further. Employers should start evaluating cost-sharing strategies and plan design options now rather than waiting until renewal season.
Understanding these employer-sponsored health insurance plan trends is one thing. Building a benefits strategy around them is another. Contact The Siekmann Company today to talk through how this year's survey findings should shape your plan for next year.
