Employee Benefit News for School, City and County Employers

2025 Employer Health Benefits Survey: Key Trends and Insights for Public Sector

Written by Dina Lubben | Oct 28, 2025 5:52:41 PM

Employer-sponsored insurance provides coverage for 154 million Americans under age 65. Each year, the KFF Employer Health Benefits Survey highlights key trends in employer-sponsored health plans. Here are some of the main findings from the 2025 survey.

 

Health Insurance Premiums

The average employer-sponsored health insurance premiums for 2025 were $9,325 for single coverage and $26,993 for family coverage, rising by 5% and 6% over the previous year. According to the 2025 KFF report, workers’ wages increased by 4% and inflation by 2.7%.

Over five years, family premiums rose 24%, while wages increased 26% and inflation 28.6%. Notably, high deductible health plans with savings options (HDHP/SOs) offered lower average premiums, $8,620 for single and $25,379 for family coverage, while preferred provider organization (PPO) plans averaged higher at $9,818 for single and $28,272 for family coverage.

 

Workers Contributions

In 2025, employees contributed an average of 16% of premiums for single coverage and 26% for family coverage, consistent with 2024 levels. This equates to $1,440 for single and $6,850 for family coverage, reflecting a modest year-over-year increase.

 

Plan Enrollment

Enrollment levels remained consistent with the prior year. In 2025, the most common plan types were: PPOs (46%), HDHP/SOs (33%), Health Maintenance Organizations (HMOs) (12%), Point-of-service plans (POS) plans (9%), and conventional indemnity plans (less than 1%).

 

Self-Funding

Self-funded plans continue to be a popular choice, with 67% of covered workers, 27% at small firms and 80% at large firms, enrolled in self-funded arrangements in 2025, a rate consistent with last year. Additionally, 37% of covered workers in small firms now participate in level funded plans, which combine self-funding with stop-loss protection.

 

Employer Cost Sharing

In 2025, the average annual deductible for single coverage was $1,886, reflecting a 17% increase over five years and a 43% increase in the past decade. Thirty-four percent of covered workers had a general annual deductible of $2,000 or more, a dramatic rise of 32% in five years and 77% over the past ten.

Most workers also pay a portion of other health care costs, with 65% responsible for coinsurance and 20% being the typical coinsurance rate for hospital admissions. Out-of-pocket maximums vary widely; among those with single coverage, 12% had a maximum below $2,000, while 21% faced an out-of-pocket maximum above $6,000.

 

Availability of Employer-sponsored Coverage

According to the 2025 survey, 61% of firms with 10 or more employees offer health benefits, a rate consistent with last year. Large employers (200+ employees) are significantly more likely to provide health benefits, 97% compared to 59% of smaller firms.

While most employees work at firms offering coverage, not all are eligible or choose to enroll. Of those eligible, 76% participate, resulting in 61% of workers at offering firms actually enrolling in coverage, mirroring the 2024 figure. Overall, 55% of all workers are covered by employer health plans, unchanged from last year.

 

Health Promotion and Wellness Programs

Recent findings from the 2025 KFF report show that a growing number of employers are investing in programs to support employee health and well-being. Over half of large organizations, and more than a third of small firms, now offer health risk assessments—many with incentives to encourage participation. Biometric screenings have also become more common, particularly among small firms, where the offering more than doubled since last year. Additionally, the majority of employers, 56% of small firms and 83% of large firms, provide wellness promotion initiatives such as smoking cessation, weight management, or lifestyle coaching, underscoring their commitment to fostering a healthier, more productive workforce.

 

GLP-1 Drug Coverage for Weight Loss

GLP-1 medications, popular for managing Type 2 diabetes and supporting weight loss, are increasingly being covered by larger employers. In 2025, 43% of firms with 5,000+ employees and 30% of those with 1,000–4,999 employees reported covering GLP-1s for weight loss, both up from the previous year. Many employers require additional steps, such as professional consultations or participation in weight loss programs, before providing coverage. However, firms noted higher-than-expected use, with 66% of the largest employers citing a significant increase in prescription drug spending. Some employers have since reduced or discontinued coverage. Determining the right approach to GLP-1 coverage remains a key priority for public sector organizations.

 

Employee Concerns About Health Plan Management

Recent trends show that employees are increasingly concerned about health plan management, including the affordability of cost sharing, timely access to providers, prior authorization complexities, locating in-network providers, and claim denials.

 

Conclusion

In 2025, average annual premiums for single and family coverage continued to rise, reflecting broader economic trends. Early forecasts for 2026 indicate even higher health care costs. Now is the time for employers to proactively review cost management tools and explore cost-sharing strategies to better control future expenses. Download the bulletin for more details.