Family coverage medical care premiums cost employers in small firms $1,232.59 in March 2024

Small businesses, those with fewer than 50 workers, have seen an increase over time in the average monthly employer premiums and employee contributions for medical care benefits that required employee contributions.

In March 2014, civilian workers paid an average of $121.80 per month for single coverage medical care plans and $519.78 for family coverage. Employers paid an average of $352.33 per month for single coverage and $782.08 for family coverage. By March 2024, the average employee contribution had increased to $170.92 per month for single coverage and $751.45 for family coverage. Average employer contributions had increased to $528.84 per month for single coverage and $1,232.59 for family coverage by March 2024.

In recent years, there has been a decline in the take-up rate for medical care benefits at small businesses. The take-up rate is the percentage of workers among those with access to an employer-sponsored benefit who choose to participate in the benefit. The participation rate is the percentage of all workers, regardless of access, who enroll in a plan.

Medical benefits were available to 54 percent of civilian workers in establishments with fewer than 50 workers in March 2014, with 38 percent of workers participating in the benefit, resulting in a 71 percent take-up rate. While 56 percent of civilian workers had access to medical care benefits in March 2024, participation rates dropped to 33 percent, resulting in a lower take-up rate of 60 percent.

These data are from the National Compensation Survey — Benefits program. For more information, see "Employee Benefits in the United States — March 2024" and the complete dataset. We also have more charts on employee benefits. Civilian workers include all employees in private industry and state and local government. Medical care plans provide services or payments for services in a hospital or by a qualified medical care provider.