Employer-sponsored family health insurance reached an average annual premium of $28,303 in 2026, according to KFF's 2026 Employer Health Benefits Survey. Although employers pay most of the premium, employees contributed an average of $7,471 a year, or about $623 a month, after a 9% annual increase that outpaced the 3.7% wage growth reported by KFF. Overall premiums rose 5% from the previous year, with average annual costs approaching $10,000 for single coverage and exceeding $28,000 for family coverage. Premiums were 28% higher than five years earlier and 55% above 2016 levels, adding pressure as everyday living costs have risen roughly 30% since 2019. The burden is particularly heavy at smaller companies: workers there contributed $2,847 more annually for family coverage than employees at larger firms, despite lower average family premiums. For a worker earning $75,000, that difference equals about 3.8% of gross income. Smaller-firm employees also faced average single-coverage deductibles of $2,624, compared with $1,772 at larger companies. KFF found that 31% of covered workers at smaller firms paid at least $12,000 annually toward family premiums, versus 13% overall. Broader household finances are also under strain, with the Federal Reserve reporting that 19.6% of borrowing families were behind on payments in 2025, up from 12.2% in 2022. The individual insurance market lost 4.6 million enrollees in the year ending June 2026. Nearly half of working-age adults had inadequate coverage in 2026, while 50% of working adults said they avoided needed care because of cost, a figure that was 43% even among insured Americans. The uninsured rate increased as marketplace and Medicaid enrollment declined, following cuts to Medicaid and the Affordable Care Act marketplace under the Trump administration. Medicaid work requirements and limits on assistance for some legal immigrants are scheduled for 2027. The figures underline why workers must assess total compensation through premiums, deductibles, employer contributions and out-of-pocket maximums, rather than salary alone.