KFF 2026 Employer Health Benefits Survey Methodology
The 2026 KFF Employer Health Benefits Survey reveals that 1,668 out of 1,937 surveyed firms currently offer health benefits to their employees, based on data collected between January and July 2026. This annual assessment, fielded by Davis Research LLC, tracks the shifting costs and coverage structures of employer-sponsored insurance across private and non-federal government sectors.
Employer Benefit Trends:
- Coverage Access: The vast majority of responding firms provide health insurance, though the influence on national statistics is heavily skewed toward large firms (200+ employees) who control 78% of the covered worker weight.
- Plan Diversity: Employers utilize a mix of HMO, PPO, POS, and HSA plans.
- Economic Benchmarks: Lower-wage workers are defined as those earning $38,000 or less per year, while higher-wage workers earn $82,000 or more, reflecting inflation-adjusted Bureau of Labor Statistics data.
Healthcare providers face a persistent gap between the number of firms offering benefits and the actual distribution of covered workers. While small firms (10-199 employees) represent 95% of the employer weight, they exhibit greater variability in offer rates and plan attributes. This disparity means that changes in small-business health offerings can significantly shift overall offer rate percentages, even if they affect a smaller total number of employees compared to large corporate plans.
Large Firms Control 78% of Covered Worker Weight
The distribution of health coverage in the U.S. remains concentrated in large-scale employment. According to the KFF data, firms with 200 or more employees hold 78% of the covered worker weight. Within this group, firms with 200 to 999 employees drive 84% of the employer weight for the large-firm category.
To capture a more precise snapshot of the corporate environment, the survey expanded its sample in 2025 to include 50 firms from the Forbes America’s Largest Private Companies list, specifically targeting U.S.-based firms with annual revenues of $2 billion or more.
Wage Thresholds and Inflation Adjustments for 2026
The 2026 survey utilizes specific income thresholds to categorize the workforce, based on the 25th and 75th percentiles of earnings reported by the Bureau of Labor Statistics (BLS). Lower-wage workers are identified as those earning $38,000 or less annually, while higher-wage workers are those earning $82,000 or more. These figures were inflation-adjusted using an average of the first three months of the year, which showed a 12-month percentage change of 2.7%.
Survey Categorizes Health Plans by Network and Cost-Sharing
The survey categorizes health plans into four primary types to track how employers manage network restrictions and cost-sharing. The data distinguishes between plans that require a primary care gatekeeper and those that allow direct specialist access.
| Plan Type | Network Restrictions | Primary Care Requirement | Key Characteristic |
|---|---|---|---|
| HMO | No coverage for non-emergency out-of-network services | Required | Strict network adherence |
| PPO | Lower cost-sharing for in-network; out-of-network allowed | Not Required | Maximum flexibility |
| POS | Lower cost-sharing for in-network | Required | Gatekeeper for specialists |
| HSA | Varies by underlying network | Varies | Deductibles $ge$ $1,650 (Single) / $3,300 (Family) |
The survey notes that Exclusive Provider Organizations (EPOs) are grouped with HMOs, while conventional indemnity plans are categorized with PPOs. Because many firms operate on plan years that do not align with the calendar year, some reported attributes—specifically HSA deductible thresholds—may not perfectly align with the most current regulatory requirements at the time of the interview.
Survey Methodology and Response Rate Challenges
The 2026 data was gathered from 1,937 firms, but the overall response rate stands at 11%. This decline in response rates is a trend noted since 2017. To mitigate potential response bias, KFF weights most major statistics by the number of covered workers at a firm. In this sample, 3.3 million workers out of the estimated 70.4 million covered workers nationwide were employed by firms that completed the survey.
To handle missing data, the survey employs a “hotdeck” imputation method for most variables, replacing missing values with observed values from similar firms based on size and industry. For single and family coverage premiums, a random forest algorithm is used to predict missing values before applying the hotdeck approach.
The 2026 survey continues a longitudinal effort that began in 1999, providing a baseline for how employer-sponsored insurance evolves alongside national health crises and economic shifts. As the gap between large-firm stability and small-firm variability persists, the reliance on these high-weight employers to maintain the standard of care for the U.S. population remains a central pillar of the public health infrastructure.
Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.