Employer health insurance premiums by state, 2025

What AHRQ’s survey measures

The Medical Expenditure Panel Survey, Insurance Component (MEPS-IC) is the federal survey of employer health plans. The Agency for Healthcare Research and Quality (AHRQ) draws a sample of employers from the Census Bureau’s Business Register each year and collects data at the establishment level: a single workplace or physical location⁠²⁠⁵. For the 2025 survey year the private-sector sample was 42,590 establishments⁠³. Since 2008, AHRQ collects each year’s data during that same calendar year⁠². The 2025 private-sector tables were released in July 2026⁠⁴. They give state-level premium estimates for all 50 states and Washington, DC⁠³.

Four things about the figures matter before you compare states:

• Private sector only. The state tables on this page cover private employers. Government employers are surveyed separately⁠².
• Per enrolled employee, at employers that offer coverage. Premium averages are annual and count only employees who are enrolled. Businesses that offer nothing are not in the average⁠¹.
• The premium is the full cost. AHRQ’s premium is the total amount paid for coverage, whether paid by the employer, the employee or both⁠⁵. For self-insured plans AHRQ uses a “premium equivalent”: claims, administration and stop-loss cost per enrollee⁠⁵. Nationally, the 2025 single premium averaged $8,795 in purchased (fully insured) plans and $9,213 in self-insured plans⁠¹.
• Firm size counts the whole company. A firm is every establishment under common ownership, including headquarters, branches and subsidiaries⁠⁵. A 12-person branch of a 3,000-employee company counts in the large-firm column.

AHRQ also publishes a standard error for every figure. It suppresses cells with too few responses and flags others with an asterisk as not meeting its standard of reliability or precision⁠¹. In 2025 the flags fall only on small-firm employee-contribution cells (in 7 states for the single-coverage dollar figure, 5 for the family one), which is why the table below does not show them.

Single and family coverage, and who pays

Single (employee-only) coverage cost $9,025 on average in 2025. Employees contributed $1,817 of that, or 20.1%. Family coverage cost $26,281, and employees contributed $7,314, or 27.8%. The shares are our calculation from AHRQ’s dollar figures⁠¹. The employer’s part is the difference: $7,208 per single enrollee and $18,967 per family enrollee.

MEPS-IC also reports employee-plus-one coverage, which this page does not show.

Firms under 50 employees versus larger firms

AHRQ splits every state figure at 50 employees. Fifty is also the line in the Affordable Care Act’s employer shared responsibility rules, which apply to employers that averaged at least 50 full-time employees, including full-time equivalents, in the preceding year⁠¹⁰. The national split for 2025⁠¹:

The single premiums are within AHRQ’s standard errors of each other ($137 for small firms, $60 for large)⁠¹. A small business does not pay more per enrollee on average. The difference is in the offer rate and in how much of the family premium employees pay: 32.1% at small firms against 27.2% at larger ones (our calculation)⁠¹. For federal rules on small-employer plans, the tax credit and reimbursement arrangements, see group health insurance.

The state table

Average total annual premium per enrolled employee at private-sector establishments that offer health insurance; the offer rate is the share of establishments offering coverage. Small firms have fewer than 50 employees. Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access and Cost Trends, 2025 survey year.

Click a column header to sort. “Single, firms under 50” and the offer rate describe firms with fewer than 50 employees in total. State averages for all firms carry standard errors of about $140 to $570 for single coverage and $480 to $2,100 for family coverage; small-firm single figures, up to about $1,320. States a few hundred dollars apart are not reliably different⁠¹.

Highest and lowest states

For single coverage, the five most expensive jurisdictions in 2025 were⁠¹:

• New York: $10,913
• Alaska: $10,630
• Massachusetts: $10,436
• Vermont: $10,004
• Connecticut: $9,987

The five least expensive were Mississippi ($7,612), Arizona ($7,734), Arkansas ($7,804), Missouri ($8,084) and Oklahoma ($8,124)⁠¹. The median jurisdiction paid $8,899.

Family coverage ranks differently. Alaska led at $30,132, followed by New York ($29,752), New Jersey ($29,666), Massachusetts ($29,619) and Washington, DC ($29,371). Mississippi was again lowest at $21,932, followed by Montana ($21,989), Arkansas ($22,956), Nevada ($23,075) and Arizona ($23,143)⁠¹. The top four family premiums are within $520 of each other, and each has a standard error of about $815 to $1,260⁠¹. On this data they are effectively tied.

The full spread is 43% for single coverage and 37% for family coverage (our calculation). That is narrower than the spread in workers’ comp: in 2023 workers’ comp cost per $100 of wages in Hawaii was nearly five times the figure in Washington, DC.

The employer’s share follows the premium. After subtracting employee contributions, employers paid the most per single enrollee in Alaska ($8,699), New York ($8,682) and Massachusetts ($8,398). They paid the least in Mississippi ($5,896), Arizona ($5,897) and Arkansas ($6,009) (our calculation)⁠¹.

Where small firms pay more, or less, than large ones

Nationally the small-firm and large-firm single premiums are equal. By state they are not. In 24 of 51 jurisdictions the average single premium at firms under 50 was higher than at larger firms⁠¹.

• Small firms paid more: Vermont $11,460 vs. $9,452 (21% more), Delaware $10,589 vs. $9,247, Arizona $8,640 vs. $7,578, Georgia and Florida (about 11-12% more)⁠¹.
• Small firms paid less: Connecticut $8,243 vs. $10,364 (20% less), Maryland, Kansas, South Dakota and Indiana (13-16% less)⁠¹.

Family coverage at small firms was cheaper than at large firms in 42 of 51 jurisdictions. The biggest gaps were in Virginia ($19,835 vs. $28,538), Kansas ($19,915 vs. $27,038) and Arkansas ($17,908 vs. $23,777)⁠¹. A lower small-firm family premium does not mean small-firm coverage is a better deal. It can reflect thinner benefits, higher deductibles, or fewer older dependents in the pool. AHRQ’s state tables do not break out benefit levels, so the table alone cannot tell you which.

Alaska’s small-firm family premium of $39,824 is the largest figure in the dataset and 35% above the state’s large-firm figure. Its standard error is $3,018, so the true figure could plausibly be several thousand dollars lower⁠¹. Treat it as a high estimate, not a precise one.

Which small employers offer coverage

The offer rate varies far more than the price does. In 2025, 32.1% of private establishments in firms under 50 offered health insurance nationally⁠¹. By state:

• Highest: Hawaii 67.6%, Washington, DC 58.6%, Massachusetts 48.6%, Rhode Island 43.5%, Nevada 41.8%⁠¹.
• Lowest: Alaska 16.5%, Indiana 17.0%, Utah 18.7%, South Carolina 21.2%, Florida 22.8%⁠¹.

Hawaii stands out because state law requires most private employers to provide health coverage. Under the Prepaid Health Care Act of 1974, employers must cover employees who work at least 20 hours a week and earn at least 86.67 times the Hawaii minimum wage per month. Coverage starts after four consecutive weeks of employment⁠⁸. The employee’s share of single coverage cannot exceed the lesser of half the premium or 1.5% of the employee’s monthly gross earnings⁠⁸. Consistent with that cap, Hawaii employees paid an average of $857 toward single coverage, the lowest in the nation and 10.3% of the premium (our calculation)⁠¹. Any employer opening a location in Hawaii should budget for health coverage as a legal requirement, not a choice.

Among firms of 50 or more, the offer rate was at least 87.9% in every state. The lowest were West Virginia (87.9%), Indiana (89.7%) and Texas (91.2%)⁠¹.

How much employees pay, by state

The employee contribution is where state figures diverge most, especially for family coverage at small firms. Using only the cells AHRQ does not flag as unreliable⁠¹, our calculation of the employee share of the small-firm family premium runs from:

• Texas: $11,247 of $21,949 (51%)
• Louisiana: $11,197 of $23,163 (48%)
• Mississippi: $8,694 of $18,158 (48%)
• Kansas: $9,353 of $19,915 (47%)

down to Wisconsin, where employees at small firms paid $3,464 of a $28,362 family premium (12%)⁠¹. Small-firm contribution figures carry large standard errors (Texas: $1,448)⁠¹. The direction is reliable, the exact share less so.

These are averages across employers that chose very different contribution policies. Outside Hawaii, which caps the employee share by law⁠⁸, the split is the employer’s decision within the plan’s rules. A low state premium paired with a high employee share, as in Texas and Mississippi, means small employers there cover family members less generously, not that coverage is cheap.

KFF’s 2025 survey as a cross-check

KFF’s Employer Health Benefits Survey is the other widely cited source. Its 2025 averages were $9,325 for single coverage and $26,993 for family coverage, with workers contributing $1,440 and $6,850⁠⁶. The single premium was 5% higher than in 2024, and the family premium 6% higher⁠⁶.

KFF’s figures run above AHRQ’s for three reasons. KFF’s 1,862 full respondents were private and non-federal public employers, so state and local government employers are in its average. For 2025 it limited its sample to firms with 10 or more workers. And it weights its premium averages by covered workers⁠⁶. KFF publishes no state figures. It reports only that average premiums are relatively higher in the Northeast and relatively lower in the South⁠⁶. That is the same pattern as AHRQ’s state table: four of the five most expensive single-coverage states are in the Northeast, and three of the five cheapest (Mississippi, Arkansas and Oklahoma) are in the South⁠¹.

KFF’s firm-size split also lines up with AHRQ’s. Single premiums at firms with 10 to 199 workers ($9,211) were close to those at larger firms ($9,361). Family premiums were lower at smaller firms ($26,054 vs. $27,280), and family contributions were higher ($8,889 vs. $6,227)⁠⁶. KFF’s 2026 survey had not been published as of October 13, 2026.

Health cost per hour worked

The Bureau of Labor Statistics (BLS) Employer Costs for Employee Compensation survey measures the same expense a different way: dollars per hour worked, averaged over all employees, including those not enrolled. In June 2026 private employers spent $3.48 per hour worked on health insurance, against $0.43 on workers’ comp⁠⁷. BLS will drop workers’ comp costs from the series starting with December 2026 data⁠⁷. The figure rises with size: $2.24 at establishments with fewer than 50 workers, $2.81 at 50 to 99, $3.73 at 100 to 499 and $6.07 at 500 or more⁠⁷. By industry it ran from $0.84 in leisure and hospitality to $7.37 in information⁠⁷.

The per-hour figure is lower at small establishments because fewer of them offer coverage and fewer workers enroll, not because each enrollee costs less. AHRQ’s premium per enrollee is what to use for pricing one plan. BLS’s per-hour figure is what to use for comparing total benefit cost with wages. BLS publishes these figures for regions and divisions, not states.

Using the table for a budget

A state average is a starting point, not a quote. Under the federal rule for small-group coverage, an insurer may vary your premium only by coverage tier (individual or family), rating area (set by your principal business address), age (at most 3 to 1 between oldest and youngest adults) and tobacco use (at most 1.5 to 1)⁠⁹. A group of older employees will price above the state average, and a group of younger employees below it.

A worked example (our calculation, for illustration only): a 12-employee business in Ohio with five employees enrolled in single coverage and three in family coverage. At Ohio’s 2025 small-firm averages of $8,379 single and $20,726 family⁠¹, the total premium is 5 × $8,379 + 3 × $20,726 = $104,073 a year. If the business pays 100% of single coverage and 70% of family coverage, its cost is $41,895 + $43,525 = $85,420, and employees pay $18,653. Premiums for 2026 and later plan years will differ from 2025 averages. KFF measured 5% to 6% growth from 2024 to 2025⁠⁶, but no source on this page forecasts the next change.

Sources

1. 1
   Agency for Healthcare Research and Quality (AHRQ), MEPS-IC 2025, private-sector data by firm size and State (Series II), Tables II.A.2, II.C.1, II.C.2, II.D.1, II.D.2 and standard errors Checked 13 Oct 2026 · Back to text ↑
2. 2
   Agency for Healthcare Research and Quality (AHRQ), MEPS-IC technical notes Checked 13 Oct 2026 · Back to text ↑
3. 3
   Agency for Healthcare Research and Quality (AHRQ), MEPS-IC sample sizes Checked 13 Oct 2026 · Back to text ↑
4. 4
   Agency for Healthcare Research and Quality (AHRQ), MEPS data release schedule, 2026 (page updated Aug. 28, 2026) Checked 13 Oct 2026 · Back to text ↑
5. 5
   Agency for Healthcare Research and Quality (AHRQ), MEPS-IC questionnaire glossary Checked 13 Oct 2026 · Back to text ↑
6. 6
   KFF, 2025 Employer Health Benefits Survey (published Oct. 22, 2025) Checked 13 Oct 2026 · Back to text ↑
7. 7
   U.S. Bureau of Labor Statistics, Employer Costs for Employee Compensation, June 2026 (released Sept. 9, 2026; health and workers' comp per-hour lines from BLS's private-industry dataset) Checked 13 Oct 2026 · Back to text ↑
8. 8
   Hawaii Department of Labor and Industrial Relations, Disability Compensation Division, About the Prepaid Health Care Act Checked 13 Oct 2026 · Back to text ↑
9. 9
   eCFR, Office of the Federal Register, 45 CFR 147.102, Fair health insurance premiums Checked 13 Oct 2026 · Back to text ↑
10. 10
    Internal Revenue Service, Questions and answers on employer shared responsibility provisions under the Affordable Care Act Checked 13 Oct 2026 · Back to text ↑

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