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Bureau of Labor Statistics > Employee Benefits > Publications > Factsheets

Medical care premiums in the United States, March 2023

The National Compensation Survey (NCS) program publishes comprehensive estimates on the incidence (the percentage of workers with access to and participation in employer provided benefit plans) and provisions of employee benefit plans. Health care is typically one of the most expensive benefits for employers to provide, constituting 7.7 percent of total compensation for civilian workers in March 2023.⁽¹⁾ The average cost for health care per state and local government employee hour worked was $6.41 and $2.83 for private industry workers.

The NCS program publishes several components of health care benefits, including medical care premiums.

A premium is an agreed upon fee paid for coverage of medical care benefits for a defined period of time (usually 1 year).
Premiums may be paid by employers, unions, employees, or shared by both the insured individual and the plan sponsor(s) depending on the plan.
Estimates are available for the share (in percent) of the premium paid by the employee and employer and the percent of workers with a contribution requirement.

Estimates for medical plan premiums are not based on actual decisions regarding medical coverage made by employees; instead, they are based on the assumption that all employees in the occupation can opt for available coverage.

March 2023 civilian worker single coverage estimates show that:

12 percent of workers participated in medical care plans without an employee contribution requirement where the average employer premium was $662.07 per month.
88 percent of workers participated in medical care plans with an employee contribution requirement where employees paid an average of $150.33 and employers paid an average of $517.88 per month.
73 percent of workers participating in single coverage medical plans with an employee contribution requirement had a flat dollar premium, with a median amount of $130.00 per month.⁽²⁾

In order to show the distribution of flat dollar medical care premiums, estimates are available by the following percentiles: 10th, 25th, 50th, 75th, and 90th. The benefits publication presents the monthly premium amount, but for this fact sheet the amounts were multiplied by 12 to show annual premium amounts. The median (50th percentile) is where half of workers have premiums less than and half of workers have premiums more than the stated premium amount. The median annual premium for civilian workers was $1,560.00 for single coverage medical care benefits and $6,099.12 for family coverage. (See chart 1.)

Table 1. Annual employee contributions for single and family coverage, civilian workers, March 2023
	10th	25th	50th (median)	75th	90th
Single coverage	$528.12	$994.44	$1,560.00	$2,290.20	$3,301.44
Family coverage	$2,655.36	$4,022.76	$6,099.12	$9,559.44	$14,130.84
Source: U.S. Bureau of Labor Statistics

State and local government workers in the lowest 25 percent wage category had a median annual premium amount of $1,181.04 for single coverage. For workers at the highest 25 percent wage category, the contribution at the 90th percentile was $3,666.00. (See chart 2.)

Table 2. Annual employee contribution for single coverage by wage category, state and local government workers, March 2023
Average wage within the following categories	10th	25th	50th (Median)	75th	90th
Lowest 25 percent	$300.00	$600.00	$1,181.04	$1,799.16	$2,622.84
Second 25 percent	$389.04	$652.56	$1,228.92	$1,844.04	$2,882.76
Third 25 percent	$304.20	$669.00	$1,201.08	$1,941.72	$2,929.20
Highest 25 percent	$462.00	$859.32	$1,450.44	$2,306.16	$3,666.00
Source: U.S. Bureau of Labor Statistics

Private industry workers in the lowest 25 percent wage category had a median annual premium amount of $6,835.20 for family coverage. (See chart 3.)

Table 3. Annual employee contribution for single coverage by wage category, private industry workers, March 2023
Average wage within the following categories	10th	25th	50th (median)	75th	90th
Lowest 25 percent	$3,055.32	$4,369.20	$6,835.20	$10,941.24	$16,759.08
Second 25 percent	$2,688.60	$4,200.00	$6,390.24	$10,357.56	$14,706.96
Third 25 percent	$2,806.08	$4,173.60	$6,142.20	$9,696.12	$14,172.72
Highest 25 percent	$2,752.68	$3,942.48	$5,845.20	$8,641.68	$12,997.68
Source: U.S. Bureau of Labor Statistics

The share of premiums paid by private workers (regardless of contribution requirement) in establishments with less than 50 workers was 22 percent for single coverage and 38 percent for family coverage. The share of premiums paid by workers in establishments with 500 workers or more was 20 percent for single coverage and 26 percent for family coverage. (See charts 4 and 5.)

Table 4. Employer and Employee share of premiums for single coverage by establishment size, private industry workers, March 2023
Establishment size	Employer Share	Employee share
Less than 50 workers	78%	22%
50-99 workers	78%	22%
100-499 workers	79%	21%
500 workers or more	80%	20%
Source: U.S. Bureau of Labor Statistics

Table 5. Employer and Employee share of premiums for family coverage by establishment size, private industry workers, March 2023
Establishment size	Employer share	Employee Share
Less than 50 workers	62%	38%
50-99 workers	61%	39%
100-499 workers	68%	32%
500 workers or more	74%	26%
Source: U.S. Bureau of Labor Statistics

Technical Note

The glossary of employee benefit terms provides definitions for plans, provisions, coverage, and related terms. The Handbook of Methods: National Compensation Measures provides information on the survey design, calculations, weighting, and imputation methods used to produce estimates for the ECI, ECEC, and Benefits publications. Information on calculating the reliability of estimates (standard errors) is also included in the calculation section.

Employee benefits in state and local government should not be directly compared to private industry. Differences between these sectors stem from factors such as variation in work activities and occupational structures. Manufacturing and sales, for example, make up a large part of private industry work activities but are rare in state and local government. One-third of the private industry sample had been rotated each year except in years when the government sample was replaced. Beginning with the March 2022 publication, however, an additional (fourth) private industry sample is used in estimation to mitigate the impact of decreasing response rates. The government sample is replaced less frequently than the private industry sample. The state and local government sample was replaced in its entirety for the March 2017 reference period.

For all published estimates of cost, coverage, and provisions of employer-sponsored benefit plans see the Employee Benefits publications.

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END NOTES

⁽¹⁾ Data from Employer Costs for Employee Compensation (ECEC) Table 1.

⁽²⁾ Flat–dollar–amount contribution requirements are a fixed dollar amount. Variable–dollar–amount requirements may vary by dollar amount depending on other factors — for example, the amount may vary by employee’s earnings or length of service.

Last Modified Date: April 11, 2024