WPMA News / Spring 2026 
 67
Associate Member News  
Health Benefits by Plan Type: In 2025, as has been the
case for decades, Preferred Provider Organization (PPO)
plans remained the most common type of plan covering
U.S. employees. These plans are generally viewed as the
most user friendly because they allow members to use
almost any provider they want with the plan paying a higher
benefit if the member uses a preferred in-network provider
since those providers offer discounts in exchange for patient
channeling. Among firms offering health benefit plans, 46%
of all workers are covered by a PPO plan. By comparison,
only 12% of workers are covered under a more restric-
tive Health Maintenance Organization (HMO) plan, which
generally limits members to a closed panel of providers and
only covers out-of-network care in the event of an emer-
gency. Approximately 33% of covered workers are enrolled
in high-deductible health plans (which are generally used in
conjunction with health savings accounts (HSAs)) and may
be offered with PPO plans or HMO plans (see Graph 2).
Graph 2
Health Benefit Cost and Employer Contribution: In
2025, the average annual premium for employer-sponsored
health insurance coverage was $9,325 for single coverage
and $26,993 for family coverage, increases of 4.2% and 5.6%
respectively. Over the past five years, the average premium
for family coverage has increased by 26%, compared to an
increase in worker wages of 28.6% and inflation of 23.5%.
On average, workers contributed about $1,500 (16%) toward
the cost of single coverage and $7,000 (26%) for family
coverage, about the same as in 2024. This means employers
contributed more than $7,800 (84%) for single coverage and
almost $20,000 (74%) for family coverage (see Graph 3).
Graph 3
Insurance Deductibles and Other Benefit Levels:
According to the KFF survey, 88% of workers are covered
under plans that have an annual deductible. This is the amount
the insured must pay before insurance benefits kick in (although
there are some benefits like wellness care that are often covered on
a pre-deductible basis). In 2025, the average annual deductible for
single coverage was $1,886. Like the benefit distinctions amongst
employer sizes, the average deductible for workers who are
covered through smaller companies is significantly higher
than those who are covered through larger companies ($2,631
compared to $1,670) (see Graph 4).
Graph 4
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* These graphs were compiled with information and data from the KFF survey.

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