Rising healthcare prices are affecting orgs throughout all industries and sizes—and small to medium-sized companies are being notably hard-hit.
A report out final week from payroll and HR options supplier Gusto highlighted the impression: The median medical health insurance premiums at small companies jumped 23% within the final three years, a full 13% increased than the inflation price. Premiums at organizations with 5 or fewer staff outpaced inflation by a full 18% in the identical time interval—hitting about $8,500 per worker this 12 months.
These numbers may proceed to soar, as employers brace for the most important hikes to medical health insurance premiums in 15 years.
For SMBs, lack of entry to advantages specialists and the truth that many smaller companies are family-owned—with leaders wanting essentially the most complete protection for his or her households—are among the many elements driving the will increase, Gusto discovered.
But, rising healthcare prices aren’t deterring small orgs from providing medical health insurance. Almost 1 / 4 of SMBs surveyed provide medical health insurance, a price that has stayed regular in recent times.
And the median employer contribution has solely dropped from 70% to 68% within the final three years.
“As a result of roughly 46% of Individuals work at small companies, the power of small corporations to affordably provide well being advantages to their staff is a essential nationwide precedence,” researchers wrote. “Medical insurance just isn’t a discretionary expense, however a core element of compensation and a significant device for attracting and retaining expertise.”
Rising healthcare prices = rising reputation of HSAs
How are small companies managing rising healthcare prices? In keeping with Gusto’s examine, many are turning to well being financial savings accounts. 5 years in the past, a couple of third of these Gusto surveyed provided their staff HSAs; this 12 months, that determine stands at nearly 48%.
HSAs provide decrease month-to-month premiums—with a tradeoff of upper deductibles—and allow staff to save lots of pre-tax {dollars} for future wants. On the identical time, researchers wrote, HSAs give staff extra selection over their protection.

Gusto economist Andrew Chamberlain tells HR Govt that SMBs are “getting artistic” with plan design—leveraging HSAs in addition to different pre-tax financial savings choices, outlined contributions plans and tiered choices.
As healthcare prices are anticipated to proceed hovering in 2026, he says, organizations of all sizes can look to how SMBs have tailored to rising healthcare wants—with expertise wants on the forefront.
“SMBs’ agility within the face of uncertainty,” Chamberlain says, “provides invaluable classes for bigger employers to be aware of: staying near staff, listening to what advantages they worth most and adapting accordingly.”

