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Ease Report Reveals Even Small Shifts in Benefits Costs Can Impact SMBs

Lexi Wahl
February 21, 2023

Annual benchmarking and trend report shows smallest businesses see biggest medical premium increases

SAN FRANCISCO, Feb. 21, 2023 – Ease®, a leading HR and benefits software solution for small- and medium-sized businesses (SMBs), insurance brokers, and insurance carriers, today released the 2023 SMB Benefits and Employee Insights Report. Now in its fourth year, this report centers on benefits cost and adoption trends for businesses with 2-250 employees nationwide.

Drawing on anonymized data from 3.4 million employees and their 85,000 employers, the report continues to see medical premiums tick up. Individual premiums saw a 21% increase from 2018, and family premiums came in slightly under that at 18% over the same time period. That’s a $104 difference in individual premiums and a $231 difference in family premiums each month — or $1,248 and $2,772 per year — significant for any household.

While the jump in average premiums from 2021 to 2022 fell under the 6.5% rate of inflation, the smallest employer groups were dealt the hardest blow. Employers with only 1-10 employees saw an increase of 12% in average family-plan premiums. That’s nearly double the rate of inflation and the largest increase this segment experienced in the past four years.

“Small businesses power the U.S., and the past three years have been anything but normal,” said David Reid, CEO and co-founder of Ease. “This report looks deeper into the benefits pressures these employers and employees face and shares data points to help make informed decisions for the coming year.

“By determining the right benefits mix, these small businesses can remain competitive,” Reid said. “That’s where lifestyle benefits — perks that go beyond medical, dental, and vision — come into play.”

When it comes to plan-type adoption, it’s no surprise HMOs and PPOs remain the most popular choice for employees. Though uptake of consumer-driven health plans remains a small slice of the pie, participation in high deductible health plans has increased 68% year over year. Panning out, HDHPs typically combine with a health savings account (HSA). Given the current state of the economy, households may be opting to use higher deductible plans to save money on their monthly premiums — in spite of the higher financial risk if a major medical event occurs, more money in their pockets each month seems like a safer bet.

Non-medical voluntary benefits offer SMBs a unique way to meet the needs of their employees without wrecking their budgets. Must-haves like dental, vision, and life top the list for SMB employees, but lifestyle benefits like financial wellness, legal services, and pet insurance continue to gain steam.

Vision coverage continues to see a decrease year-over-year in premium cost. Short-term disability saw the biggest jump from 2020 to 2022 at almost 12% ($2.75 per month, or $33 more annually).

Download a copy of the full report, which dives deeper into benefits, costs, and adoption.

About Ease

Started in 2012 in San Francisco by employee benefits veteran David Reid and web and engineering architect Courtney Guertin, Ease has grown into the #1 rated benefits administration and HR software for businesses with 2-250 employees, powered by insurance brokers. More than 2,300 agencies trust Ease to help them and their clients grow. Over 85,000 businesses trust Ease to manage benefits and HR for 3.4 million+ employees. Visit ease.com for more.


This report reflects small- and medium-sized businesses using Ease from January through December 2022. This analysis uses anonymized data collected in January 2023.

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