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Advice & Opinion

Employers expect 8.2% higher health costs in 2027. Check your plan before you pay.

Marsh says two-thirds of large employers plan to shift more premium costs to workers. Here's what to check at open enrollment.

Employers expect 8.2% higher health costs in 2027. Check your plan before you pay.
Stock photo. Photo by Vitaly Gariev on Unsplash

Every fall, your employer sends an email with a subject line like "Your 2027 Benefits Are Here!" and that exclamation point is working overtime. This year, open it and read it.

Employers expect health benefit costs per employee to rise 8.2% in 2027, the biggest jump since 2003, according to preliminary results from Marsh (the benefits consultancy formerly called Mercer), released Sept. 2 from a survey of more than 1,800 U.S. employers. Without changes like higher deductibles, employers told Marsh their costs would climb about 11%. Marsh also found that about two-thirds of large employers plan to raise workers' share of premiums, so your paycheck deduction could rise faster than the headline number. Fierce Healthcare reported the same projection.

That's on top of a baseline that already hurt. KFF's 2025 Employer Health Benefits Survey put the average family premium at $26,993, with workers paying $6,850 of it themselves. KFF's 2026 edition had not been posted as of Wednesday, Oct. 21.

People who buy their own insurance have it worse. In KFF's review of proposed 2027 rates from 276 insurers across all 50 states and D.C., the median requested increase was 15%, after a 20% median increase for 2026. The enhanced premium tax credits that cut marketplace bills for millions expired at the end of 2025, and KFF lists that expiration among the reasons rates are climbing.

Read the fine print before it reads you

Open enrollment is usually your only chance to change plans until next fall. After it closes, you generally need a qualifying life event. Marriage, a birth, or an adoption opens a special enrollment window, but you typically have just 30 days to ask your employer's plan to add you, according to the Labor Department.

Compare the total, not the premium. Add up a year of premiums, the deductible, and the out-of-pocket maximum. A cheap premium with a huge deductible is a bet that nobody in your house gets sick next year. Price the bad year, not just the good one.

Demand the SBC. Federal regulation, 29 CFR 2590.715-2715, requires your plan to give you a Summary of Benefits and Coverage: a standardized, plain-language summary of no more than four double-sided pages, with sample costs for common situations like having a baby. If you ask for one, the plan must provide it within seven business days. Line up the SBCs side by side.

Get the real documents. The SBC itself says it's only a summary; the plan document controls. Under ERISA, the federal law that governs most private-sector benefit plans, the plan administrator must give you the summary plan description and the plan's governing documents if you ask in writing. They can charge a reasonable copying fee. Ask anyway.

Check for a spouse penalty. Some plans charge extra to cover a spouse who could get insurance through their own job. Look for a "working spouse" surcharge before you add your partner on autopilot.

Use the tax breaks. If you pick a high-deductible plan, the IRS set 2027 HSA limits at $4,500 for self-only coverage and $9,000 for family coverage.

The 10.22% test

The IRS set the 2027 Affordable Care Act affordability percentage at 10.22% of household income, up from 9.96% in 2026, in Rev. Proc. 2026-26, EY reported. In plain English: if the cheapest self-only plan your employer offers costs you more than that share of your household income, the law treats it as unaffordable, and you may be able to get a premium tax credit on the marketplace instead.

Buying your own? Circle Nov. 1

HealthCare.gov open enrollment starts Sunday, Nov. 1. Sign up by Dec. 15 for coverage that starts Jan. 1; the site lists Jan. 15 as the last day to enroll. Some states run their own exchanges with different deadlines. Don't let your plan auto-renew. With premiums up and subsidies smaller, last year's plan may be this year's mistake.

Laid off? You still have options

If you lose your job at a company with 20 or more workers, COBRA generally lets you keep the same plan for up to 18 months, but you can be charged up to 102% of its full cost. You get at least 60 days to elect it. Losing job-based coverage also gives you 60 days to pick a marketplace plan, so compare both. If you're offered severance, company-paid COBRA premiums are something you can negotiate. If layoffs are rumored, here are the warning signs and how to prepare.

Employers are passing their costs down the line, and workers are at the end of it. Today, find your enrollment deadline, put it on your calendar, and request the SBC for every plan you're considering.

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