Employees who waive your plan face higher marketplace prices in 2027.
When an eligible employee declines your group coverage and shops HealthCare.gov, the price they see for 2027 is higher than last year’s. KFF estimates the average HealthCare.gov increase at about 13%, as reported by The Hill, and the enhanced federal premium tax credits that held prices down ended with 2025.
That changes the conversation at your open enrollment. Some employees who waived will look again at your plan, and some will ask why they cannot get a subsidy. Send us your renewal and we will give you a second opinion in writing.
Three things employers should understand about waivers.
Why they usually cannot get a subsidy
An employee offered affordable, minimum-value employer coverage is generally not eligible for a premium tax credit, even if they decline the offer (IRC §36B(c)(2)(C)). Employees who say “I will just use the marketplace” should hear that before they decide.
A waiver rate is a signal
A high share of eligible employees waiving often points to the cost of the employee contribution, especially for dependents. Compare your waiver rate by tier before you set 2027 contributions.
Payments for waiving need care
Cash offered in exchange for waiving coverage can count toward the affordability calculation under the ACA. Model it with your broker and counsel before you offer it. See cash in lieu of benefits.
Keep reading.
HealthCare.gov premiums rise again in 2027
What the 2027 marketplace increases mean for an employer plan. Back to the marketplace page.
Keep reading on 2027 marketplace premiums.
Where these figures and rules come from.
Figures and rules
Premium tax credit eligibility: Internal Revenue Code §36B(c)(2)(C). KFF and The Hill: KFF estimates about 13% for HealthCare.gov in 2027, as reported by The Hill on October 31, 2026; KFF’s review of insurer filings found a median proposed increase of 15% (KFF, How Much and Why ACA Marketplace Premiums Are Going Up in 2027). This page is general information, not legal or tax advice.
Send us your renewal.
Four documents — the renewal letter, the plan summary, the contribution split by tier and enrolled counts by tier. We’ll come back with a competitive read, where we see opportunity, and the five questions we’d put to your carrier.
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