Employer surveys project health cost increases of roughly 8 to 10 percent for 2027, and Michigan regulators approved a 9.6 percent average for small-group plans. This page puts the numbers, the cost drivers and the 2027 limits in one place, with a guide behind each.
If you read nothing else, read these six points. Each links to the guide behind it, and every figure comes from a source listed at the bottom of the page.
Michigan regulators approved a 9.6 percent average increase for 2027 small-group plans, and national employer surveys land between 8 and 10 percent. Budgeting to that range, then tightening it when your renewal arrives, is more reliable than planning around one number.
The 2026 Milliman Medical Index shows pharmacy cost rising 14.8 percent against 7.2 percent for the total family-of-four cost. Specialty drugs and GLP-1 medications are the usual reasons, so drug coverage rules now matter as much as the network.
KFF puts the 2026 worker share of an average family premium at $7,471 of $28,303, or 26 percent. In Michigan the 2025 family split was 27 percent employee and 73 percent employer. Contribution strategy is one of the main levers an employer controls.
KFF finds the average single deductible is $2,624 at firms with 10 to 199 workers against $1,772 at larger firms. For a small employer the 2027 conversation is often about deductible and cost sharing, not only the premium.
For 2027 the HSA limit is $4,500 self-only and $9,000 family, and the HDHP out-of-pocket maximum is $8,700 and $17,400. The ACA affordability percentage rises to 10.22 percent from 9.96 percent.
Some employers are dropping or limiting GLP-1 coverage, shifting more cost to employees or changing carriers. KFF finds 16 percent of firms changed insurers. The charts below show how common each response is.
Three figures frame the year. Each links to the guide that goes deeper.
Michigan regulators announced an approved 2027 average increase of 9.6 percent for small-group plans, covering about 400,000 people at businesses with fewer than 51 employees, as reported by Bridge Michigan. Your own renewal can land above or below that average.
Business Group on Health reports a median projected increase of 9.2 percent for 2027, about 8 percent after plan design changes. The International Foundation of Employee Benefit Plans reports a median of 10 percent. These are surveys of employers as a group, not of Michigan small groups, so treat them as context rather than a forecast for yours.
The same Michigan announcement put the average individual-market increase at 14.2 percent. That matters to employers weighing an ICHRA or comparing group coverage with individual plans.
The estimates differ because they measure different things: a regulator average, employer surveys and individual-market filings. The chart puts them on one scale so you can see the spread. It does not suggest that any one bar is your number.
The spread of more than six points between the lowest and highest bar is the lesson. A regulator average, an employer-survey median and an individual-market filing answer different questions, and your renewal depends on your own claims, size, ages and plan.
The Michigan small-group average falls inside the national 8 to 10 percent range, near the middle. The individual-market figure is well above it, which is worth knowing if you are weighing group coverage against an ICHRA.
A practical use is to budget to a range, such as 8 to 10 percent, and tighten it when your carrier’s renewal arrives. The budget section further down turns that range into dollars.
Three independent benchmarks show where costs stand today, before 2027 renewals are applied.
KFF’s 2026 Employer Health Benefits Survey puts the average annual premium at $9,804 for single coverage and $28,303 for family coverage, each up about 5 percent from 2025. KFF says forecasts for 2027 are approaching double digits.
Covered workers contribute an average of $1,672 for single coverage (18 percent of the premium) and $7,471 for family coverage (27 percent). At firms with 10 to 199 workers, the family contribution averages $9,687, or 37 percent, against $6,840 (25 percent) at larger firms.
The average single-coverage deductible is $1,955 across all firms. KFF finds it is $2,624 at firms with 10 to 199 workers against $1,772 at larger firms, and 55 percent of small-firm workers face a deductible of $2,000 or more versus 33 percent at larger firms.
The 2026 Milliman Medical Index projects $37,824 for a family of four covered by an average employer plan, up 7.2 percent. Per person it is $8,460, up 7.9 percent, the largest rise in more than a decade outside the pandemic years.
Milliman reports pharmacy cost per person up 14.8 percent. Outpatient facility care is about 31 percent of spending, and outpatient care plus pharmacy account for 69 percent of the year-over-year increase.
AHIP’s analysis of 2022 to 2024 averages, covering employer and Marketplace plans, puts hospital care at 40.7 cents of each premium dollar, prescription drugs at 23.6 cents and doctor visits at 12 cents. Administration is 4.5 cents, taxes and fees 3.1 cents and profit 2.5 cents.
AHIP is the health insurance industry’s trade association, so read its breakdown as one view alongside the independent KFF and Milliman figures. KFF defines small firms as 10 to 199 workers.
These charts use the national benchmarks above. They show how a family premium splits between employer and worker, how fast the main cost lines are growing, where the premium dollar goes and how deductibles differ by firm size.
At the 2026 average the employer pays about $20,800 of a $28,303 family premium. A small change in the employee share moves real money: each percentage point of that premium is about $283 per family per year.
Pharmacy growth of 14.8 percent is roughly three times the 5 percent KFF reports for the average family premium. The two numbers measure different things, but they point the same way.
In AHIP’s breakdown hospitals take 40.7 cents of each premium dollar and drugs 23.6 cents. Network design and drug coverage are therefore where plan choices can change cost the most.
AHIP is an insurer trade association, so treat its breakdown as one view of the premium dollar.
National benchmarks rarely break out Michigan. These are the Michigan-specific figures we could confirm, each from the year shown.
KFF State Health Facts puts Michigan’s 2025 average family premium per enrolled employee at $23,800 against $26,281 nationally, and single coverage at $8,230 against $9,025. In 2024 the figures were $24,252 and $8,885, close to the national $24,540 and $8,486. These are survey estimates, and SHADAC reports no state had a statistically significant decrease in single premiums, so the dip from 2024 should not be read as costs falling.
KFF State Health Facts splits Michigan’s 2025 average single premium of $8,230 into $1,970 from the employee and $6,260 from the employer. For family coverage the $23,800 average splits into $6,437 from the employee (27 percent) and $17,363 from the employer (73 percent). See what your own split costs the company across the whole package.
The approved 2027 average covers about 400,000 people at businesses with fewer than 51 employees. For 2026, the proposed filings were 11 percent for small employers and nearly 9 percent for large self-funded employers, according to the Michigan Chamber of Commerce.
SHADAC’s review of Michigan employer coverage found that fewer small employers offer health insurance than in earlier years, and that rising deductibles are a growing burden on workers.
Blue Cross Blue Shield of Michigan reports its core health business lost $1.03 billion in 2024, that pharmacy claims expense rose 15 percent, and that prescription drugs were 21 percent of premium dollars. These are the carrier’s own published figures.
Altarum’s 2025 Michigan survey of about 1,300 adults found 65 percent delayed or went without care because of cost in the past year and 76 percent worry about affording future care. It is a consumer survey, not an employer one.
Michigan data is published less often than national data, so the years differ by source. We will refresh these figures as new releases appear.
KFF’s state tables for 2025 give Michigan its own numbers. Michigan premiums sat below the national average that year, but SHADAC cautions that single-year state differences can be survey noise, so read these as a snapshot and not as a trend.
In 2025 the average Michigan family premium was $23,800 against $26,281 nationally, a gap of about $2,500. Single coverage was $8,230 against $9,025.
Michigan employers covered about 73 percent of the 2025 family premium and employees 27 percent. For single coverage the employee share was $1,970, about 24 percent.
SHADAC reports that no state had a statistically significant decrease in single premiums, so Michigan’s lower figure is not evidence that costs are falling here. The 9.6 percent small-group approval for 2027 is the better guide to direction.
Employers responding to the 2027 cost surveys name a consistent set of pressures.
In the International Foundation survey, 32 percent of employers named catastrophic claims as the leading cost category. Stop-loss and funding structure decide how much of that risk a group carries.
21 percent of surveyed employers named specialty drugs as their primary driver. Autoimmune and inflammatory therapies, cancer drugs and cell and gene therapy were among the categories cited.
Among the employers who named specialty drugs as their main driver, 67 percent pointed to GLP-1 drugs. Coverage rules, utilization management and cost sharing are decisions each employer makes. KFF finds 18 percent of firms with 200 or more workers cover GLP-1 drugs for weight loss, and 29 percent of those that do say the coverage has had a significant impact on drug spending.
Business Group on Health found 70 percent of employers cite cancer as a top condition driver, with musculoskeletal conditions at 68 percent and cardiovascular conditions at 37 percent. Start with how much of your own increase is really yours.
A federal rule on pharmacy benefit manager fee disclosure for self-funded plans is part of the 2027 picture. Our guide covers who it reaches among Michigan employers.
The carrier’s loss ratio sits behind the rate it quotes you. This guide explains how it is read and what to ask for.
Figures come straight from the IRS revenue procedures listed under Sources.
$4,500 for self-only coverage and $9,000 for family coverage in 2027, up from $4,400 and $8,750 (Rev. Proc. 2026-24).
Minimum deductible of $1,750 self-only and $3,500 family. Maximum out-of-pocket of $8,700 self-only and $17,400 family (Rev. Proc. 2026-24).
Up to $2,250 may be newly made available for plan years beginning in 2027, up from $2,200 (Rev. Proc. 2026-24).
10.22 percent for 2027, up from 9.96 percent in 2026 (Rev. Proc. 2026-26).
For 2027 the indexed Section 4980H amounts are $3,780 under 4980H(c)(1) and $5,670 under 4980H(b)(1) (Rev. Proc. 2026-22).
Where to find the filed 2027 rates for each Michigan carrier, so you can compare an offer with the filing.
Contribution and cost-sharing limits reset every year. The chart shows the self-only and family figures side by side so you can test your plan design against them.
The 2027 HSA limit is $4,500 self-only and $9,000 family. The HDHP minimum deductible is $1,750 and $3,500, and the out-of-pocket maximum is $8,700 and $17,400.
The ACA affordability percentage is 10.22 percent for 2027 under Rev. Proc. 2026-26, up from 9.96 percent. The two section 4980H penalty amounts are $5,670 and $3,780 under Rev. Proc. 2026-22.
An excepted-benefit HRA can reimburse up to $2,250 in 2027. It sits alongside group coverage instead of replacing it, which makes it a way to add flexibility without changing the main plan.
Federal tax-law changes, employer GLP-1 decisions and cost shifting all shape the plan you renew.
The annual dependent care FSA limit rose from $5,000 to $7,500, or from $2,500 to $3,750 for married people filing separately, starting January 1, 2026.
The rule letting a high-deductible plan cover telehealth before the deductible without costing HSA eligibility is now permanent, for plan years beginning after December 31, 2024.
Direct primary care arrangements no longer cost HSA eligibility if monthly fees stay within limits. For 2027 the IRS limit is $150 for an individual and $300 where the arrangement covers more than one person (Rev. Proc. 2026-24).
Marketplace bronze and catastrophic plans now qualify as HSA-eligible high-deductible plans, generally beginning in 2026. It matters to employers weighing group coverage against individual plans.
Employers may reimburse up to $5,250 a year of an employee’s student loan payments tax-free. The limit is indexed for inflation starting in 2027.
Employers may contribute up to $2,500 a year, indexed for inflation, to a Trump account for an employee’s child, tax-free under a written plan. The annual contribution limit is $5,000 per child under 18.
Business Group on Health’s 2026 survey of 105 large employers found 67 percent cover GLP-1s for weight management, 72 percent of those expect to continue in 2027 and 10 percent likely will not. Its separate 2027 survey has 14 percent having dropped or planning to drop coverage. KFF’s broader survey finds 18 percent of firms with 200 or more workers cover them, and 12 percent of non-covering firms stopped in the past year.
KFF finds 18 percent of all firms raised the workers’ share of premiums and 4 percent raised deductibles. At firms with 200 or more workers it is 44 percent and 21 percent, and 16 percent changed insurers or plan administrators.
A 2026 survey of more than 300 employers found 20 percent actively implementing AI in their benefits programs and nearly three-quarters aiming to within two years. Only 1 percent have governance frameworks for benefits teams, and 56 percent are working toward or considering one.
Tax-law provisions are summarized from public guidance and the IRS; confirm how each applies to your plan. General information, not legal or tax advice.
Two sets of survey results show the response to cost pressure: what employers decided about GLP-1 coverage, and how many shifted cost to employees.
Two thirds of the large employers in one survey cover these drugs, while KFF finds 18 percent of firms with 200 or more workers do. Sample and definitions likely explain much of the gap.
KFF finds 44 percent of firms with 200 or more workers raised the worker share of premium against 18 percent of all firms. They also raised deductibles more often, 21 percent against 4 percent.
Sixteen percent of firms in the KFF survey changed insurers. Marketing a renewal is a normal part of cost management, and it works best when it starts well before the renewal date.
Percentages are hard to budget against. The chart applies each estimate to a $500,000 annual premium, and the table shows four of them on three premium sizes. This is arithmetic on round numbers, not a forecast for any group.
| Annual premium | 8.0% increase | 9.6% increase | 10.0% increase | 14.2% increase |
|---|---|---|---|---|
| $250,000 | +$20,000 | +$24,000 | +$25,000 | +$35,500 |
| $500,000 | +$40,000 | +$48,000 | +$50,000 | +$71,000 |
| $1,000,000 | +$80,000 | +$96,000 | +$100,000 | +$142,000 |
On a $500,000 premium each percentage point is $5,000 a year. The gap between an 8 percent and a 10 percent renewal is $10,000, which is why negotiating, marketing or restructuring the plan can matter even when the starting point looks reasonable.
Divide the added cost by enrolled employees to see the per-person effect. $48,000 across 25 enrolled employees is $1,920 each per year, or $160 a month, before any change in how the cost is shared.
The same increase can be absorbed by the employer, shared through higher employee contributions or reduced through plan design such as a higher deductible. How your claims drove the renewal, including your loss ratio, shows which of those is realistic.
A renewal handled in the last two weeks is a negotiation with very little leverage. This calendar works backward from the effective date and applies to any plan year, so shift the dates to match yours.
Pull current rates, plan documents, the census and any claims or utilization reports your funding arrangement provides. Set the budget range you can live with so the conversation has a target.
Decide whether you will renew as is, change plan design, change contributions or take the plan to market, and how much of the budget range each lever can cover.
If you are going to market, request quotes and give each carrier the current plan designs and rates as a baseline so quotes compare on the same terms. Ask about funding alternatives where the group size supports them.
Check the renewal against the filed rates, the loss ratio and the benchmarks on this page. Look beyond price to changes in the network, drug formulary, deductible and out-of-pocket maximum.
Choose the plan and contribution, then work out the employee share per person and by coverage tier before anything is announced.
Open enrollment, notices and carrier paperwork come next. Check affordability against the 10.22 percent threshold if you are an applicable large employer, and confirm HSA and HRA limits against the 2027 figures.
These are planning checkpoints, not regulatory deadlines. Your carrier’s notice requirements and your plan’s effective date set the real dates.
A national average blends very different arrangements. How an increase reaches you depends on how the plan is funded, so the useful question is which numbers apply to you.
Rate approvals are the best public reference for a fully insured small group. Your renewal can still land above or below the average, so compare it with the carrier-level filings.
A level-funded plan pairs a fixed monthly payment with stop-loss protection. At renewal the payment tends to reflect your own claims experience more than a market average does, so ask how unused claim funds are treated at year end.
Your cost follows your own claims plus administration and stop-loss premiums. National trend figures are a reference for budgeting claims, and stop-loss renewals are priced separately.
A higher deductible lowers the premium but moves more cost to employees. Check that your deductible and out-of-pocket maximum fall within the 2027 HDHP limits, and decide whether the employer contributes to the HSA.
The 14.2 percent Michigan individual-market average is the reference point if you are weighing an ICHRA against group coverage. Compare the total cost for your workforce, not the average increase alone.
CFH places group captives for clients, and other structures such as reference-based pricing are handled as advisory, case by case. The plan-structures guide shows which fit a group your size.
Every figure here comes from a source listed at the bottom of the page. This section explains how the figures differ so you can use the right one for the question you are asking.
A filed rate is what a carrier submits to regulators, and an approved rate is the average the regulator allows. A survey figure is what employers report. Your renewal is the carrier’s price for your group. The four are related but are not the same number.
KFF defines small firms as 10 to 199 workers, so its small-firm figures include companies far larger than a typical Michigan small group. Business Group on Health surveys large employers, and AHIP represents insurers. Each chart caption names its source and its limits.
Milliman measures the total cost of care for a family of four, KFF measures premiums, and your cost is premium plus deductibles and copays. A 7 percent rise in the total cost of care does not mean a 7 percent rise in your premium.
The page reflects sources published through November 2026. Final carrier-level 2027 rates, new IRS guidance and the next KFF and Milliman releases can change the numbers, and we refresh the page when they are published.
None of these guarantees a lower number. Each is a way to test whether the number you were given is the number you should accept.
Separate the part of the increase that is trend from the part that is your group’s own experience.
Know where your group sits and what a rebate or a rate action would mean for you.
Compare fully insured with level-funded, and see where stop-loss changes the risk. Not every group is a fit for every structure.
Network type and plan design move cost as much as the headline rate does.
Model what the whole package costs the company before changing what employees pay.
Our process for reading a renewal end to end: what the carrier sent, what it means and what to put back to them.
Know the carrier you are renewing with: Blue Cross Blue Shield of Michigan, Blue Care Network, HAP and Priority Health.
Surveys point to roughly 8 to 10 percent: Business Group on Health reports a median of 9.2 percent (about 8 percent after plan design changes) and the International Foundation reports a median of 10 percent. Michigan regulators approved an average of 9.6 percent for small-group plans. Your own number depends on your claims experience, group size, plan design and carrier.
No. It is an average across small-group plans. Your rate comes from how the carrier rates your group. Self-funded and level-funded plans are generally priced differently and are not set by these filings.
Employers name catastrophic claims, specialty prescription drugs, GLP-1 drugs and cancer most often in the 2027 surveys. The numbers are on this page, and each links to a deeper guide.
$4,500 for self-only coverage and $9,000 for family coverage. A qualifying high-deductible plan has a minimum deductible of $1,750 self-only or $3,500 family, and a maximum out-of-pocket of $8,700 self-only or $17,400 family (Rev. Proc. 2026-24).
10.22 percent, up from 9.96 percent in 2026 (Rev. Proc. 2026-26). It is the most the employee’s share of the lowest-cost self-only premium can be, as a share of income, for coverage to count as affordable. Employers commonly test it with an IRS safe harbor.
As soon as you have it, and before you accept it. Send the renewal letter, the plan summary, the contribution split and the enrolled counts by tier. There is no cost and no obligation to move anything.
KFF’s 2026 survey puts the average annual premium at $9,804 for single coverage and $28,303 for family coverage. Workers contribute an average of $1,672 for single and $7,471 for family coverage. Milliman’s 2026 index projects $37,824 for a family of four covered by an average employer plan.
Recent survey data says yes, with a caveat. KFF State Health Facts shows an average 2025 family premium of $23,800 in Michigan against $26,281 nationally, and $24,252 against $24,540 in 2024. These are survey estimates that can move from year to year. SHADAC notes Michigan has historically had lower-than-average costs but has been moving closer to the national average.
The 2025 federal tax law raised the dependent care FSA limit to $7,500, made the telehealth-before-deductible HSA rule permanent, allowed direct primary care alongside an HSA, made bronze and catastrophic marketplace plans HSA-eligible and indexed the $5,250 student loan benefit for inflation starting in 2027. Confirm how each applies to your plan before changing it.
Start with a range of 8 to 10 percent, which spans the national employer surveys and sits around the 9.6 percent Michigan small-group average. Apply it to your current annual premium, divide by enrolled employees to see the per-person effect, then adjust once your carrier’s renewal arrives. The budget section on this page shows the arithmetic for three premium sizes.
They measure different things. Regulator approvals are averages of filed rates, KFF and Business Group on Health are employer surveys with different samples, Milliman measures total cost of care, and AHIP is an insurer trade association. The caption under each chart says what is measured and who was surveyed.
Compare it with the range on this page and with the carrier’s filed rates, check the loss ratio and any plan changes, and ask for the rate-change explanation in writing. If the increase is above the range, send us the renewal and we will review it and market the plan if that makes sense.
Ready? Send us your renewal, or talk it through with someone first. General information, not legal or tax advice.
Current as of November 5, 2026. Business Group on Health 2027 Employer Healthcare Strategy Survey · PLANADVISER summary of the 2027 cost-trend surveys · Bridge Michigan, Michigan 2027 rate announcement · Michigan DIFS health coverage rate review · IRS Rev. Proc. 2026-24 · IRS Rev. Proc. 2026-26 · IRS Rev. Proc. 2026-22 · KFF 2026 Employer Health Benefits Survey · Milliman 2026 Medical Index · AHIP, where the premium dollar goes · KFF State Health Facts, family premiums · KFF State Health Facts, single premiums · WZMQ 19 on the SHADAC Michigan study · Michigan Chamber of Commerce · Blue Cross Blue Shield of Michigan, Blue Daily · Altarum Michigan consumer survey · SHADAC on the 2025 employer premium data · Venable on the 2025 federal tax law and benefits · Becker’s Payer Issues on the tax law and benefits · Business Group on Health GLP-1 survey · SHRM on employers dropping GLP-1 coverage · Becker’s Payer Issues on AI in benefits
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
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