How much are small-group health insurance premiums going up for 2027?

Insurers filing 2027 small-group rates asked for a median 14% increase (KFF’s August 6, 2026 review of nearly 300 insurers). Most requests fall between 10% and 20%, with six insurers above 30% (Healthcare Dive, August 7, 2026). Employer surveys (Mercer, Aon, Business Group on Health, August 2026) expect health cost per employee to rise 8% to 9.5%.

Insurers asked for 14% more.

Small-group coverage means health coverage for companies with 50 or fewer employees in most states, and up to 100 employees in a few states. Every year, the insurers that sell small-group coverage file the rates they want to charge next year with state regulators. KFF pulled the preliminary 2027 filings together on August 6, 2026 and found that nearly 300 insurers, across all 50 states and DC, asked for a median proposed increase of 14%. In KFF’s words, “Nearly 300 insurers offering small group coverage reported a median proposed premium increase of 14% for next year.”

The 14% is a proposed rate. State regulators still review the filings. The 14% is a median, so half the insurers asked for more and half asked for less. And the 14% is specific to small-group coverage.

Healthcare Dive’s August 7, 2026 report on KFF’s August 6 rate-filing review showed where the requests clustered: “Most insurers want to raise rates between 10% and 20%, though six want to hike rates above 30%.” So the 30%-plus filings are real, but they come from six insurers out of nearly 300.

Employers expect an 8% to 9.5% rise.

Mercer, Aon and Business Group on Health each survey employers about what the employers expect health coverage to cost per employee next year. The three surveys’ 2027 projections run from 8% to 9.5%, lower than the median 14% increase that small-group insurers filed (KFF, August 6, 2026).

Mercer’s survey, published August 31, 2026, projects that health plan cost per employee will rise 8.2% in 2027, which Mercer calls the biggest increase since 2003. Employers told Mercer the cost of their current plans would rise 11% if the employers took no action to lower costs, so the 8.2% already assumes employers will change something to hold costs down. Mercer’s actuaries also estimate that rising use of GLP-1 weight-loss drugs accounts for a full percentage point of 2027 cost growth on its own.

Aon, in a release carried by PR Newswire on August 20, 2026, projects U.S. employer health care costs will rise 9.5% in 2027 before employers change anything to offset the increase, pushing per-employee cost above $19,000.

Business Group on Health’s 2027 survey, reported by MedCity News on August 25, 2026, has employers expecting costs to rise a median 9.2% in 2027, or 8% after plan design changes. Business Group also says costs could rise 76% over the ten years from 2018 to 2027, before any plan changes.

The employer surveys cover employers of all sizes. Aon’s 9.5% and Business Group’s 9.2% are what employers expect before the employers change anything, and Mercer’s employers said 11% if the employers did nothing. Mercer’s 8.2% and Business Group’s 8% are the numbers after the plan changes employers intend to make. The rate filings are what insurers asked to charge small groups before any employer changes a plan. A 14% filed median and an 8% to 9.5% employer projection don’t contradict each other. Insurers filed what they want to charge, and employers reported what they expect to pay.

Medical costs are rising almost 10% a year.

Trend is how fast medical bills are growing on their own, before any insurer sets a price or any employer changes a plan. Segal’s 2027 Health Plan Cost Trend Survey, published July 23, 2026, projects prescription drug trend above 11%. Segal also puts medical trend, in Segal’s words, at “nearing double digits,” and about the same whether the plan is a PPO, an HMO or a high-deductible plan.

Both the rate filings and the employer surveys are built on top of trend. KFF’s August 6, 2026 review reports what the insurers themselves blame: “Small group insurers say rising medical prices, including for hospitalizations, physician care, and prescription drugs, and increased utilization are major drivers of the premium increases.” Hospitals, doctors and drugs cost more, and people are using more care.

Is your renewal increase high or low?

Take the percentage on your renewal notice and hold your percentage against the 14% median and the 10% to 20% band most insurers filed. If your company is over your state’s small-group cutoff, your carrier prices your company at least partly on your company’s own claims, so compare your renewal to what employers of all sizes expected before employers cut anything: 9.2% to 11% in the Aon, Business Group and Mercer surveys.

If your increase is under 10%, you came in below the median and below most of the filings. You’re closer to what the employer surveys project than to what insurers asked for, and for 2027 an increase under 10% is a good place to be.

If your increase is between 10% and 20%, you’re in the middle of the pack. Most insurers filed in the 10% to 20% band, and 14% is the center of the band. A renewal in the 10% to 20% band doesn’t mean your carrier singled you out.

If your increase is above 20%, you’re in the upper part of the filings. Above 30%, you’re with the six insurers Healthcare Dive flagged on August 7, 2026. If your increase is above 30%, find out whether your carrier filed that high in your state, or whether something on your side changed, like an older group or more people, or, if your company is over the cutoff, big claims.

If your company is over the cutoff, any increase above 11% is more than employers expected before the employers cut anything.

To put the percentages in dollars: across all the employers KFF surveyed (October 22, 2025), a family plan ran about $27,000 a year, with workers paying $6,850 of the $27,000 from their paychecks. A 14% increase on $27,000 is about $3,800 per family.

No national number predicts your renewal.

The filed median is a request. State regulators can push back, and the rate on your renewal can differ from what your carrier filed. The number to trust is the number on your renewal notice.

A national median can’t tell you whether your own renewal is high or low. Your renewal depends on your state, your carrier, your plan and who’s on your plan. Two groups of the same size in the same town can get very different renewals.

The employer surveys aren’t small-group numbers. Mercer, Aon and Business Group on Health surveyed employers of all sizes, and Mercer’s 8.2% (August 31, 2026) already counts the plan changes the surveyed employers intend to make, so 8.2% isn’t what a small group’s renewal will say.

None of the figures on this page say anything about 2028. The figures tell you where 2027 is landing.

This page is refreshed each quarter as filings are finalized and surveys update. Every figure on this page was checked on its source page on September 11, 2026.

If you’re being offered an ICHRA (you reimburse people for their own policies), a level-funded plan (a group plan priced off your claims) or a PEO (a company that shares employer duties with you), we explain what each option changes for your plan and your employees. Read: Should I switch to an ICHRA, go level-funded, or join a PEO when my renewal goes up? SIMERP, a self-insured medical expense reimbursement plan your company sponsors, redirects payroll tax you already spend into real medical care for your team, and SIMERP can offset part of a premium increase. simerp.com/renewal shows how much of your increase SIMERP can offset, using two numbers on your renewal notice.

References

• KFF, How much and why premiums are going up for small businesses in 2027, August 6, 2026. https://www.kff.org/health-costs/how-much-and-why-premiums-are-going-up-for-small-businesses-in-2027/
• Healthcare Dive, “Insurers want to hike small businesses’ premiums by 14% next year: KFF,” August 7, 2026. https://www.healthcaredive.com/news/small-business-health-insurance-premiums-2027-kff-rate-filings/827247/
• Mercer, survey of employer health plan cost projections for 2027, August 31, 2026. https://www.mercer.com/en-us/insights/us-health-news/survey-health-benefit-costs-expected-to-jump-in-2027/
• Aon via PR Newswire, U.S. employer health care costs continue multi-year climb, projected to rise 9.5% in 2027, August 20, 2026. https://www.prnewswire.com/news-releases/aon-us-employer-health-care-costs-continue-multi-year-climb-projected-to-rise-9-5-in-2027--302855864.html
• Business Group on Health via MedCity News, employer health care costs projected to rise 9.2% in 2027, August 25, 2026. https://medcitynews.com/2026/08/business-group-on-health-employer-healthcare-costs-projected-to-rise-9-2-in-2027/
• Segal, 2027 Health Plan Cost Trend Survey, July 23, 2026. https://www.segalco.com/consulting-insights/2027-health-plan-cost-trend-survey/
• KFF, annual family premiums for employer coverage in 2025 and what workers pay toward them, October 22, 2025. https://www.kff.org/health-costs/annual-family-premiums-for-employer-coverage-rise-6-in-2025-nearing-27000-with-workers-paying-6850-toward-premiums-out-of-their-paychecks/