ALL 50 STATES AND DC · CMS RATE REVIEW · APPROVED RATES, PULLED NOVEMBER 1, 2026
What will insurers charge you in 2027?
14.8% more for marketplace plans. 12.7% more for employer group plans. Flat isn't on the menu anywhere.
Regulators have finished. 613 of the 615 filings for 2027 are decided, and these are the approved rates your renewal gets built on. Insurers had asked for 15.3% and 14.5%. Regulators came in lower in 27 states and higher in 18.
Every state
What did regulators approve where your people live?
Seven columns, one row per state. The 2027 figures are what regulators approved, not what insurers asked for. Marketplace plans here means Individual (Marketplace) plans, also called ICHRA or CHOICE Arrangement plans.
The last three columns are the ones your renewal packet won't have: whether marketplace plans actually cost less than group plans in your state, whether a PPO is even filed in your counties, and what a mid-level plan runs in a typical county.
| State | Marketplace 2027 approved | Group 2027 approved | Marketplace costs less per member | Counties with a PPO | Lowest cost silver, age 40 | Lowest cost PPO silver, age 40 |
|---|
Go deeper by state
Want the full read for one state?
Each state has its own page: the 2027 approved rates, what insurers had asked for, the county premium spread, whether a PPO is filed where your people live, and what actually moves the number for an employer there.
Alabama · Alaska · Arizona · Arkansas · California · Colorado · Connecticut · Delaware · District of Columbia · Florida · Georgia · Hawaii · Idaho · Illinois · Indiana · Iowa · Kansas · Kentucky · Louisiana · Maine · Maryland · Massachusetts · Michigan · Minnesota · Mississippi · Missouri · Montana · Nebraska · Nevada · New Hampshire · New Jersey · New Mexico · New York · North Carolina · North Dakota · Ohio · Oklahoma · Oregon · Pennsylvania · Rhode Island · South Carolina · South Dakota · Tennessee · Texas · Utah · Vermont · Virginia · Washington · West Virginia · Wisconsin · Wyoming
What changed that you probably haven't been told
Five things moved between mid-2025 and today
| When | What | What it means for you |
|---|---|---|
| September 2026 | ICHRA is now called a CHOICE Arrangement | CMS and the Small Business Administration adopted the new name on September 3, 2026. The regulation didn't change and there's no new tax credit. If a write-up says "ICHRA is now CHOICE, with a tax credit," the first half is true and the second half isn't yet. |
| December 31, 2025 | Enhanced marketplace subsidies expired | A 3-year extension passed the House on January 8, 2026 and hadn't been enacted as of August 2026. If you run a CHOICE Arrangement or QSEHRA, the allowance that cleared the affordability test in 2025 needs a fresh look. |
| January 1, 2026 | Bronze and catastrophic plans count as high-deductible plans | An employee on a bronze marketplace plan can now fund an HSA. Before 2026, most couldn't. Allowance plus bronze plan plus HSA is a real structure now. |
| January 1, 2026 | Direct primary care no longer breaks the HSA | A membership up to $150 per month individual or $300 family is no longer disqualifying coverage, and the fee is a qualified medical expense. The telehealth-before-deductible safe harbor also became permanent. |
| January 29, 2026 | The 2027 out-of-pocket maximum rose 13% | $12,000 self-only and $24,000 family, up from $10,600 and $21,200. That's the ceiling an employee can be exposed to inside a compliant plan. Some write-ups still print $10,150 for 2026; the June 2025 final rule superseded it. |
Sounds concerning? You have options.
Your state's number is the market's number. What decides yours?
The national median approved increase is 14.8% on marketplace plans and 12.7% on employer group plans. Insurers had asked for 15.3% and 14.5%. Two employers the same size in the same state can land 20 points apart on the same filings, because the filing sets the starting point and the plan design sets everything after it.
Here's the part that isn't anyone's fault. The systems that surface plan options only surface what's already inside them. The marketplace shows you what insurers filed for the marketplace. Your broker shows you the markets their appointments reach. Both are doing their job. Neither one can show you what sits outside it. 99% of the brokers we talk to have never had visibility to our programs. They sit outside their commissioned channels.
And check off the marketplace before you rule anything out. In 4 of the 18 states with no PPO or POS anywhere on the marketplace, out-of-network coverage is still sold off it, and a CHOICE Arrangement can pay for it: Mississippi 11,578 enrolled, Arizona 9,034, Massachusetts 8,959, Oregon 2,457. Missouri, Nevada and New York have plans filed off the marketplace with 115 people, 1 person and nobody in them, so those are paper options until a carrier quotes them. The other 11 states have nothing filed either way. Check your county.
| What you run today | What changes | Range observed |
|---|---|---|
| Fully insured, mid-market | Level-funded, shelf-rated, or a partially self-funded design, so a good claims year comes back to you instead of staying with the carrier. | 15 to 25% of plan cost |
| Already self-funded | Stop-loss restructured, a captive layer, and claims priced off a defensible benchmark instead of a billed charge. | 20 to 30% of plan cost |
| Any plan, any funding | Layers that sit on top of what you already run. 2,000+ medications at $0 to the whole household. Unlimited virtual primary and behavioral care. A supplemental layer that pays the employer back every pay period. | $2,000+ per employee per year plus up to about $988 per employee per year in new cashflow about $100K per year for every 50 people |
| A group plan you can't move yet | A GCHRA or EBHRA running alongside it, so people buy what they actually need with pretax dollars without touching the plan itself. | No audited range published. Depends entirely on take-up. We won't print a number we haven't measured. |
| Ready to leave the group plan | A CHOICE Arrangement. Defined contribution instead of a defined plan. Your cost becomes a number you set rather than a renewal you receive. | Priced per census. Whether it beats your group plan depends on the county mix in your census, not the state average. |
Why the ranges are keyed to what you run today and not to a product name: that's how they were measured. Every range above comes from completed client projects, grouped by the employer's starting point. We don't publish a savings percentage next to "level-funding" or "captive" as a category, because nobody measured a category. If you see a number like that anywhere, ask what it was measured on.
$0 upfront. Billed out of savings. Live in 30 to 45 days. Same broker, same doctors, same cards. First-year ROI has landed at 10 to 16x across completed projects.
Compare all 12 plan designs · Benchmark your own cost · Get it priced on your census
Your state's row is in the table above. Which of these five would you want priced against it?
Ranges are what we have observed across completed engagements. They are not a guarantee, not a quote, and not an offer of coverage. Your result depends on group size, plan design, census, and utilization.
What to do with it
Your renewal is a number. What are you allowed to change about it?
The rate filing sets the market. It doesn't set your cost. Two companies in the same state with the same headcount can land 20% apart, and the difference is what's inside the plan, not which insurer is on the card.
Three questions worth asking before you sign:
| 1 | Does every rebate on my employees' prescriptions come back to my plan? On a standard insured plan you can't ask. On a self-funded one you can. |
| 2 | If we moved to marketplace plans, can my people keep their doctors? In 18 states no county has a PPO or POS plan at all, though a PPO is sold off the marketplace in 5 of them. |
| 3 | What would it cost to add a $0-copay layer instead of raising everyone's deductible? Under $100 per employee per year for pharmacy. It lowers claims and improves the benefit at the same time. |
Design changes have landed at $2,000+ per employee per year in real client projects, with about $988 per employee per year in new cashflow on top of that and independent of it. About $100K per year for every 50 people. $0 upfront, billed out of savings. Same broker, same doctors, same cards.
See the 12 designs compared · Check PPO availability in your county · Benchmark your current cost
Results vary by group size, plan design, and utilization.
Where these numbers come from
Rate changes are the midpoint of what regulators approved for each insurer in that state, from the CMS rate review service, pulled November 1, 2026. 613 of the 615 filings for 2027 are decided. The 2 still open are both small group filings in Hawaii, so Hawaii's group figure reads "under review" rather than showing a number.
Insurers had requested a median 15.3% on marketplace plans and 14.5% on group plans. On marketplace plans regulators approved less than was asked in 27 states, more in 18, and the filed number in 6. Oregon and Minnesota are the clearest cases of an approval landing above the request, both recorded by the state as rates approved as modified. Requested and approved figures are kept separate throughout, because they are two different claims.
Both medians are taken across filings rather than across states, so a state with 17 insurers carries more weight than a state with 2. The median across state medians is a different number, 16.0% on the requested figures. Two housekeeping notes: CMS has since cleared the preliminary rate field on a handful of decided filings, so the requested medians are computed from the filings that still carry a preliminary value, and in a few small states that leaves the requested figure sensitive to a single filing. Where a state median matched between request and approval, individual insurers inside that state still moved in both directions.
"Marketplace costs less per member" compares the 2026 average premium per member per month from the insurers' own filings, marketplace against small group, weighted by enrollment. It is a price comparison from one source on both sides. It is an average across each plan's enrolled mix, not a same-metal, same-plan-type quote. A true like-for-like comparison at the same age and metal level is possible in only 2 states from public files, because small group rate tables sit in state filing attachments rather than any published dataset.
PPO availability counts every plan filed in every county for 2026 and asks whether any of them is a PPO or POS. Lowest cost silver is the median across that state's counties for a 40-year-old non-smoker, before any subsidy.
Nothing here is a quote.
