What does the benchmark plan cost in your county?

9.96% for plan years beginning in 2026. The IRS set it in Revenue Procedure 2025-25, published July 18, 2025.

That's up from 9.02% in 2025, and it's the highest the percentage has ever been. The original statutory figure was 9.5%, and the IRS re-indexes it every year.

A higher percentage works in the employer's favor. An employee can be asked to pay a larger share of income before the offer is unaffordable, so a smaller contribution can still pass.

One trap on timing: the percentage attaches to the plan year, not the calendar year. A plan year that started in late 2025 keeps 9.02% until that plan year ends.

Your contribution is the other half of it.

The premium above is what the employee would pay with no help from you. Subtract your monthly contribution, then compare what's left to 9.96% of their income for a 2026 plan year. Under it, the offer is affordable.

Here's where people slip: this is tested per employee, per location. One company can pass for its headquarters staff and fail for a remote hire two states away, on the identical contribution.

Two things happen, and only one of them is a penalty.

For the employee. An unaffordable offer can be turned down. They can decline it and claim a premium tax credit instead, if they're otherwise eligible. An affordable offer removes that option, whether or not they enroll.

For the employer. If you're an applicable large employer, generally 50 or more full-time equivalents, an unaffordable offer creates exposure under the employer shared responsibility rules when an employee goes to the exchange and receives a credit. Employers under that threshold have no mandate and no penalty.

Model it before you commit. For a lower-wage workforce in a market with rich subsidies, a poorly sized contribution can leave employees worse off than no offer at all.

No. Almost no employer knows what their employees' households earn, and the IRS doesn't expect you to.

You can use one of three safe harbors instead, applied consistently to a reasonable category of employees.

W-2 safe harbor. Measured against Box 1 wages for the year.

Rate of pay safe harbor. Hourly rate times 130 hours per month, or monthly salary for salaried staff. The most common choice, because you can calculate it before the year starts.

Federal poverty level safe harbor. Measured against the federal poverty line for a single person. The simplest and the most conservative, because it produces the lowest threshold.

A safe harbor doesn't change the premium side of the equation. The lowest-cost Silver plan in their rating area is still where you start.

No, and this catches people out.

The subsidy world runs on the second-lowest-cost Silver plan, the benchmark used to calculate premium tax credits. Almost every public dataset publishes that number, because it's what tax forms need.

CHOICE Arrangement affordability runs on the lowest-cost Silver plan. Different plan, different number, usually lower. If someone hands you a benchmark premium for an affordability test, check which one it is.

It doesn't change the test at all, and this is the most misunderstood part of the rule.

Affordability is always measured on the self-only lowest-cost Silver plan. An employee with a spouse and four children is tested against the same number as a single colleague of the same age in the same rating area. Family size never enters the calculation.

That cuts both ways. You can't fail the test by hiring people with large families. You also can't assume an offer that passes the test is enough for a family to live on.

What family size does change is what the household actually pays. Individual market coverage isn't sold in flat tiers the way group plans are. Each covered person is priced separately and the premiums are added together: the employee at their age, the spouse at theirs, and each child.

One rule worth knowing. Only the 3 oldest children under 21 are charged. A household with 5 young children pays for 3 and the other 2 are free.

The tool above shows both figures, because you need both. The green one is what the regulation tests. The gold one is what your employee lives with.

Generally the employee's age on the first day of the plan year. You set it once at the start and it holds for the year, even if they have a birthday in March.

This matters more than people expect. Federal rules allow a 64-year-old to be charged up to three times what a 21-year-old pays for the same plan, so the affordability answer for two employees in the same county can be completely different.

The tool above lets you change the age for exactly this reason. Run your oldest employee and your youngest, and you'll see the spread you're contributing against.

It tells you how much competition your employees have where they live.

A rating area with 12 carriers filing Silver plans behaves very differently from one with 2. More carriers generally means more plan designs, more network options and more price pressure. It's one of the better predictors of whether a CHOICE Arrangement will feel like an upgrade or a downgrade to the person shopping.

These counts come from final 2026 rate filings, so they're current for every state.

Because rating areas don't always follow county lines. A handful of counties sit across two or more rating areas, usually split by 3-digit ZIP.

Where that happens, two employees in the same county can face different individual market rates, and the affordability test has to be run for each of them separately.

It's the median approved cumulative rate change for individual market plans in that state for 2026, taken from final rate filings submitted to CMS.

Read it as context, not as your number. It describes what happened to the market, not to a specific plan. Some plans moved far more than the median and some far less.

It's useful for one thing in particular: if your renewal conversation is anchored on a number well above your state's approved individual market change, that gap is worth asking about.

Twenty states plus DC run their own health insurance exchanges. They file rates with those exchanges rather than the federal marketplace, so their filed premiums sit outside the federal data this page is built from.

For those states we show what we can verify from final filings: the rating area, how many carriers compete there, and the approved rate change.

To get the premium itself, pull the lowest-cost Silver plan from your state's exchange for the employee's ZIP code and age, or ask your administrator to run it. The calculation is identical once you have the number.

Yes. On September 3, 2026, CMS and the Small Business Administration adopted CHOICE Arrangement, short for Custom Health Option and Individual Care Expense Arrangement, as the federal name for what everyone called an ICHRA.

It was an agency terminology change, not an act of Congress. The underlying regulations are unchanged, existing plan documents stay valid, and the affordability math on this page is the same math it always was.

Expect both names in circulation for a while. Carrier forms, IRS guidance and plan documents still say ICHRA in plenty of places.

Full guide to how a CHOICE Arrangement works

Annually, when CMS publishes the plan year files, and again whenever a state posts corrected data during open enrollment.

Premiums here are plan year 2026 final filed rates. Carrier counts and approved rate changes come from the Unified Rate Review file posted in March 2026.

The date this page was last reviewed is at the bottom. If it's stale, treat the numbers as stale.