If your group health plan renews January 1, the renewal letter is either on your desk now or will be within a few weeks. For a lot of Tulsa-area owners, the number on it is going to hurt.
Insurers selling small group coverage have filed for a median increase of 14% for 2027, based on filings from 295 insurers across all 50 states. That is the steepest proposed jump the small group market has seen in more than a decade, and it lands on top of the double-digit increase many owners already absorbed this year.
Here is the part most owners do not hear: a renewal is an offer, not a bill. You have until your plan's deadline to ask questions, compare options and decide. This article walks through what is behind the number, what to ask before you sign, and the choices most small employers do not realize they have.
Why the number is so high this year
Your renewal is not only about your group. Three forces are pushing every small group renewal up at once.
- Care simply costs more. Insurers estimate the underlying cost of medical care is rising about 10.8% for 2027, before anything else is added. Hospital stays, doctor visits and prescriptions are all part of it.
- Specialty drugs. GLP-1 weight-loss medications now make up about 20% of prescription spending in employer plans, and a member using one costs a plan close to $7,400 a year.
- A shrinking pool. Enrollment in traditional fully insured small group plans fell 41% between 2013 and 2024. As healthier groups leave for other arrangements, the groups who stay carry more of the cost.
That last point matters. If your renewal keeps climbing year after year, it may not be anything your team did. It may be the pool you are in.
Five questions to ask before you sign
Before you accept the renewal as written, sit with these. Some are for your broker. Some are for you.
- What exactly changed? Look past the premium. Did the deductible, out-of-pocket maximum, copays or prescription tiers move? Some renewals hold the rate down by quietly shifting cost to your employees.
- What does this cost per employee, per month, and what does each employee pay? A 14% increase on the company side can mean a much bigger jump in a payroll deduction, especially for employees covering a spouse or kids.
- Has anyone actually shopped this? A renewal is one carrier's offer. If nobody has compared it against other carriers and other funding models, you do not know whether it is a good number.
- How many of your people are really using the plan? If most of your team is healthy and rarely sees a doctor, you may be paying for a pool built around someone else's claims.
- What would happen if your best employee saw their new deduction? Benefits are part of why people stay. If the increase gets passed straight through, how do you think your team will feel about it in January?
If you cannot answer most of these with confidence, that is not a failure. It just means the conversation is not finished yet.
Your options are wider than "accept it or drop it"
Most owners think there are two choices: swallow the increase or cancel coverage. There are more, and each has real trade-offs.
Renew, but redesign. Keep your carrier and adjust the plan itself, such as a different deductible, a different network or a different employer contribution. This is the least disruptive move, but it usually just shifts cost from the company to your employees.
Move to MightyWELL Health. MightyWELL pairs set-copay everyday care and $0 telemedicine with a HealthShare arrangement for major expenses. Groups moving from a traditional fully insured plan commonly see premiums 40 to 60% lower. It is not the right fit for every group, especially one with significant ongoing medical needs, and I will tell you plainly if it is not right for yours. Learn about MightyWELL for employers.
Switch to a Choice Arrangement. Instead of a group plan, you set a fixed monthly allowance and employees choose their own individual coverage, reimbursed tax-free. Your cost becomes predictable, and renewal letters stop driving your budget. How a Choice Arrangement works.
Add voluntary benefits to close the gap. If deductibles are going up, employee-paid accident, hospital indemnity and critical illness coverage can soften the out-of-pocket hit at no premium cost to you. See voluntary benefits.
Many small businesses end up using a combination. The right mix depends on your budget, the size of your team and how your people actually use their coverage.
What to do between now and December
A January 1 change needs lead time. Enrollment, payroll setup and ID cards all take weeks, so waiting until mid-December usually means you renew by default.
- Early October: Find your renewal letter and note the deadline to accept or change. If you have not received one, ask for it now.
- Mid-October: Get side-by-side options. Your current renewal, a redesigned version and at least one alternative funding model.
- Late October to early November: Decide on direction and gather your employee census (names, dates of birth, ZIP codes and who is covered).
- November: Hold your employee education meeting and run enrollment. People make better choices when someone walks them through it in plain English.
- December: Confirm enrollment, update payroll deductions and make sure ID cards are in hand before January 1.
For more on the enrollment side, see The small employer's open enrollment checklist.
Want a second set of eyes on your renewal?
Send me your renewal letter. I will look at what changed, what it means for your team and whether there is a better option, and give you a straight answer either way. No pressure, and no obligation.
Schedule a 15-minute call or call (918) 400-0387.
Sources
- How Much and Why Premiums Are Going Up for Small Businesses in 2027, KFF, August 2026
- Small-business health insurers seek 14% premium increase for 2027, Healthcare Finance News
- Small group premiums face 14% hike in 2027, KFF data shows, Insurance Business