Open enrollment feels like a fall problem. It is really an August problem, because by the time the benefits portal opens you have about two weeks to make a decision that sets your paycheck deduction for the next twelve months, and most people spend those two weeks doing nothing and re-electing the same plan they had last year. That habit is getting expensive. The cost projections for 2027 are already out, and they are not gentle.
Here is what we know so far, and what you can do in the next few months to keep more of the paycheck.
The 2027 Numbers Are Already Ugly
Employers are getting hit first. Mercer’s national survey found that health benefit costs are running about 6.7% higher this year, the biggest jump in roughly fifteen years, with the average cost per employee expected to pass $18,500 in 2026. Looking ahead, Mercer has flagged a 9% underlying cost trend for 2027, which would push the average employer cost per employee above $20,000 for the first time (Mercer).
Companies do not eat that quietly. Two thirds of large employers surveyed said they expect to raise the monthly premium employees pay through payroll deduction in 2027, and roughly half said they will also raise deductibles, copays, or other out of pocket costs. So there is a decent chance you get both a bigger deduction and a bigger bill when you actually use the coverage.
For context on where you are starting from, KFF’s most recent employer survey put the average family premium at $26,993, with workers paying about $6,850 of that out of their own paychecks, and an average single-coverage deductible of $1,886 (KFF). Add another 6% to 9% and you can see why this is worth an afternoon of attention.
Stop Auto-Renewing the Plan You Already Have
The single most common money mistake in benefits season is inertia. You picked a PPO four years ago when your kid needed a specialist, the specialist is long gone, and you are still paying PPO money for network flexibility you have not used since.
When your enrollment window opens, pull up every plan your employer offers and do a boring piece of arithmetic. Take the annual payroll deduction for each plan, add the deductible, and then add whatever you actually spent out of pocket last year on visits, prescriptions, and labs. Your HR portal or insurer site can usually export last year’s claims in a few clicks. What you want is total annual cost under each option, not the sticker premium, because a plan with a $2,000 higher deductible and a $1,600 lower premium is only a bad deal if you actually hit the deductible.
Most people who run this comparison honestly find that the plan they would have picked by habit is not the cheapest one for how they actually use care. Sometimes the gap is a few hundred dollars. Sometimes it is a couple thousand.
The Account Most People Leave on the Table
If a high deductible plan wins that math, it usually comes with a health savings account, and the HSA is the closest thing to free money in the benefits menu. Contributions come out pre-tax, growth is untaxed, and withdrawals for qualified medical expenses are untaxed too. Plenty of employers also drop a few hundred or a thousand dollars into the account just for enrolling, which functionally lowers your deductible without lowering your premium.
The part that trips people up: an HSA is not use it or lose it. The money rolls over forever and follows you when you change jobs. A flexible spending account, which pairs with traditional plans, generally does not work that way, so if you elect an FSA, elect an amount you are confident you will spend. The IRS keeps the current contribution limits and eligibility rules posted, and they change every year, so check them rather than assuming last year’s number (IRS).
If you are already funding an HSA and treating it as a checking account for copays, consider letting the balance build in a savings or investment option inside the account instead, and paying small expenses out of pocket. That turns it into a long term tax free medical fund rather than a pass-through.
If Two People in the House Have Coverage, Compare Both
Married couples with two employer plans often default to putting everyone on whichever plan feels better, without ever pricing the alternative. It is worth pricing three versions: everyone on plan A, everyone on plan B, and a split where each spouse takes their own employer’s single coverage and the kids ride on whichever plan has the cheaper dependent tier.
Family tiers are priced strangely. Some employers charge nearly the same for “employee plus one” as for “employee plus family,” which makes splitting pointless. Others charge a steep spousal surcharge if your spouse could have gotten coverage at their own job, sometimes $100 or more a month. Read the surcharge language before you enroll, not after the first deduction shows up.
Buying Your Own Coverage Changed Again
If you buy through the marketplace instead of an employer, the ground has shifted under you. Proposed 2027 rate filings range widely by insurer, with most of the requested increases landing between 10% and 25% (healthinsurance.org). The enhanced subsidies that softened premiums in recent years are gone, and the income cliff at 400% of the federal poverty level is back in play, meaning a household that goes a dollar over the threshold loses subsidy help entirely.
For 2027, a single person in the continental US can qualify for subsidy help with income up to roughly $63,840, and a household of four up to about $132,000. Those thresholds are worth knowing in August rather than December, because income you can still control, like a year-end bonus deferral or an extra retirement contribution, can be the difference between qualifying and not.
Open enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027 on HealthCare.gov, with December 15 as the deadline for coverage that starts January 1. Several state-run exchanges extend to the end of January. Mark whichever applies to you now, because the December 15 date is the one people miss.
Do Not Let the Savings Evaporate
Say you switch plans and your paycheck deduction drops $85 a month. If that money just lands in checking, it becomes groceries and gas by the fifteenth and you will never notice it again. Move it the same week you make the election. A standing transfer of $85 into a separate savings account on payday turns a benefits decision into roughly $1,020 a year sitting somewhere you can see it, which happens to be about half a typical single-coverage deductible.
That is really the point of the exercise. Healthcare costs are rising faster than most of us can offset with better shopping, so the goal is not to win, it is to lose more slowly and to bank the difference where it can cover the deductible you will probably meet. Spend a couple hours on the plan comparison this fall, put the savings somewhere with its own name and its own balance, and the year gets meaningfully easier.
