A survey eHealth released on September 16 found that 54% of small and mid-sized businesses are facing double-digit health plan premium increases for 2027, with more than a fifth seeing hikes of 15% or higher. The company polled over 500 business owners and managers at firms with up to 500 employees in late August.
If you are self-employed and either offer coverage to a small staff or are weighing whether to, this survey is a preview of the sticker shock heading your way at renewal time.
What The Survey Actually Found
Roughly 80% of respondents said they were surprised by how big their increase turned out to be, and 44% called themselves very surprised. Nearly three-quarters said they are now considering dropping traditional health benefits altogether, and 85% pointed to cost as the main reason.
Among businesses that do not currently offer coverage, 65% said they would like to but cannot afford it, and 85% of all respondents worried they will not be able to keep offering benefits within three years if costs keep climbing at this pace.
Why This Matters For Self-Employed Owners
Many self-employed people eventually cross the line from solo operator to small employer, hiring an assistant, a contractor who becomes a W-2 employee, or a small team. The moment you do, you inherit this same premium math, often with even less bargaining power than a bigger company has.
Even if you never hire anyone, the survey’s numbers are a useful gut check on your own individual coverage costs, since group and individual premiums tend to climb together when underlying medical costs rise.
What Self-Employed Owners Should Do Next
If you already offer group coverage, ask your broker now, before renewal, what alternatives exist to a standard fully-insured plan. The survey found rising interest in level-funded and self-funded arrangements, along with defined-contribution options that let a small employer set a fixed amount instead of absorbing every rate hike directly.
If you are considering offering benefits for the first time, run the numbers on a defined contribution approach before assuming a traditional group plan is your only option. Pairing a high-deductible plan with an HSA is another way solo owners are managing rising costs.
What To Watch Next
Watch for 2027 open enrollment materials from your carrier or broker, since the specific increase on your renewal notice may land well above or below the 54% double-digit figure depending on your plan and region.
Also keep an eye on interest in alternative funding arrangements. If more small employers shift away from traditional fully-insured plans over the next year, it could reshape what typical small-business health coverage looks like within a few renewal cycles.
