On January 29, 2026, HHS announced the premium adjustment percentage and related guidance to inform the payment parameters for the 2027 benefit year.
Premium Adjustment Percentage
The ACA requires non-grandfathered group health plans to comply with an out-of-pocket maximum on expenses for essential health benefits (i.e., “cost-sharing”). This HHS guidance establishes the premium adjustment percentage that is used to index the annual limitation on cost-sharing. HHS announced that the premium adjustment percentage for the 2027 benefit year is 1.8916224814, which represents an increase in employer-sponsored insurance premiums of approximately 89.2 percent over the period from 2013 to 2026.
This premium adjustment percentage will also be used to index the employer mandate provision’s penalty amounts for the 2027 benefit year (see our article, IRS Releases 2026 ACA Employer Mandate Penalty Amounts, from the July 29, 2025, edition of Compliance Corner for the employer mandate penalty amounts for the 2026 plan year).
Annual Cost-Sharing Limits
Applying this premium adjustment percentage, HHS announced that the maximum annual limitation on cost-sharing for 2027 is $12,000 for self-only coverage and $24,000 for other than self-only coverage. This represents an approximately 13.2% increase from the 2026 parameters of $10,600 for self-only coverage and $21,200 for other than self-only coverage. Note that the IRS issues separate guidance for the cost-sharing limits for HDHPs (see our article, IRS Releases 2026 HSA and EBHRA Limits, from the May 6, 2025, edition of Compliance Corner for the most recent information concerning cost-sharing limits for HDHPs).
Employer Takeaway
Employers should be aware of these cost-sharing limits when planning their benefits and group health plan coverage for the 2027 benefit year.
For more information, review the 2027 PAPI Parameters Guidance from CMS.