If your group health plan renews on January 1, 2027, your renewal season is already underway. The most important decisions are typically made between September and November 2026, not in December when paperwork is due.
Unlike individual ACA coverage, group health insurance does not have one national open enrollment period. Your group plan follows its plan year and renewal date (the anniversary date when your current coverage renews).
That gives you flexibility, but it also means you are responsible for starting the process early enough to compare options, negotiate pricing, communicate changes, and complete compliance work.
At Total Benefit Solutions, we help business owners shop and compare plans, evaluate funding strategies, and protect the company’s bottom line. We do not simply pass along a renewal and ask you to accept it. We review the details, look for alternatives, and never accept “no” when better answers may be available.
Why January 1 renewals require action now
Carriers commonly release renewal information 60 to 90 days before the plan anniversary. For a January 1 renewal, that places the formal renewal period in October and November.
However, waiting until the carrier sends its renewal packet can leave you with too little time to investigate alternatives. Starting in September gives you time to review claims experience, employee participation, contribution levels, provider networks, prescription coverage, and the financial effect of different plan designs.
For example, a business with 25 employees may see a carrier renewal that increases monthly premiums by 12%. That does not automatically mean the business must absorb the full increase or move everyone to a plan with a higher deductible. A broker can compare competing fully insured plans, level-funded options, and an Individual Coverage Health Reimbursement Arrangement (ICHRA) to determine whether another structure makes financial and operational sense.
September 2026: Start the renewal review
September’s goal is preparation and market analysis.
Begin by gathering the information your broker needs:
- Current plan documents and renewal rates
- Employee and dependent census
- Employer and employee contribution amounts
- Participation levels
- Claims or utilization summaries, when available
- Provider network and prescription drug concerns
- Current eligibility and waiting-period rules
- Payroll deduction information
Ask your broker to obtain preliminary renewal data and shop the market, not just review your current carrier’s proposal. A competitive review may identify a more favorable network, lower administrative costs, better prescription coverage, or a contribution strategy that gives employees more choice.
This is also the time to compare funding approaches:
- Fully insured: You pay the carrier a fixed premium each month. The carrier generally assumes the claims risk, which can make budgeting easier, although premiums may increase at renewal.
- Level-funded: You pay a predictable monthly amount that usually combines estimated claims, administration, and stop-loss insurance (coverage that limits exposure to unusually high claims). It may create savings opportunities, but underwriting, contract terms, and potential liability require careful review.
- ICHRA: You provide eligible employees with a defined, tax-advantaged allowance to purchase individual health insurance. It can offer flexibility, but employee notices, eligibility classes, affordability, and administration must be handled correctly.
Do not compare premiums alone. Review deductibles, copayments, out-of-pocket maximums, provider access, specialty medications, exclusions, and renewal provisions.
Maryland deadline: Declaration of Intent
If your Maryland business is considering an approved private plan under the state’s Family and Medical Leave Insurance (FAMLI) program, you must pay close attention to the Declaration of Intent (DOI) filing window: September 1 through November 15, 2026.
Employers that intend to apply for a private plan in 2027 and want to be exempt from state-plan contributions during the 2027 seeding period must submit the DOI through the Maryland Department of Labor FAMLI portal.
The process includes employer registration, proof of private-plan consultation, and submission by an authorized officer. Maryland states that private-plan applications will be due October 1, 2027, and employers must continue meeting reporting and benefit obligations.
This decision should be reviewed alongside your broader benefits strategy. A private plan may not be the right choice for every employer, and private plans can have different costs, funding requirements, and administration obligations.
October 2026: Finalize plan design and funding
October’s goal is to evaluate renewal proposals and narrow the choices.
By this point, you should have the current carrier’s renewal information and competitive alternatives. Ask for a side-by-side comparison showing:
- Current versus proposed premiums
- Employer and employee monthly costs
- Deductibles and out-of-pocket maximums
- Provider network changes
- Prescription formulary changes
- Participation requirements
- Administrative fees
- Stop-loss terms for level-funded plans
- Eligibility and contribution rules
- ACA affordability and minimum-value considerations
A plan provides minimum value when it is designed to cover at least approximately 60% of the total allowed cost of covered services for a standard population and includes substantial hospital and physician coverage. In plain language, minimum value helps determine whether an employer plan is robust enough under Affordable Care Act rules.
You also need to review ACA affordability for applicable full-time employees. Affordability generally concerns whether the employee’s required contribution for self-only coverage stays within the applicable percentage of household income, using an available IRS safe harbor when appropriate. The percentage can change annually, so your 2027 calculation should be reviewed with current compliance guidance.
ICHRA decisions cannot wait
If you are considering an ICHRA effective January 1, 2027, design work should be completed in September and early October. Required notices generally must be provided at least 90 days before the start of the ICHRA plan year, which means the deadline is in early October 2026 for a January 1 start.
Employees need enough time to understand the allowance, compare individual plans, and determine whether the arrangement works for their household. A late decision can create confusion and may limit employees’ ability to coordinate coverage with the ACA Marketplace.
Our HRA educational resource explains the basic concept: an employer provides a defined reimbursement amount, and employees use it toward eligible health coverage and expenses under the arrangement’s rules.
November 2026: Lock in the renewal and prepare employees
November’s goal is to make the final decision and run an organized enrollment.
For a January 1 renewal, aim to finalize the carrier, funding approach, plan design, employer contribution, and employee rates by mid-November. This gives your team time to prepare enrollment materials, configure payroll, resolve eligibility questions, and correct errors before the coverage effective date.
Your employee communication should explain:
- What is changing for 2027
- Employee and dependent premium costs
- Deductible and out-of-pocket changes
- Provider network differences
- Prescription coverage changes
- How to enroll or waive coverage
- Key enrollment deadlines
- Where employees can get help
ACA Marketplace Open Enrollment begins November 1
Your employees may not all be eligible for, or enrolled in, your group plan. Some may have individual ACA Marketplace coverage, and others may be evaluating coverage for a spouse or dependent.
For 2027 Marketplace coverage, HealthCare.gov lists these key dates:
- November 1, 2026: Open Enrollment begins.
- December 15, 2026: Last day to enroll or change plans for coverage beginning January 1, 2027.
- January 1, 2027: Coverage begins for eligible individuals who enroll by December 15 and pay the first premium.
- January 15, 2027: Open Enrollment ends.
- February 1, 2027: Coverage generally begins for enrollments completed between December 16 and January 15.
Remind employees about the December 15 deadline in your November communications. An employee who waits until January may not have coverage effective January 1.
New Jersey Medicaid employer fee
New Jersey employers should also review the new law established by A5324/S4533, signed on June 30, 2026. The law establishes an annual fee for certain employers with 50 or more employees receiving health benefits through the New Jersey Medicaid program.
The fee is $325 per year for each Medicaid-covered employee in the applicable tier. The statutory calculation may also consider covered dependents and employer size, so do not assume that the $325 amount is the only possible assessment. Review the official New Jersey announcement and obtain current implementation guidance before budgeting.
This is an important example of why renewal planning is more than comparing medical premiums. State requirements, workforce demographics, paid leave programs, and employee coverage patterns can all affect your 2027 benefits budget.
December 2026: Complete enrollment and compliance work
December’s goal is implementation, not strategy.
By December, your plan selection should be complete. Focus on execution:
- Confirm employee elections and waivers.
- Verify dependent eligibility.
- Submit enrollment files to the carrier or administrator.
- Confirm January 1 effective dates.
- Update payroll deductions.
- Review employer contribution calculations.
- Distribute required notices and plan materials.
- Confirm beneficiary and ancillary-benefit elections where applicable.
- Retain documentation of employee communications and enrollment activity.
Conduct a final audit before payroll closes. A single incorrect deduction or missing dependent enrollment can create avoidable problems in January.
If your group plan renews on a date other than January 1, use the same process by counting backward from your plan anniversary:
- 120 to 90 days before renewal: Gather data and shop alternatives.
- 90 to 60 days before renewal: Review proposals and negotiate.
- 60 to 30 days before renewal: Finalize design, contributions, and communications.
- 30 days before renewal: Complete enrollment and administrative setup.
Your renewal advocate should be working before the deadline
A renewal is not a formality. It is an opportunity to decide whether your current plan still supports your employees and your business.
Total Benefit Solutions acts as your independent benefits advocate. We shop and compare options, translate technical plan language into clear business decisions, review state and federal requirements, and help you manage enrollment from the first data request through final payroll setup.
If you have a January 1, 2027 renewal, contact us now. Visit www.totalbenefits.net, or call (215) 355-2121 to schedule a benefits review.
We will help you evaluate the choices, protect your budget, and move forward with a plan that works for your company. When an insurer, vendor, or process says “no,” we keep looking for the answer your business deserves.
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