PwC projects a 9% group medical cost trend for 2027, the highest level in 17 years.
For brokers heading into 1/1/27 renewals, that number needs some context.
A 9% medical trend does not necessarily mean every employer will receive a 9% renewal increase. Medical trend reflects the expected year-over-year increase in the cost to treat patients, assuming benefits stay the same. An employer’s actual renewal will also reflect their group's claims experience, plan design, pharmacy costs, stop-loss terms and other factors.
Stop-loss is feeling the same pressure. Gallagher has reported average stop-loss premium increases in the mid-teens, with some increases above 20%.
These market realities make the conversation with a CFO less about explaining why healthcare costs are rising and more about identifying where the plan still has room to act.
The major 2027 forecasts are clustered in the same range.
PwC projects a 9% medical cost trend for the group market.
Business Group on Health reports a median employer projection of 9.2% before plan changes and 8% after them.
Marsh expects total health benefit cost per employee to rise 8.2% after planned cost-reduction measures. Employers in its survey estimated costs would rise 11% if they made no changes.
Those numbers all point to the same conclusion: the 2027 cost environment is difficult, but employer decisions still matter. For a broker, these trends create an opportunity to explore strategies beyond the typical renewal exercises.
Start with the funding structure.
Self-funded employers retain routine claim risk and typically use stop-loss to protect against larger claims. A group medical stop-loss captive adds another layer by allowing participating employers to share a defined portion of high-cost claim volatility.
That structure can affect volatility, collateral, surplus opportunity and the way risk is managed over several years.
Those details deserve attention, especially when stop-loss pricing is rising.
Funding structure is only one part of the plan’s economics.
The same healthcare service can carry very different prices depending on where and how it is purchased.
That makes unit cost worth examining alongside utilization.
One option is guided cash-pay care. Blackwell recently partnered with Apta Health to make Apta Cash available to employers participating in Blackwell captive programs.
Apta Cash helps members find appropriate providers, secure transparent cash pricing and coordinate payment for eligible care. Depending on plan design and eligibility, members who follow the guided process may have little to no out-of-pocket cost.
For brokers, the value is straightforward: some planned care may have a more favorable purchasing path than simply running it through the traditional network. This approach give the employer another tool for managing what care costs before the claim is paid.
Price matters. So does what is creating the claim in the first place.
Cancer, chronic kidney disease and specialty pharmacy are among the areas Blackwell’s B.Well Blueprint is designed to address. The program combines analytics, care navigation and targeted clinical intervention so participating employers have resources available during the plan year.
That becomes more important as healthcare trend rises.
A lower unit price can help with a shoppable procedure. A developing cancer case or progression toward dialysis requires a different response. Employers need both kinds of tools.
For a self-funded employer, there are several places to affect plan performance. The funding structure determines how risk is retained, shared and transferred.
Tools such as Apta Cash can address the price paid for eligible care.
Clinical and pharmacy programs can focus on conditions with the potential to become large claims.
Claims and financial reporting then give the broker and employer a way to see what is changing and decide where action is warranted.
Blackwell brings those pieces together through its captive programs, B.Well Blueprint and year-round program management.
The ultimate goal is to give employers more opportunities to proactively manage healthcare risk during the year, while the captive and stop-loss structure address the financial exposure that remains.
Three questions can help move the conversation beyond the headline trend number.
How are we financing the risk?Look at the funding structure, stop-loss terms, volatility and potential participation in favorable performance.
What are we paying for care?Identify where price transparency, navigation or alternative purchasing models could reduce the cost of appropriate care.
What is driving our largest claims?Review the conditions and pharmacy spend behind the plan’s high-cost claims and what resources are available to address them during the year.
A 9% national medical trend is useful context.The employer’s own claims, cost drivers and plan structure are what make the renewal actionable.
PwC projects a 9% medical cost trend for the group market in 2027. Business Group on Health projects a median 9.2% increase before plan changes, while Marsh projects an 8.2% increase after employers’ planned cost-reduction measures.
No. Medical trend is an industry projection of how much the cost to treat patients is expected to rise. An individual employer’s renewal also depends on claims, plan design, pharmacy spend, stop-loss pricing and other factors.
Gallagher reported average stop-loss premium increases in the mid-teens in 2026, with some cases above 20%. Actual pricing varies by employer and risk profile.
Employers can review how risk is financed, what the plan pays for care and which conditions are driving large claims. Those areas point to different strategies, including funding changes, price transparency, care navigation, pharmacy management and clinical intervention.
Have a client heading into a 1/1/27 renewal? Let’s look at the structure, cost drivers, and talk about proactive strategies together. Talk with Blackwell.