Open enrollment for employer-provided health insurance is approaching or here.

Many employer-sponsored health care plans hold open enrollment annually, in October or November. Employees generally have a couple of weeks during open enrollment to choose health insurance plans for the coming year for themselves and covered family members.

Employers and employees are paying more for coverage than they did in 2026, continuing a four-year trend. Average costs are expected to rise 9% to 10% in 2027. The issue has become a key topic ahead of the midterm elections.

More than 150 million Americans have health insurance coverage through an employer. Employees of small businesses with fewer than 200 workers are hit hardest. Employers will need to assess service prices and how often employees use those services. That could affect where and from whom employees receive care.

Some current drivers of rising costs are the increased use of services and technology, including artificial intelligence, as well as the cost of specialty and weight-loss medications. Coverage for weight-loss medications has declined since 2025.

Employees should review their health care spending over the past year and the services they expect to need next year to determine which plan best fits their needs. Employees should review monthly premiums, deductibles, copayments, and maximum out-of-pocket costs. For some, a plan with a higher deductible and a health savings account may be a better fit. Funds in a health savings account can cover various expenses, including medication purchased through a pharmaceutical company’s cash-pay program. However, that expense does not count toward a deductible or the maximum out-of-pocket limit. Employees should speak with their employer’s benefits manager for more information.