Small Group Health Premiums Rise 6.9% to 21.6%

Washington businesses with fewer than 50 employees face higher premiums from nine insurers for the new plan year.

Updated on Nov. 2, 2026 in Healthcare

Small Group Health Premiums Rise 6.9% to 21.6%

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Washington's Office of the Insurance Commissioner approved rate increases ranging from 6.9% to 21.6% for nine small group health insurers. Small businesses with fewer than 50 employees will see these higher premiums when the new plan year begins in 2027.

Why it matters

The approvals were based on actuarial reviews of each insurer's financial projections, and the increases mostly reflect rising basic healthcare costs. For employers buying coverage for their teams, the spread between the lowest and highest approved increases means premium budgets for the coming year should be modeled against a wide range rather than a single assumed rate.

The Washington Office of the Insurance Commissioner approved increases from 6.9% to 21.6% for nine small group health insurers, all of which sold small group plans in 2026. Small group plans cover businesses with fewer than 50 employees, and five of the approved insurers will offer plans in Benton and Franklin counties.

The players

Washington Office of the Insurance Commissioner

The state regulator that reviews and approves health insurance rates and oversees insurers operating in Washington.

The details

Each insurer's requested rate was reviewed through an actuarial analysis of its financial projections before the commissioner approved the adjustments. The increases largely track rising basic healthcare costs that insurers pass through to premiums. Businesses with fewer than 50 employees are not legally required to offer health benefits, so the decision to keep or drop coverage rests with each employer as premiums climb.

All nine insurers sold small group health plans for 2026.
Approved rate increases take effect for small business plans in the new year, 2027.

Market Landscape

Washington's rate-review process for small group plans is run by the state insurance commissioner, which evaluates each carrier's actuarial projections before approving changes. Nine carriers operating in the small group market all sought increases, placing the entire pool of small group insurers under upward pressure at the same time.

Small businesses with fewer than 50 employees should model next year's health benefit costs using the full 6.9% to 21.6% range of approved increases rather than a single figure. Employers weighing whether to keep offering coverage should consult a qualified benefits advisor or accountant before changing their plan.

The takeaway

Small employers should treat the wide 6.9% to 21.6% spread as a planning range and compare the nine carriers available for 2027 before renewing. Because businesses under 50 employees are not required to offer health benefits, the cost decision belongs with the employer and should be reviewed with a qualified professional.