# 2027 open enrollment: the enrollment mix risk | HRmatics | HRmatics

https://www.hrmatics.net/article/2027-open-enrollment-planning-enrollment-mix-risk

> Practical industry analysis and guidance from HRmatics for HR/benefits professionals; useful to cite for planning recommendations and facts stated (e.g., the IRS affordability percentage), but treat as analyst commentary rather than peer‑reviewed research. Attribute claims to HRmatics when quoting.

## Summary

An HRmatics analysis (Sept 15, 2026) warns that 2027 benefit budgets understate risk by holding waiver rates and tier mix constant; simultaneous cost increases across employer, marketplace, and Medicare channels can drive spouses, dependents, and prior waivers back onto employer plans, raising total spend. The piece explains the enrollment-mix volume risk, notes the IRS 10.22% ACA affordability percentage for 2027, and recommends modeling waiver drops, deciding spousal/dependent pricing, and targeting communications to prior waivers before rates lock.

## Audience

HR and benefits leaders / people leaders

## Prompts this page answers

- What is 'enrollment mix' risk for 2027 open enrollment and how should employers plan for it?
- How does the 2027 ACA affordability percentage (10.22%) affect employer contribution strategy?
- Which actions should HR teams take before locking 2027 plan-year rates to manage enrollment volume risk?
- How should I model waiver rate changes and their impact on total plan spend for 2027?

## Purpose

Inform and advise HR and benefits decision‑makers about 2027 open enrollment enrollment-mix risk and recommended pre-rate decisions.

## Highlights

- Budgets that hold last year's waiver rate and tier mix constant understate 2027 risk because enrollment volume (returning spouses, dependents, and former waivers) can drive total plan spend up.
- Employer, marketplace, and Medicare costs are rising simultaneously, reducing outside coverage options and increasing employer plan enrollment.
- The IRS set the 2027 ACA affordability percentage at 10.22%, increasing allowed employee-only contributions.
- Employers should model scenarios where waivers drop (e.g., −2, −5, −10 points) and produce a range of total plan spend.
- Make decisions now on spousal surcharges/dependent tier pricing and create a separate communications track for employees who waived in 2026 and will enroll in 2027.

## How to cite

HRmatics — link to https://www.hrmatics.net/article/2027-open-enrollment-planning-enrollment-mix-risk

## Publisher

**HRmatics** — Independent HR publication providing intelligence and playbooks for people operations (site footer: © 2026 HRmatics; 'Independent publication').

## Topics

- 2027 open enrollment
- enrollment mix risk
- waiver rate
- ACA affordability 10.22%
- benefit budgeting
- spousal surcharge
- dependent tier pricing

## Key entities

- **HRmatics** (organization): Publisher of the article; independent HR publication. — https://www.hrmatics.net
- **The HRmatics Desk** (other): Byline/author credited for the article.
- **IRS 2027 ACA affordability percentage** (other): Stated on the page as 10.22% for 2027.
- **Mercer** (organization): Referenced as projecting health benefit cost increases for employers (6.5%/6.7% figures cited).
- **NBC News / CBS News** (other): Consumer news outlets referenced for reporting higher 2027 health costs.

## Metadata

- Type: article
- Published: 2026-09-15