#health-insurance
Track health insurance costs and employee benefits
Congress's February 2026 PBM reform mandates 100% rebate pass-through, bans spread pricing, and requires transparency reporting by August 2028. In West Virginia, an early rebate pass-through approach cut average 2026 group plan rate increases to 12.6% versus 19.5% under the old system. Here's what small employers should do before the 2029 enforcement date.
Small-group health insurance premiums are rising a median 11% for 2026, with single coverage averaging $703 a month and family coverage near $2,000 per employee. Here's why costs are spiking, how level-funded plans, QSEHRA, and ICHRA compare to traditional group coverage, and a five-question framework for deciding before your renewal deadline.
IRS Revenue Procedure 2026-26 sets the 2027 ACA employer affordability threshold at 10.22% and updates the premium tax credit applicable percentage table (2.15%–10.22% of household income by federal poverty line bracket). Here is how the new numbers — and a quiet premium-growth methodology change — affect self-employed marketplace buyers and small employers.
Revenue Procedure 2026-24 raises 2027 HSA contribution limits to $4,500 self-only and $9,000 family, with HDHP minimum deductibles of $1,750/$3,500 and out-of-pocket maximums of $8,700/$17,400. Here's what the new numbers mean for self-employed owners — including why the HSA deduction doesn't reduce self-employment tax, the April 15 contribution deadline that extensions don't move, and the over-contribution traps around employer contributions and the Last-Month Rule.
New Jersey's A5324, effective July 1, 2026, bills employers $325–$725 per year for each Medicaid-enrolled employee or dependent once 50 or more are enrolled — matched by the state, not self-reported. Here is how the tiered fees work, which workers are exempt now and in 2027, and how to prepare your books for a bill you didn't calculate.
Colorado's FAMLI program now offers up to 12 weeks of paid Neonatal Care Leave for NICU stays, separate from the existing 12 weeks of bonding leave, funded by a 2026 payroll premium of 0.88% of wages split between employer and employee for businesses with 10 or more workers.
Small-group health insurance premiums are rising a median 11% in 2026, per Peterson-KFF analysis of 318 insurer rate filings, with 2–5 employee firms up 23% since 2022. What's driving it — GLP-1 drugs, a shrinking risk pool, 9% medical inflation — and seven concrete cost levers, from level-funded plans to ICHRAs.
The IRS raised 2026 HSA limits to $4,400 self-only and $8,750 family (Revenue Procedure 2025-19). A small business owner's guide to the S-corp more-than-2% shareholder rules, the 35% comparability excise tax, cafeteria plan workarounds, and how to avoid excess-contribution penalties.
Section 125 cafeteria plans must pass three IRS nondiscrimination tests each year — eligibility, benefits and contributions, and the 25% key employee concentration test. This guide covers the 2026 thresholds ($220,000 officer and $160,000 HCI compensation, $3,400 FSA and $7,500 DCAP limits), what a failed test costs your top earners, and when a Simple Cafeteria Plan under Section 125(j) lets employers with 100 or fewer employees skip testing entirely.
OBBBA Section 71308 and IRS Notice 2026-05 let you pair a Direct Primary Care membership of up to $150/month per adult ($300 family) with an HSA starting January 2026, reclassify all Bronze and Catastrophic marketplace plans as HSA-eligible, and make the telehealth pre-deductible safe harbor permanent. Here is how freelancers, solo S-corp owners, and small employers should stack DPC, marketplace coverage, HSAs, and QSEHRA/ICHRA reimbursements without double-dipping.
The enhanced premium tax credits expired January 1, 2026, restoring the 400% FPL cliff. This guide walks self-employed filers, S-corp owners, freelancers, and early retirees through the 2026 applicable percentage schedule, MAGI levers like Solo 401(k), SEP-IRA, HSA, and Section 162(l), and Form 8962 reconciliation strategies to avoid five-figure repayments.
A field guide to coordinating the Section 162(l) self-employed health insurance deduction with the Premium Tax Credit's circular calculation, HSA contributions, and the Augusta Rule (Section 280A(g)) — including Form 7206 mechanics, S-corp W-2 Box 1 reporting under IRS Notice 2008-1, Medicare Part B and D deductibility, and 2026 contribution limits.
