# Pennsylvania's 2027 rates: why bigger increases do not settle ICHRA versus group coverage

Canonical reader page: https://ichrareport.com/news/pennsylvania-2027-individual-small-group-rates/

Publisher: ICHRA Report

Originally published: 2026-09-22

Substantively updated: 2026-09-22

Sources checked: 2026-09-22

Data period: Pennsylvania final rate decision · September 18, 2026

[Home](https://ichrareport.com/) [News](https://ichrareport.com/news/)  Pennsylvania's 2027 rates: why bigger increases do not settle ICHRA versus group coverage

State market rates

Pennsylvania's individual-market average rose more than small group for 2027. Learn why the two percentages do not decide an employer's ICHRA comparison.

At a glance

Evidence  **Sourced state-market reporting**

Event / data period  **Final Pennsylvania rate decision: September 18, 2026**

Review cutoff  **September 22, 2026**

By [ICHRA Report](https://ichrareport.com/about/) · Published  September 22, 2026

What changed

Pennsylvania approved average 2027 increases of 15.97% for individual coverage and 10.28% for small-group coverage. The individual-market average is higher, but those two growth rates do not establish whether ICHRA or group insurance will cost less for a particular workforce. [source](https://www.pa.gov/agencies/insurance/newsroom/pennsylvania-releases-aca-2027-health-insurance-rates)

## What Pennsylvania approved

On September 18, 2026, the Pennsylvania Insurance Department approved final ACA rates for the state's individual and small-group markets. Insurers had requested average increases of 17.14% and 11.49%, respectively. The department says its review denied $94.7 million in proposed increases that the supporting data did not justify. [source](https://www.pa.gov/agencies/insurance/newsroom/pennsylvania-releases-aca-2027-health-insurance-rates)

The statewide individual-market result also hides substantial carrier variation. The department lists approved average changes ranging from 1.4% for Oscar Health Plan of Pennsylvania to 35.1% for Ambetter Health of Pennsylvania. Those are carrier averages, not the change in every plan or a quality ranking.

## Does this make ICHRA more expensive than small group?

**The new rates do not answer that question by themselves.**  Percentage changes from two different markets do not reveal the starting premium, plan design, network, employee contribution or employer cost for the same workforce. A 15.97% increase applied to one set of premiums cannot be compared with a 10.28% increase applied to another set as if they were competing quotes.

An ICHRA comparison begins with the individual plans available where each employee lives, the employer contribution and the applicable affordability analysis. A group comparison begins with an actual quote for the same employee census and a defined employer contribution. Use the same plan year and workforce assumptions on both sides.

## Why the statewide average is not the ICHRA benchmark

The ICHRA affordability calculation uses the applicable self-only lowest-cost Silver premium for the employee, after the employer's contribution, together with the required household-income test. The 2027 percentage is 10.22%. Pennsylvania's 15.97% average does not supply the local Silver amount and is not a required contribution increase. [source](https://www.healthcare.gov/small-businesses/learn-more/individual-coverage-hra/) [source](https://www.irs.gov/irb/2026-31_irb)

The plan an employee selects can also differ from the affordability benchmark. Keep the benchmark, selected-plan premium and statewide rate change as three separately labeled numbers.

## Build a fair comparison for one workforce

| Input | ICHRA side | Group side |
| --- | --- | --- |
| People and geography | Employee age, home location, class and qualifying coverage | The same employee census and eligible population |
| Insurance price | Current local individual-plan premiums and the applicable Silver benchmark | A dated 2027 group quote for comparable enrollment assumptions |
| Employer spending | Available reimbursements, administration and implementation | Employer premium contribution, administration and implementation |
| Employee spending | Premium remaining after the allowance, deductible and other cost sharing | Payroll premium contribution, deductible and other cost sharing |
| Coverage | Networks, formularies and plan availability by employee location | The quoted group's networks, formularies and plan options |

Use the [ICHRA versus group comparison](https://ichrareport.com/guides/ichra-vs-group-health-insurance/) and [total-cost guide](https://ichrareport.com/guides/ichra-total-cost/) to keep employer and employee costs separate. The [2027 affordability guide](https://ichrareport.com/guides/ichra-affordability-2027/) handles the legal premium test; it is not a complete comparison of care costs.

## What the claims-cost statement means

The department reports that Pennsylvania individual- and small-group insurers together paid $845 million more in medical and prescription-drug claims in 2025 than in 2024, a 13% increase across the combined markets. That is a regulator's aggregate explanation. It is not an ICHRA cost statistic, an individual-market-only figure or a causal breakdown of every 2027 increase. [source](https://www.pa.gov/agencies/insurance/newsroom/pennsylvania-releases-aca-2027-health-insurance-rates)

## What this decision does not establish

- the increase for every carrier, plan, county, age or household;
- the change in each rating area's lowest-cost Silver plan;
- the contribution Pennsylvania employers will offer through ICHRA;
- which arrangement has the stronger network or financial protection;
- whether one strategy saves money for a specific employer or employee.

The [2027 planning outlook](https://ichrareport.com/research/ichra-2027-planning-outlook/) places this approved market average beside other evidence types without averaging them together.

### Practical conclusion

Pennsylvania's final averages are a reason to refresh the comparison. Let actual local plans, a comparable group quote and a complete employer-and-employee cost model determine the result for the workforce.

## Sources and evidence

[1 Pennsylvania Insurance Department — Pennsylvania Insurance Department Releases Affordable Care Act 2027 Health Insurance Rates Final weighted average rate changes for Pennsylvania's individual and small-group markets. Statewide and carrier averages are not employee-level premiums, lowest-cost Silver benchmarks or ICHRA-versus-group cost results. Source reviewed 2026-09-22](https://www.pa.gov/agencies/insurance/newsroom/pennsylvania-releases-aca-2027-health-insurance-rates)[2 HealthCare.gov — Individual Coverage Health Reimbursement Arrangements Federal overview of ICHRA contributions, employee classes, class-size minimums, affordability, and implementation timing. Source reviewed 2026-09-11](https://www.healthcare.gov/small-businesses/learn-more/individual-coverage-hra/)[3 Internal Revenue Service — Revenue Procedure 2026-26 Section 3.02 sets the required contribution percentage at 10.22% for plan years beginning in 2027. Section 5 establishes the effective period. Source reviewed 2026-09-11](https://www.irs.gov/irb/2026-31_irb)

Review dates are recorded for each source above. Company pages are useful for confirming how a product is described, but they do not prove service quality or customer results.