Did you know …
76% of Michigan small businesses say rising health care costs are limiting hiring—and 51% have reduced benefits? You’re not imagining it: for 2026, individual-market premiums are proposed to rise ~16.8% on average in Michigan, with small-group ~11.1% (as filed with DIFS and subject to approval). Pair that with the scheduled sunset of enhanced ACA premium tax credits after 2025, and both employers and families face a pivotal enrollment season.
What’s changing in 2026 (plain English)
- Rates: Michigan’s 2026 filings show a 16.8% average requested increase in the individual market (covering ~532,645 people) and 11.1% for small group, pending DIFS approval. (Your actual change can be higher or lower depending on plan, region, age, tobacco status, and contribution strategy.)
- Subsidies: The enhanced ACA premium tax credits (the rules that made coverage more affordable for many since 2021) are scheduled to expire after 2025, unless Congress extends them. If they lapse, eligibility tightens and net premiums can jump for many households in 2026.
- Market shifts: Some carriers are scaling back or exiting certain ACA markets nationwide for 2026; locally, footprints can change by county, so network checks matter more than ever.
- Dates to know: Open Enrollment for 2026 runs Nov 1, 2025 – Jan 15, 2026. Choose a plan by Dec 15, 2025 for Jan 1 coverage. Missing deadlines usually means waiting a year unless you qualify for a Special Enrollment Period.
Why this hits Michigan SMBs and families
Michigan small businesses report a direct hit to hiring and investment: 76% say costs limit hiring, 51% reduced benefits, 83% say health costs hinder broader investment, and 67% saw >10% increases this year. That pressure shows up in recruiting, retention, and take-home pay—especially in smaller teams.
Your 2026 playbook
For Small Businesses
- Start early (now): Run scenarios that combine contribution strategy (percent vs. fixed-dollar), deductible/OOP max, and HSA/HRA designs. Early quotes help avoid last-minute compromises.
- Value-based & network strategy: Explore value-based plans and tighter networks if they align with your workforce’s ZIP codes and providers—often lower net cost, but validate access and quality.
- Carve-outs & mix: Consider voluntary supplemental options (hospital indemnity, accident, critical illness) to protect employees from unexpected bills without overbuying major-medical richness.
- Dependent logic: If dependents push the premium beyond budget, compare marketplace options (if PTC-eligible) vs. staying on the group plan. (Be mindful of the family affordability rules.)
- Renewal timeline: Lock a timeline: census cleanup → broker/agency review → plan compares → leadership preview → employee meetings → elections. Clear milestones = fewer surprises.
For Individuals & Retirees
- Don’t auto-renew blindly: Formularies, networks, and premiums change. Shop plans and verify your doctors/hospitals and prescriptions are still covered affordably.
- Mind the subsidy rules: If enhanced credits aren’t extended, 2026 eligibility and required household contributions change—run the numbers before you select a plan.
- “Fill the gaps” wisely: If you’re on Medicare, review Medigap/Advantage/Part D options to control out-of-pocket risk; if you’re under 65, consider appropriate supplemental policies to cover deductibles, accidents, and high OOP events.
- Circle the dates: Enroll by Dec 15, 2025 for coverage starting Jan 1, 2026; otherwise, you may wait unless a Special Enrollment Period applies.
How JDW makes this easier
JDW & Associates is a Chelsea, Michigan independent agency serving individuals and businesses since 1991. We’re education-first, compare multiple carriers, and stay with you after enrollment—especially at renewal. Our mission is simple: “Simplify your business and individual insurance needs.”
What a complimentary review includes:
- A simple intake (your household or employee census, providers, prescriptions)
- Side-by-side plan comparisons with plain-English explanations
- Gap analysis + supplemental options where it’s cost-effective
- A clear, no-pressure recommendation and help with enrollment
Request a complimentary, obligation-free insurance review to make sure you’re not overpaying—or under-protected—for 2026.
Disclaimer: This information is general and not legal or tax advice. Plan availability, eligibility, and pricing vary by carrier and county.
