Open Enrollment 2027: What to Review Before You Choose Your Benefits

Open enrollment season is upon us again, and this year it deserves a little more of your attention than usual. After several years where employers absorbed most rising health costs, many are now passing more of those costs to employees. At the same time, a few new tax limits and benefit changes are showing up in enrollment packets for the first time.

Last year, we walked through the full open enrollment process for individuals and couples, and that framework still holds. This year, we want to focus on what's changed and where salaried workers are most likely to see a difference in their paychecks.

Here’s where we’d spend our time.

Start by figuring out what changed

You do not need to become an expert in your health plan. Instead, we’d recommend pulling out this year’s benefit information and last year’s, and comparing a handful of numbers:

• What comes out of your paycheck for the premium?

• What is the deductible?

• What is the out-of-pocket maximum?

• What are your copays or coinsurance for the care you tend to use?

• If you have an HSA, how much does your employer contribute?

• By comparing these five numbers year over year, you’ve done the most important part of the work: figuring out whether your coverage actually got more expensive and where that added cost is likely to show up.

For example, maybe your monthly premium only increased by $25. That does not sound particularly meaningful on its own. But if your family deductible also increased by $1,000 and your employer is contributing $500 less to your HSA, you have a very different health plan than you had last year.

This is especially worth watching in 2027. Nearly half of large employers surveyed by Mercer said they expect to make plan changes that will increase employees’ out-of-pocket costs next year. If your employer offers several options, resist the urge to assume the plan you’ve always chosen is still the obvious one.

If there are two employers in your household, run the numbers again

For couples who both have access to employer-sponsored insurance, open enrollment gives you a few ways to cover the family. Everyone can go on one spouse’s plan, each spouse can stay on their own plan and put the kids on one of them, or the whole family can move from one employer’s plan to the other. There’s no single setup that works best for every family, so run the numbers on each option. Start with the annual premiums, then compare the deductible and out-of-pocket maximum, add in any employer HSA contributions, and make sure your doctors, specialists and regular medications are covered.

Also check whether either employer charges a spousal surcharge for covering a spouse who has access to insurance through their own job. We see couples spend a lot of time comparing deductibles while overlooking a meaningful difference in what comes out of their paychecks each month. Look at the cost over the full year, and factor in what you already know about the year ahead. A pregnancy, planned surgery, ongoing therapy or expensive prescription can change the math considerably, so the plan that worked best for your family last year may not be the one that makes the most sense for 2027.

Run the numbers on the HSA plan before you dismiss it

High-deductible health plans can be easy to rule out because of, well, the high deductible. But if your employer offers an HSA-qualified plan, compare the full cost before deciding it is the more expensive option.

We’d recommend looking at how the numbers break down and comparing the following:

• The difference in annual premiums

• Any HSA contribution your employer makes

• The deductible

• The coinsurance

• The out-of-pocket maximum

• How much health care you realistically expect to use

For example, say the PPO costs your family $4,000 more in premiums over the course of the year, and your employer contributes $1,500 to your HSA if you choose the high-deductible plan. That gives the HSA plan a $5,500 head start before anyone in your family has gone to the doctor.

That does not mean the HSA plan will always come out ahead. A family expecting a high-health-care year may still be better served by the richer coverage. But comparing the plans this way gives you a much more useful picture than looking at the deductible alone.

If the HSA plan does make sense for you, the account itself can also become a valuable long-term savings tool. Contributions can be made pre-tax or be tax deductible, the money can grow tax-free, and withdrawals are tax-free when used for qualified medical expenses. If you can afford to pay current medical costs from cash flow, you can also leave the HSA invested for future health care expenses.

For 2027, the HSA contribution limits increase to $4,500 for individual coverage and $9,000 for family coverage. If you're 55 or older, you can contribute an additional $1,000. Just remember that any employer contribution counts toward that annual limit.

There have also been a few changes to the HSA rules. Certain direct primary care arrangements can now work alongside HSA eligibility, and telehealth services can be covered before the HDHP deductible is met without affecting your ability to contribute to an HSA. If either applies to you, check with HR or your benefits provider to confirm how your plan handles it.

Parents: take another look at the Dependent Care FSA

The Dependent Care FSA got more useful in 2026. For years, the federal limit was stuck at $5,000 even as the cost of childcare kept climbing. That limit is now $7,500 for most households.

If you’re paying for daycare, preschool, before- or after-school care, day camp, or other eligible care so that you and your spouse can work, it’s worth revisiting your election this year. For families who already know they’ll spend well above $7,500, increasing the amount can create meaningful tax savings.

Before you make the election, check:

• Which of your childcare expenses qualify (we like this handy list created by HealthEquity)

• How much you realistically expect to spend during the year

• Whether your employer’s plan has any additional rules

• How the benefit applies if you’re married and both spouses are working

• Unlike an HSA, a Dependent Care FSA generally comes with stricter use-it-or-lose-it rules, so this is not a place to overfund just to maximize the tax break.

Check your prescriptions before you choose your plan

This year, we think anyone who takes an expensive medication should spend a few minutes with the prescription drug coverage, especially for those on GLP-1 medications.

Employer coverage continues to vary widely. A 2026 survey from the International Foundation of Employee Benefit Plans found that 60% of surveyed employers covered GLP-1 medications for diabetes only, while 36% covered them for both diabetes and weight loss. Employers that do offer coverage may also require prior authorization, specific health criteria or participation in other programs.

Coverage can change from one year to the next. If you take a GLP-1, specialty drug or any prescription that would be painful to pay for without insurance, we’d recommend confirming the following during open enrollment:

• Is my medication still covered by the plan?

• What will I pay for it?

• Does it require prior authorization?

• Has it moved to a different drug tier?

Do this before enrollment closes. Finding out in January that a medication is no longer covered is definitely not the  way to start the new year.

Think about what 2027 might look like for you

Before you finish your elections, think through what you already know about the year ahead. A few expected changes can have a big impact on which benefits are most valuable to you.

Maybe you're planning to have a baby, starting a child in daycare, expecting orthodontia, scheduling a surgery, seeing a therapist regularly, or helping care for an aging parent. Those are all good reasons to look more closely at the benefits tied to those needs.

Depending on your employer, that could include:

• Fertility and family-building benefits

• Backup childcare or caregiver support

• Mental health benefits

• Elder-care resources

• Adoption assistance

• Legal benefits

• Student loan support

You do not need to use every benefit your employer offers. But if you already know you'll be spending money in one of these areas next year, it's worth checking whether your employer offers a benefit that can offset some of that cost.

This is also a good time to think about any major life changes that could affect your coverage. If one spouse expects to leave a job, your family may need to rethink which employer plan everyone uses. If you're planning a pregnancy or surgery, you'll want to pay closer attention to deductibles, out-of-pocket maximums and network coverage than you might in a lower-use year.

Don't skip disability and life insurance

Every year, when we review open enrollment elections with clients, we find at least a few people who have skipped over disability or life insurance altogether. These are some of the most important benefits in the package, especially if your household depends on your income.

For long-term disability coverage, a good starting point is to look for a benefit that would replace roughly 60% to 70% of your income if you could not work for an extended period of time. Then check whether the policy has a monthly benefit cap. This matters more for higher earners, because a plan that says it replaces 60% of income may still fall well short if the monthly cap is low.

It’s important to pay attention to how the premiums are taxed. If your employer pays the disability premium and the cost is not included in your taxable income, any disability benefits you later receive are generally taxable. If your plan gives you the option to have the employer-paid premium (imputed as taxable income now), that can allow future disability benefits to be received tax-free instead. 

For life insurance, the better question is whether your current coverage would be enough for your family. Rather than relying on a broad rule of thumb, we recommend asking your financial advisor to run a life insurance needs analysis based on your income, mortgage, childcare, education goals, existing savings and how long your family would need support. This is something we do for every Mana client.

Employer-provided life insurance can be a helpful starting point, but it may not be enough on its own, especially for families with young children or a large mortgage. It is also tied to your job, so we generally would not want a household’s entire life insurance plan to depend on workplace coverage alone.

During open enrollment, we’d check:

• Does your long-term disability policy replace around 60% to 70% of income?

• Is there a monthly benefit cap that would materially reduce that coverage?

• Can you elect to have employer-paid disability premiums imputed as income so future benefits may be tax-free?

• Is your current life insurance enough based on a proper needs analysis?

• Are your beneficiaries up to date?

A few minutes spent reviewing these benefits now can make a huge difference if your family ever has to rely on them.

Use your open enrollment window to make one or two other financial decisions

You’re already logged into the benefits portal. You have your paystub nearby. You are thinking about next year.

Take advantage of the moment!

• Check your 401(k) contribution rate. If your employer match changed, make sure you're getting the full amount available to you. If your income increased this year, consider whether you can increase your savings rate.

• Review your beneficiaries on your retirement accounts.

• If you're enrolling in an HSA, decide how much you want coming out of each paycheck instead of telling yourself you'll figure it out later.

• If you're using an FSA, think about known expenses before choosing a number.

You don't need to turn open enrollment into a giant financial planning project. A few thoughtful decisions now can save you from trying to fix them in February when some of your choices are locked in for the year.

Give yourself 30 minutes before you click submit

Open enrollment does not need to become a major project, but this is one of those moments where a little attention can save you money and prevent headaches later. Before you submit your elections, take 30 minutes to compare this year’s benefits with last year’s, think through what you expect 2027 to look like, and make sure the coverage you are choosing still fits your family. That may mean switching health plans, increasing your HSA or Dependent Care FSA contribution, adding disability coverage, or realizing that what you already have still makes sense.

The goal is simply to make the decision on purpose instead of rolling everything forward because it is easier. You got this!

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Stephanie Bucko and Cristina Livadary are fee-only financial planners based in Los Angeles, California. Stephanie is the Chief Investment Officer and Cristina is the Chief Executive Officer at Mana Financial Life Design (FLD). Mana FLD provides comprehensive financial planning and investment management services to help clients grow and protect their wealth throughout life’s journey. Mana FLD specializes in advising ambitious professionals who seek financial knowledge and want to implement creative budgeting, savings, proactive planning and powerful investment strategies. As fee-only fiduciaries and independent financial advisors, Stephanie and Cristina never receive commission of any kind. Stephanie and Cristina are legally bound by their certifications to provide unbiased and trustworthy financial advice.