Insurers are rolling out commercial offerings for 2027, and many are navigating a landscape of greater affordability pressures on employers and, ultimately, their employees.
Professional services firm Aon projected that average employer healthcare costs could surpass $19,000 per employee in 2027, a 9.5% increase. Between 2025 and 2026, employee premiums increased by 6.4%.
Some commercial payers are introducing products designed to give employers another option beyond HMOs and PPOs: exclusive provider organizations, or EPOs.
“An EPO offers a strong middle ground between a PPO and an HMO,” Chris Fanning, executive vice president and chief commercial officer at Independence Blue Cross, told Becker’s in a statement. “Members have access to a broad network of providers and can see specialists without referrals, while employers can often realize cost savings because coverage is generally limited to in-network care. We already offer a range of PPO and HMO options, and EPOs give employers another choice to meet the needs of their workforce.”
IBX is launching eight EPOs for large groups and two for small groups in 2027.
Point32Health’s Harvard Pilgrim Health Care is launching an EPO for small employers in Maine and New Hampshire, building on earlier offerings across all segments in Massachusetts. Larger businesses in New Hampshire, Maine and Rhode Island also had access to EPO plan designs in 2026.
Like HMOs, EPOs are closed-network plans, meaning out-of-network care is not covered, according to consulting firm Mercer. Like other plan types, EPOs cover emergency care. Similar to PPOs, EPOs usually do not require primary care providers to act as gatekeepers to specialist care. Harvard Pilgrim Health Care’s Jake Biscoglio, president of commercial and specialty, said provider access under an EPO can be available locally, regionally and nationally based on the specific network.
Harvard Pilgrim Health Care’s EPO plan premiums in Massachusetts are roughly 5% below comparable PPOs, according to Mr. Biscoglio. Monthly premiums could vary by state and membership segment, he said.
“Employers are seeking ways to manage rising benefit costs without significantly reducing the value of coverage offered to employees,” Mr. Biscoglio said. He added that EPOs can be a competitively priced option that also supports hybrid or remote workforces and helps improve employee satisfaction.
Mr. Fanning said small and large employers can see premiums lowered by about 2% to 3% when changing from a PPO, depending on plan design. Historically, IBX had roughly 5% of fully insured group members enrolled in an EPO.
“That relatively modest enrollment reflects, in part, the limited availability of these plans in our employer portfolios,” Mr. Fanning said. “At the same time, we’ve seen growing interest in EPOs as affordability has become a greater focus for employers and consumers. That interest is one reason we’re expanding our offerings for 2027.”
Mr. Biscoglio reported interest, as well.
“Since launching our EPO products (in Massachusetts) on Jan. 1, 2026, we have seen continued market interest — in fact, many smaller employers with PPO plan designs have opted for an EPO plan instead,” he said.
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