Learn how your organization can prepare for these challenges and better manage benefits spending.
Many employers faced higher-than-expected renewal rates, with group underwritten plans seeing average increases of 18% to 25% — and some plans exceeding 60%. The main cost drivers include:
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3 Key Trends Shaping Employer Health Plan Spending in 2026
Several factors are contributing to higher health plan renewals
The high cost of chronic conditions and new medications, which continues to put pressure on health plan budgets despite a decline in obesity rates.
Rising pharmacy costs — with specialty drugs now accounting for over 50% of all Rx spending.
As healthcare expenses keep increasing, employers may want to reconsider their current health plan strategy.
To better understand the impact of AI on business operations, employers should take a more structured approach to workforce technology.
Healthcare providers and claim payers are using AI tools in an escalating battle over claim reimbursements. This will likely continue to escalate and face regulatory action in the coming year.
HR departments will expand the utilization of AI in recruiting and administration.
AI advancements will continue to make a significant impact in 2026:
Artificial intelligence (AI) is reshaping all facets of an employer’s business
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Benefits administration systems should see AI-related improvements in efficiency and employee engagement.
Employers should remain diligent in reducing their risk of noncompliance — and related penalties and fines — especially as new rules are released.
New federal guidance clarified how fertility benefits may be structured as excepted benefits.
Employer-sponsored health plans have several ongoing reporting requirements, while federal regulators are expected to issue a final rule related to machine-readable files for prescription drug pricing.
Healthcare and transparency remain top priorities of the federal government, as regulators resume work on the backlog of pending guidance and rulemaking that could affect employee benefits:
Health and welfare plan compliance is becoming more complex
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This material is for informational purposes and is not intended to be exhaustive nor should any discussions or opinions be construed as legal advice. Contact your broker for insurance advice, tax professional for tax advice, or legal counsel for legal advice regarding your particular situation. USI is not responsible for the content of the information provided or for consequences of any actions taken based on the information provided. © 2025 USI Insurance Services. All rights reserved.
USI’s 2026 Employee Benefits Market Outlook provides insights from our experts on the healthcare and compliance trends impacting benefits administration and costs in the new year. Check your inbox for the full report on January 6.
New guidance has been issued for 530A “Trump Accounts” (individual retirement accounts for children) as well as expanded HSA eligibility under the One Big Beautiful Bill Act.
