Health Insurance Costs to Jump Again in 2026: What Employers Can Do Now
Employers face the largest health insurance cost jump in 15+ years, with 2026 increases near 9–10% on a ~$25,500 family-plan baseline. See real-world cases, survey data, and a step-by-step framework to control trend — plus how Benton Oakfield can help without blunt cost-shifting.
Employers across the U.S. are preparing for the steepest health insurance cost increases in more than 15 years. After multiple years of sharp jumps, 2026 is projected to bring an average 9–10% rise in employer-sponsored coverage, with family plans already averaging about $25,500 per year.
Why costs are accelerating
- Hospital pricing power: Inflation continues to ripple through contracts, with large health systems negotiating higher rates.
- Higher utilization: More employees are seeking care, including for serious conditions such as cancer, atrial fibrillation, and musculoskeletal issues.
- Pharmacy spend: High-cost therapies—especially GLP-1 drugs for diabetes and weight loss—are reshaping trend lines.
What employers are seeing
Benefits consultancies project the fastest cost growth since at least 2011: Aon estimates ~9.5% for 2026; WTW’s employer survey suggests ~9.2%. Many employers say the current model feels unsustainable and are weighing plan design changes, vendor switches, and cost-sharing adjustments.
Case studies from the field
Kall Morris Inc. (Marquette, MI) — a space-services firm with ~20 employees — experienced a ~20% plan cost increase for the plan year starting Aug. 1, after a 9% increase in 2024. To keep coverage viable, the plan’s out-of-pocket maximum rose from $8,150 per family to $10,000.
Mutual of Omaha (Omaha, NE) — ~6,300 employees — saw double-digit increases this year and stopped covering GLP-1 drugs for weight loss (e.g., Wegovy, Zepbound). The company is preparing to bid out its health and drug-benefit administration and is considering smaller, alternative vendors.
Employer survey results at a glance
| Survey Finding | Figure | Why it matters |
|---|---|---|
| Expected average increase in employer health costs (2026) | ~9–10% | Largest annual rise in at least 15 years |
| Average cost of family coverage (2025 baseline) | ~$25,500 | Costs now comparable to a small car |
| Large employers planning to consider new insurer or PBM | ~60% | Growing dissatisfaction with pricing and services |
| Employers prioritizing new plan designs (e.g., narrower networks) | ~1/3 | Stronger steerage and access controls to manage trend |
Real-world examples, side by side
| Employer | Employees | What happened | Action taken |
|---|---|---|---|
| Kall Morris Inc. (MI) | ~20 | +20% plan cost after +9% prior year | Kept plan; raised family OOP max from $8,150 to $10,000 |
| Mutual of Omaha (NE) | ~6,300 | Double-digit cost growth | Removed GLP-1 weight-loss coverage; bidding vendors incl. smaller alternatives |
Signals from health-plan leaders
Regional Blue plans report rapid, broad-based escalation, driven by aggressive billing (increasingly tech-enabled) and a rise in serious conditions among working-age adults. The implication for employers: trend pressure is systemic, not isolated.
Action framework for 2026 renewals
- PBM and formulary audit: Quantify GLP-1 exposure; evaluate step therapy, prior auth, and outcomes-based programs. Model net cost after rebates.
- Network and site-of-care strategy: Consider narrow/high-performance networks, carve-outs for complex care, and steerage to ambulatory settings.
- Plan design modernization: Use precision cost-sharing (e.g., copay caps for specialty drugs, value-based coverage for high-value services) to reduce low-value spend without hurting access.
- Contracting and analytics: Benchmark unit prices, flag outliers, and pursue bundled or reference-based arrangements where feasible.
- Condition management: Target oncology, cardiometabolic, and MSK with proven programs and transparent vendor guarantees.
- Communication & retention: Support employees with clear navigation tools; avoid blunt shifts that damage morale or recruiting.
Where Benton Oakfield fits
We help employers design and negotiate benefit strategies that bend the trend without blunt cost-shifting. From PBM restructures and GLP-1 governance to network optimization and employee education, our playbook focuses on measurable savings and employee experience.
If you’re staring at a high-single-digit or double-digit renewal for 2026, now is the time to act.
Contact Benton Oakfield to review your pharmacy strategy, network configuration, and plan design options — and to bring competitive bids (including innovative, smaller vendors) to the table.