Employee Benefits Market Check Survey: 2026 Medical Renewal Insights

As the year draws to a close, many employers are finalizing loose ends related to their medical renewals. For much of the last few months, we heard that 2026 renewals would be the most difficult in many years. Headwinds, including increased utilization of services, price inflation, high-cost specialty drugs, gene therapies, tariffs, and deterioration in overall health, led to exorbitant premium increases for many plan sponsors.

We conducted a survey on December 18 to confirm final cost impacts, causes, and tactics employers took to address their premium increases for the upcoming year. The following summarizes the responses.

*Results based on 95 employer respondents.

Other reasons cited that received less than a 10% response rate:

• Carrier or vendor limitations
• Collective bargaining or contractual limitations
• Limited data or insight into cost drivers
• Limited remaining levers

Key Findings

Unfortunately, the data confirms what was suspected for some time; 2026 was a challenging renewal year for many employers.  Just over half of respondents are seeing their costs increase by at least 7% over 2025, and that is after they have made all possible changes to offset the price increase. The top changes implemented to reduce the cost increase were to increase employee payroll contributions and to revise the plan design. These are consistent with prior years and are the levers that can have the most immediate impact, but are felt heavily by employees.

There are currently numerous dynamics affecting healthcare premiums, and the primary driver for employers is also a mixture. The prevalence of catastrophic claims (those exceeding $1 million annually) continues to rise, and the overall utilization of the delivery system remains on the upswing as well. Pharmacy was the #1 driver last year, but dropped to third on the list this year. While not the primary cost driver for many, it still causes concern as prescription drugs become a greater share of the overall medical spend and will require continuous monitoring by benefit leaders.

Amidst all the difficulties with managing an employee benefits budget that is growing at a confounding rate, employers remain sensitive to additional changes. The workforce remains top of mind for benefit leaders as they contemplate revisions to their benefit plans. Affordability concerns and satisfaction remain critical factors for decision makers as they explore a benefits model for the future.

Should you have any questions regarding any of this information or want to discuss your health plan renewal, please contact your local Assurex Global adviser.