As health plan costs continue to increase, more employers intend to change or reduce their 2026 benefit offerings to control spending, according to July 16 survey results from Mercer.
For instance, 51% of large employers (defined as those with 500 or more employees) said they’re likely — or very likely — to make plan changes that would shift more costs to employees, such as raising deductibles or out-of-pocket maximums. The percentage increased from 45% in 2024.
“Employers project average health benefit costs to grow by nearly 6% this year, and 2026 may be even more challenging from a cost perspective,” Ed Lehman, leader of U.S. health and benefits at Mercer, said in a statement.
“While short-term cost containment actions might be needed to address current budget realities, we also see some employers using longer-term strategies, such as offering narrow network plans, that emphasize high-quality, high-value care,” Lehman said. “These strategies may improve health outcomes or make healthcare more affordable for employees.”
In a survey of more than 700 U.S. employers, including 500 large companies, 35% of large employers said they plan to offer a non-traditional medical plan option in 2026, such as variable copay plans. Among the 6% of large employers that offered a variable copay plan in 2025, an average of 28% of their covered employees chose to enroll.
When it comes to pharmacy benefits, employers pointed to challenges around covering GLP-1 drugs for diabetes and obesity. About 44% of large employers said they cover the drugs to treat obesity. Looking ahead, 77% of employers said it’s extremely or very important to manage costs related to these drugs due to their high price tag — roughly $1,000 per month per patient without rebates factored in.
“While the trend over the past couple of years has been to add coverage for GLP-1s approved for weight-loss, some employers facing large cost increases in 2026 may feel this coverage is out of reach,” Alysha Fluno, a pharmacy leader at Mercer, said in a statement. “Employers are weighing the immediate costs of covering these drugs against the potential for generating savings down the road once their workforce’s health improves.”
In addition, well-being and mental health continue to be a major priority, Mercer found. More than 75% of large employers said they’ll offer digital stress management or resiliency resources in 2026, including apps for mindfulness, meditation and cognitive behavioral therapy. Beyond that, 51% will offer in-person or live online resources for stress management or resiliency.
Looking further ahead, other research indicates employers are weighing additional changes. By 2027, nearly 1 in 3 employers plan to expand voluntary benefits, including quality-of-life products such as pet insurance and employee perks programs, according to a Gallagher report. These benefits can reduce stress, improve employee satisfaction and boost productivity, the report found.
Whether adding or subtracting benefits, most U.S. employers intend to shift their benefit strategy in the next three years, according to a WTW report. Nearly two-thirds said they’ll reallocate or rebalance spending, using benefits as a strategic tool to drive engagement, retention and purpose, WTW said.
