The benefits landscape is increasingly shaped by medical and pharmacy cost pressures, alongside demand for innovation and sustainability in plan design, as detailed in Brown & Brown’s annual survey.
The Employer Health and Benefits Strategy Survey 2026, outlines how 1,241 US employers are adjusting benefits strategies amid rising costs and changing workforce expectations.
Cost containment has moved to the top of employers’ strategic priorities for both their organizations and their employees, replacing “attracting and retaining a competitive workforce,” which ranked first in the inaugural 2025 survey.
Employers are deploying a range of cost-management tactics, including reviewing stop-loss plan structures, tightening audit practices and partnering with digital health providers to improve transparency and plan performance. These measures are intended to address rising trend while limiting the extent to which higher costs are passed on to workers.
Findings from other consulting firms suggest employers are trying to balance that cost focus with competitive positioning in the labor market.
Gallagher’s earlier benefits report found that 31% of US employers made changes to enhance medical benefits and 12% upgraded pharmacy offerings to support talent attraction and retention, indicating that many organizations are refining coverage rather than simply cutting back as they manage healthcare inflation.
At the same time, employers are maintaining or expanding investments in workforce support. Brown & Brown reported that 77% of respondents include wellbeing programs in their healthcare strategies, and 78% of that group plan to increase budgets for those initiatives.
Parental leave also remains a focus area. According to the survey, 71% of employers now offer paid leave that goes beyond statutory requirements, signaling continued attention to family and caregiver benefits despite budget pressures.
“Employers are taking decisive action to manage rising health care costs, from rethinking plan design to adopting digital care solutions and more rigorous pharmacy management strategies,” said Chana Bieker (pictured above), senior vice president – benefits, national account leader at Brown & Brown.
She said that “amid inflation, economic volatility and shifting social expectations, our survey shows organizations are prioritizing cost control more than ever,” while still using available budget “to reinvest in employee well-being in diverse ways, such as more inclusive benefits and expanded parental leave.”
The survey also examines how employers are responding to the rapid growth in use of GLP-1 drugs for weight loss. Nearly half of respondents (48%) cover GLP-1s for weight loss, and among those that do, 89% expect to maintain coverage over the next one to two years.
However, coverage is often subject to limits. More than six in 10 employers that cover GLP-1s for weight loss (63%) report having restrictions in place, and 49% say those restrictions go beyond prior authorization, such as requiring members to meet clinical criteria that exceed US Food and Drug Administration guidelines.
