Nearly half of employers anticipate healthcare budget increases in the coming plan year, as rising benefits costs and growing employee financial pressures continue to challenge organizations.
The findings come from the 2026 US Benefits Trend Report released by NFP, based on separate employer and employee surveys.
"Across industries, leaders are shifting from a transactional view of employee benefits to a more purposeful approach that balances financial stewardship with the responsibility to support a workforce under growing strain," said Doug Hammond, CEO of NFP.
Pharmacy benefits have emerged as a focal point, with 70% of employers expecting cost increases in the coming year. The report identifies a shift toward a three-pillar cost model comprising declining legacy medications, rising specialty prescriptions and fast-growing GLP-1 drugs.
GLP-1 utilization for diabetes and weight-loss treatments is driving costs, with 51% of employers citing these drugs as a top factor in rising prescription spend. Four in 10 employers expressed concern about pharmacy cost sustainability.
Hub International's 2026 Benefits Cost Trends Report offers additional perspective on the cost environment facing employers. The report projects national trends for combined medical and prescription drug coverage at 8% to 10% for 2026. Prescription drug trends alone are expected to range from 10% to 12%, while medical-only trends are projected at 7% to 9%.
The talent implications are notable. Nearly three in 10 employees (29%) indicated they would consider changing employers for GLP-1 coverage. Kim Bell, EVP and head of Health and Benefits at NFP, noted that when coverage decisions influence employment choices, "it's more than cost control."
In response, 49% of self-funded employers now carve out pharmacy benefits with a pharmacy benefits manager, up from 27% in 2025.
The report also highlights gaps in employee wellbeing initiatives. Average employer spending on mental health resources dropped roughly 7% year-over-year, and fewer than half (40%) of employers provide burnout prevention training.
A communication gap persists: 63% of employers rate their wellbeing communication as strong, while only 42% of employees agree.
Financial stress compounds these challenges. Two in five employees have less than $500 in emergency savings, and more than a quarter cite money as their top workplace stressor. Only 35% of employers offer structured financial wellbeing programs.
On artificial intelligence, only 28% of employers have comprehensive governance policies in place. Half of employees report career uncertainty related to AI preparedness. States including Colorado, New York and California are introducing legislation requiring algorithmic transparency in employment decisions.
