Summary
Our State of Employee Benefits Report 2026 gives brokers an opportunity to see benefits enrollment trends over the past three years. In this blog, we highlight some of those trends that brokers can use to drive meaningful conversations with their clients. Find out more about these highlights:
- Overall enrollment holds steady at 44%, but industry and regional gaps are widening.
- Retail trade sees declining participation, dropping to 28.5% in 2026.
- Core and voluntary benefits remain critically underutilized across the board.
- Regional differences span nearly 20 percentage points, from 38.5% in the Midwest to 58.2% in the West.
Enrollment data is more than a year-end scorecard. It reveals where employees feel supported and offers opportunities for employers to optimize their benefits plans. As we look at benefits enrollment trends for 2026, the data tells a compelling story. Based on our analysis of large employer groups across the U.S.,1 overall enrollment has held relatively steady at about 44% over the last three years. But this flat average doesn’t reveal the variation underneath.
The brokers with the opportunity to add the most value in 2026 are those who move beyond averages. By engaging clients with industry- and region-specific intelligence, brokers can help employers build optimal benefits programs. Here are the key findings worth discussing with your clients.
Core and Voluntary Benefits Are Underutilized
Across the industries in our employer groups, we find that core benefits are generally underutilized. Between 2024-2026, enrollment for medical benefits averaged 47%, dental was 60% and vision was 56%. Voluntary benefits follow a similar pattern, with critical illness at 18.5% and voluntary life at 22.7%. These numbers represent gaps between what employers are offering and what employees are using. The good news is that brokers are uniquely positioned to help close these gaps when they’re equipped with relevant data that can help build an effective benefits engagement strategy.
Retail Trade is Falling Behind on Core Benefits Enrollment
When we look at core benefits of dental, medical and vision, retail trade has a lower enrollment rate than other industries based on available Dun & Bradstreet (D&B) proprietary industry classifications, using D&B 8-digit SIC and standard NAICS mapping frameworks. Enrollment rates for retail have grown slightly from 15% in 2024 to 18% in 2026, yet they are less than half the rate of all other industries, with 58% enrollment in 2024 and 56% in 2026. The geographic gaps within retail provide another layer of insight. Over the past three years, benefits enrollment for dental, medical and vision among retail employees was 54% in the Midwest compared to 63% in the West.
These enrollment rates may be unsurprising to some, considering that retail employers may face high turnover, seasonal workforce dynamics and limited HR resources. This means enrollment support can fall to the bottom of the priority list and it’s a challenge that’s actively worsening. Retail employees are among the most benefit-eligible populations who simply aren't getting covered. Brokers have an opportunity to make a real difference by proactively bringing communication strategies and enrollment technology solutions to retail clients before the next open enrollment cycle begins.
Regional Enrollment Gaps Are Nearly 20 Percentage Points Wide
One of the most actionable findings in this year's data is just how wide the regional divide has become among certain voluntary benefits like short-term disability (STD), long-term disability (LTD) and accidental death and dismemberment (ADD). These three voluntary insurance benefit types saw the highest participation rates among benefit-eligible employees/members across our client population, but we see a persistent gap between the Midwest and South, and the West and Northeast. When looking at enrollment rates for STD, LTD and ADD between 2024-2026:
- Employees in the West enrolled at an average rate of 82%.
- Their counterparts in the Midwest enrolled at just 62% — a 20 point gap.
- The South trails closely behind the Midwest at 59%.
- The Northeast lands in the middle at 70%.
Telehealth2 tells a particularly compelling and complicated story. The Northeast and West continue to lead overall, with telehealth enrollment rates hovering near 97–99% consistently across all three years, suggesting that telehealth has effectively become table stakes in those regions. In the Midwest, momentum is strong and accelerating: telehealth enrollment jumped from 32.6% in 2024 to 78.3% in 2026, an increase of nearly 46 percentage points in just two years. That's a strong talking point when positioning digital health benefits to employers who may be still catching up on modern enrollment tools.
Financial wellness benefits show a similar regional pattern. These financial benefits include things like dependent care FSA, daycare FSA, college counseling, commuter and transportation reimbursement and health living reimbursement. Enrollment rates for these benefits show:
- Employees in the West enroll at a rate of 34.5%.
- Midwest employees enroll at 21%.
- Northeast employees enroll at 17%
- The South’s rate is slightly above the Midwest at 21.9%.
For clients in the Midwest and Northeast, financial wellness is arguably an underleveraged benefit and a meaningful conversation starter heading into the next enrollment season.
How Brokers Can Take Action
Data without action is just a report. Here are some options that offer the opportunity to turn these insights into meaningful next steps for your clients:
- Frame the cost of non-enrollment. Research suggests that employees who are uninsured or underinsured may be more likely to delay care, experience financial stress and disengage from work. These factors can be associated with unfavorable workplace outcomes like increased absenteeism, reduced productivity and higher voluntary turnover. 3,4,5 To address these issues, brokers can suggest a benefits strategy that includes expanding access to benefits that support employee health and financial well-being. This strategy is associated with lower voluntary turnover rates and may contribute to reduced total cost of care for employers over time. 6,7,8 Use regional benchmarks to contextualize your clients' results. A Midwest employer at 42% enrollment might be satisfied until you show them the West is at 58% enrollment. Understanding where a client stands relative to regional peers opens the door to meaningful conversations about plan design, communication gaps and technology investments that can help impact workforce satisfaction and retention. Over time, closing regional enrollment gaps offers a way to help strengthen employee engagement and position employers as competitive benefit providers in their local talent markets.
- Suggest year-round education and communication campaigns rather than a single open enrollment window, especially for retail and other high-turnover industries. Tying communications to seasonal health observances — such as American Heart Month9 in February, Mental Health Awareness Month10 in May or open enrollment season in the fall — gives employees timely, relevant reasons to engage with their benefits throughout the year.
- Recommend mobile-first, simplified enrollment tools built for distributed and hourly workforces. When employees can explore their options, compare plans and enroll from any device, the enrollment process becomes less intimidating and more accessible. Decision-support tools that translate complex benefit details into clear, personalized guidance are especially powerful for hourly and frontline workers who may have limited time or prior experience navigating benefits.
- Highlight telehealth and financial wellness as high-opportunity categories in regions where the data shows underperformance. For employees, telehealth can help reduce barriers to care by enabling them to address health concerns without taking time away from work, while financial wellness resources provide the tools and confidence to help manage everyday financial stress. For employers, higher engagement in both categories can help support optimal health and financial outcomes for their workforces — offering the chance to reduce absenteeism, improve productivity and lower long-term healthcare costs.
Enrollment data reveals that the gap between what's available to employees and what they actually use isn't fixed. We believe the brokers who will create the most value in 2026 aren't just selling products. They're bringing insights, asking informed questions and helping employers build benefit programs that truly work for their people.
Ready to dive deeper into the data? Download the full State of Employee Benefits Report 2026 or request a data review with your Benefitfocus team today.
