How Some Employers Are Beating the 2026 Cost Curve

Across the benefits industry, the outlook is clear: rising costs are becoming the norm. For HR and benefits leaders, that creates a familiar pressure: how do you manage costs when forecasts point upward? 

Interestingly, not every employer is experiencing the same level of increase. 

As discussed in our recent webinar, data from the 2026 State of Employee Benefits shows a different story. Between 2024 and 2025, client medical spend per employee declined slightly, while pharmacy costs rose. When combined, total spend increased by only about 2%—far below industry expectations1

It’s not luck or one-time plan changes driving this gap. It comes down to visibility into the data. Employers with access to near-time data are identifying cost drivers earlier, adjusting utilization patterns and guiding employees toward appropriate care decisions before costs escalate. 

Instead of reacting at renewal, these organizations are actively managing benefits throughout the year, offsetting pharmacy pressure with curated care solutions and benefits incentive experiences

For benefits administrators, the takeaway is clear: benchmarks don’t have to define your outcomes. With the right insights, you can move from reacting to controlling trend. 

Ready to see how your plan compares? Contact us to learn more about how Benefitfocus Health Insights can help you turn real-time data into action and help bend your cost curve.

1The State of Employee Benefits 2026 was compiled from enrollment transactions aggregated across 316 large employers (1,000+ full time employees) within the Benefitfocus customer base, representing more than 1.8 million employees in total. The data was evaluated on an anonymous basis. Enrollment records include both active and passive enrollments made by a variety of industry roles (employee, carrier representative, broker, benefits administrator, etc) from the fall of 2023 through fall of 2025 for plan year effective dates of January 1. These measurements are not meant to be a nationally representative sample, but to represent the aggregate activity for large employers on the Benefitfocus platform. 

For data related to medical and prescription drug claims, Benefitfocus drew from 68 employers in our Health Insights Platform with a total population of approximately 600,000 employees and their dependents. Claims were assessed based on claim service dates from 1/1/24 through 12/31/2025, for year over year comparison periods. Population Health data was compiled using Johns Hopkins ACG® System (version 14.0.1). The underlying claims demographics and claims were sanitized per HIPAA Safe Harbor guidelines and were filtered to exclude generations older than Baby Boomers to comply with the age 90 cutoff mentioned in section (3) of “Guidance on De-identification of Protected Information. November 26, 2012” which cites the Code of Federal Regulations Title 45 §164.514(b)(2)(i)(C).” 

The information provided does not, and is not intended to, constitute legal advice; instead, all information and content herein is provided for general informational purposes only and may not constitute the most up-to-date legal or other information. Benefitfocus does not act in a fiduciary capacity in providing products or services; any such fiduciary capacity is explicitly disclaimed. 

Benefitfocus assumes no obligation based on the information presented and does not guarantee actual results. 

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