How Benefitfocus Can Help Employers Manage Health Care Costs: Potential Savings, Practical Strategies
Summary
According to the most recent data, health benefit costs per employee rose 6.0% in 2025 and are projected to climb another 6.7% in 2026 — the highest increase in 15 years.1 This blog explains how Benefitfocus can use relationship insights and complementary solutions to help clients manage rising costs. Learn about potential cost savings through these methods:
- Dependent eligibility audits - Over $110k in one-year savings potential.
- Health care point solution engagement – A reported reduction of over $2,000 per participant in annual medical costs for one organization.
- Automated payroll reconciliation to reduce premium leakage.
Total health benefit cost per employee rose 6.0% in 2025, and the projected increase for 2026 is 6.7% — the highest in 15 years.1 Employers are looking for ways to reduce spending and foster employee habits that support well-being and help mitigate high-cost claims.
At Benefitfocus, we offer a combination of technology, service and relationship insight. We help you identify cost drivers, evaluate potential solutions and manage programs designed to support employee health and financial outcomes and reduce ongoing health care costs.
Benefitfocus client data offers an encouraging result: average medical and prescription spend increased by less than half the reported industry average during the period measured.2 These results reflect the experience of the clients included in the analysis and may vary.
Let's explore four ways our solutions may help clients identify benefits cost savings.
1. Dependent Audit Verification: One-Year Savings Potential
When ineligible dependents remain on your plan, the costs can add up quickly. The average annual medical claims cost per dependent rose to $6,9253 in 2025.
For a representative 5,000-employee client with 400 dependents and a 4% average rate of ineligible dependents, a dependent eligibility audit could identify over $110,000 in potential one-year savings.3
Dependent verification can help support your budget and the consistent application of plan rules. We manage key administrative details so your team can focus on supporting your people. It is a proactive step that may help identify ineligible enrollment and related costs.
2. Health Care Point Solution Engagement: A Per Participant Year-One Savings Potential
Benefitfocus can help you analyze your health care claims data, spot concentrated areas of health care and/or prescription spend, recommend digital health plan solutions designed to help address those costs, and use targeted employee messaging to support engagement. Our Care Partner Panel brings together a variety of health solutions that address specific employee needs, from chronic condition management to preventive care. When you implement one of these partners through Benefitfocus, you also gain access to comprehensive reporting that lets you see how well the solutions are working to change healthy behaviors.
One Care Partner Panel member, Hello Heart, reported a $2,300 per-participant reduction in year-one total medical costs for one organization that implemented its solution.5
By integrating trusted partners into a single, connected experience, we can help make it easier for employees to access tools designed to support improved health outcomes and help employers manage costs.
3. Decision Support: Annual Tax Savings Potential
When employees choose the optimal plan for their needs, employees and employers may both benefit. Employees may be less likely to over insure or under insure, and employers may see greater plan efficiency.
One client saw an 8% increase in High-Deductible Health Plan (HDHP) adoption in a single year through personalized decision support6 — translated to an estimated $103,000 in annual Section 125 tax savings.7
Personalized guidance delivered by our Decision Support solution can help employees make informed choices about their benefits. When people better understand their options, their decisions may contribute to savings for both them and the organization.
4. Reduced Premium Leakage: Potential Savings in Six Months for a Retail Organization
Premium leakage — when deductions and premiums don't align with actual enrollment — can increase benefits administration costs and may be an overlooked source of unnecessary spending.
Based on past experience, a representative retail organization of 5,000 employees where eligibility, payroll deductions, and premium collection experience frequent changes could potentially realize a premium leakage reduction of approximately $750,000 over six months.8
Automating payroll reconciliation and validating deductions against enrollment data can help identify errors and reduce the risk of overpayments by organizations and employees.
Take the Next Step
As health care costs rise, employers can work with a partner to take steps to identify cost drivers, evaluate strategies that may produce savings, and support employee health and financial outcomes.
We're here to help you navigate every step. Contact us to find out what savings opportunities may be available for your plan.
