5 Employee Benefits Trends Shaping 2026

Employee benefits are entering a period of major change in 2026. Rising health care costs, evolving pharmaceutical trends, new legislation, and shifting employee expectations are reshaping how employers design and manage benefits programs. Organizations are under increasing pressure to balance affordability with competitiveness while navigating regulatory updates and healthcare innovation.

Below are five key employee benefits trends shaping 2026.

1. Rising Health Care Costs Continue to Challenge Employers

Health care costs have been increasing at an alarming rate, and 2026 shows no signs of relief. Surveys project that health care costs in the United States may rise by 6.5% to more than 10% in 2026. Regardless of the exact percentage, employers should expect continued cost increases and will absorb much of the financial impact.

Several factors are driving these higher costs, including:

• Chronic health conditions

• Cancer care

• Rising health care labor costs

• Medical inflation

• Increased use of specialty drugs, including GLP-1 medications

Managing health care expenses remains one of the most pressing employee benefits challenges for employers in 2026.

2. Continued Popularity of GLP-1 Drugs

Glucagon-like peptide-1 (GLP-1) drugs are a significant driver of rising health care costs. While originally prescribed for diabetes, these medications are now widely used for weight loss. According to a RAND report:

• 12% of Americans have used GLP-1 drugs for weight loss

• 14% are interested in using them

• Prescriptions have more than tripled since 2020

Additional GLP-1 drugs are expected to enter the market by 2026, which could further increase employer health plan costs. One major development is the approval of the first oral GLP-1 therapy. The FDA approved the oral Wegovy pill in December 2025, with availability beginning in January.

GLP-1 medications typically:

• Cost around $1,000 per person per month

• Require long-term, continuous use to remain effective

• Are available in multiple doses and strengths

As employees increasingly request coverage for weight loss drugs, employers remain divided on whether to include these medications due to their high cost and long-term commitment.

3. The Impact of the One Big Beautiful Bill Act (OBBBA)

The One Big Beautiful Bill Act (OBBBA), signed into law by President Donald Trump, introduces sweeping changes to employee benefit plans, most of which take effect in 2026.

Key employee benefits-related provisions include:

Expanded Access to Health Savings Accounts (HSAs)

Effective January 1, 2026:

• Individuals with direct primary care (DPC) arrangements may contribute to an HSA if monthly fees are $150 or less ($300 for family coverage)

• DPC fees are treated as medical expenses payable with HSA funds

Increased Dependent Care FSA Limits

Also effective January 1, 2026:

• Maximum annual limit increases to $7,500 for single filers and married couples filing jointly

• $3,750 for married individuals filing separately

New Tax-Advantaged “Trump Accounts” for Children

Beginning in 2026:

• Available for children under age 18

• Annual contributions capped at $5,000 per child

• Employers may contribute up to $2,500 per year to an employee’s or dependent’s account

Additionally, enhanced Affordable Care Act subsidies were not renewed after expiring at the end of 2025. This nonrenewal may result in higher premiums and reduced enrollment. Potential changes to Medicare and Medicaid could also influence employer decisions regarding retiree health benefits and supplemental coverage.

4. Growth of Specialty Drugs and Advanced Therapies

The specialty drug market continues to expand rapidly, reshaping employer-sponsored health plans. In 2025, nearly 80% of FDA drug approvals fell into the specialty category—a trend expected to continue into 2026.

Biologics and Biosimilars

• Biologics dominate treatments for autoimmune diseases, cancer, and other complex conditions

• Biosimilars are gaining traction as cost-effective alternatives

• The FDA approved 19 biosimilars in 2024 and 10 in 2025

• Predictions suggest at least 10 biosimilars will be approved annually for the next five years

Biosimilars can only be marketed once biologics lose exclusivity, which lasts 12 years, prompting employers to rethink formulary strategies.

Cell and Gene Therapies (CGT)

Cell and gene therapies are seeing record approvals, including advanced treatments such as CAR-T therapy for cancer. These therapies offer promising outcomes but come with:

• High costs

• Complex administration and monitoring

• Manufacturing and scalability challenges

The industry is investing in automation and specialized production technologies to reduce costs and expand access, but specialty drugs will remain a major consideration for employee benefits planning.

5. Expansion of Fertility Benefits

Infertility rates continue to rise, with the CDC reporting:

• 9% of men

• 11% of women of reproductive age

As more individuals seek fertility treatments, including in vitro fertilization (IVF), employee demand for fertility benefits continues to grow.

New federal guidance allows employers to offer:

• Fertility benefits as independent, noncoordinated excepted benefits

• Excepted benefit HRAs to reimburse fertility-related out-of-pocket costs

• Coaching and navigator services through employee assistance programs (EAPs), as long as regulatory requirements are met

Reproductive health benefits remain a key area for employers aiming to stay competitive while supporting employee well-being.

2026 has the potential to be a pivotal year for employee benefits. Escalating health care costs, innovative drug therapies, and significant legislative changes are reshaping the benefits landscape. Employers that plan proactively and remain agile will be better positioned to compete for talent while managing costs effectively.

As employee benefits continue to evolve, staying informed is essential for organizations committed to supporting their workforce.

Contact BenePro today for more employee benefits resources.

 

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