The Rising Cost of Healthcare in 2026: What Employers & Brokers Need to Know

For U.S. employers, 2026 is shaping up to be the most turbulent health benefits renewal season in more than a decade. According to the Wall Street Journal, employers are bracing for the largest healthcare cost increase in 15 years, with an average rise in cost of 6.5% across employer-sponsored plans.

Behind these numbers lies a perfect storm: inflation, specialty drug costs, and legislative upheaval under the newly introduced Big Beautiful Bill. As parts of the Affordable Care Act (ACA) face reinterpretation and legal uncertainty, employers are being asked to make decisions in an environment that’s shifting under their feet.

For brokers, it’s no longer enough to manage renewals, but about helping clients survive the volatility. And for employers, it’s time to reimagine what “control” really means when it comes to healthcare costs.

Healthcare operates on a delayed economic cycle. The medical inflation trends in employer health plans are closely monitored. The inflationary wave that hit consumer goods in 2022 and 2023 is now reaching provider contracts in 2026. Hospitals and health systems are renegotiating with insurers, citing labor shortages and higher supply costs. Those negotiations are being passed directly to employer-sponsored plans.

Even self-funded employers (historically insulated from carrier rate hikes) are seeing some cost pressure. In many markets, unit costs for inpatient care have risen 8-10%, and outpatient services are following close behind.

The Big Beautiful Bill, introduced in late 2025, has triggered significant turbulence in the Affordable Care Act marketplace. Changes to federal subsidies, employer shared responsibility penalties, and plan affordability thresholds are creating confusion for compliance teams and benefits administrators alike.

While the full impact remains to be seen, it’s already complicating renewals for 2026: brokers must now assess plan affordability under a moving target, and employers must prepare for potential audits or reclassification under updated IRS guidance.

Affordable Care Act compliance and employer responsibilities must be a priority in 2026.

Mercer projects that pharmacy costs will drive up to 40% of total trend in 2026. The culprit? Speciality drugs like GLP-1 weight-loss medications and gene therapies that can cost six figures per treatment course. Employers are being forced to choose between coverage limits and member satisfaction–often with incomplete visibility utilization data.

Without careful plan design and stop-loss coordination, a single specialty claim can distort an entire employer’s renewal.

Rising premiums are only the symptom. The real issue is lack of control. Employers trapped in fully insured plans are effectively spectators to their own costs. Carriers dictate the renewal rate, and the underlying claims experience remains hidden behind pooled risk.

This year, more employers are re-evaluating their funding models than ever before. Through Benecon, employers can transition to a self-funded consortium model that offers both flexibility and protection. By pooling with other like-minded organizations, employers retain ownership of their plan while sharing stop-loss strength and administrative infrastructure.

The result? Predictable renewals, transparent data, and the ability to make informed, proactive adjustments instead of constant cuts.

Brokers are at the center of this storm. In 2026, their role extends beyond placement and squarely into full orchestration.

A strong broker will:

• Model multiple funding scenarios (fully insured vs. level-funded vs. self-funded) and compare true risk exposure.
• Guide employers through new ACA compliance thresholds introduced by the Big Beautiful Bill.
• Negotiate stop-loss contracts that anticipate inflation and new high-cost claim categories.
• Deliver actionable insights from claims data to keep renewals defensible and data-driven.

But doing all this requires infrastructure: underwriting support, compliance expertise, and real-time data visibility. That’s where Benecon comes in.

Benecon was built for moments like this. When employers and brokers need clarity amid chaos, Benecon is specially poised to help. We built cost-containment into our model.

Benecon’s VERIS Benefits Consortium allows employers to maintain their independence while gaining collective bargaining power. Members receive guaranteed renewals with no new lasers and consistent access to favorable stop-loss terms. There are only a few standalone self-funded employers that could ever achieve this on their own.

Within Benecon’s ecosystem, every employer receives detailed reporting on claims trends, pharmacy spend, and cost drivers. Instead of receiving a rate increase and a one-line justification, employers see where their dollars went; that means you can make optimization adjustments to the plan every year.

Benecon partners with brokers, not against them. We provide quoting platforms, analytics dashboards, and compliance resources that allow brokers to scale without sacrificing service. Whether it’s a new prospect proposal or a renewal defense, Benecon equips brokers with the insights and structure to lead with authority.

ERISA, COBRA, ACA–three sets of initials that can become a compliance nightmare when legislation changes. Benecon’s legal and compliance team stays ahead of federal updates, and translates those regulatory changes into clear guidance and proactive plan adjustments.

In an environment where costs are unpredictable and regulations are volatile, self-funding is the most adaptive funding model available. It puts employers back in control of three key levers to their plan:

1. Claims Data Transparency – Employers can identify exactly where spending is rising and take action.
2. Plan Design Flexibility – Adjust benefits mid-year or at renewal without waiting for carrier approval.
3. Shared Risk Protection – Through Benecon’s consortium model, employers access group-level stop-loss buying power and guaranteed renewals.

When paired with a knowledgeable broker, these levers create a long-term stabilization strategy that resists the market’s chaos.

Want to learn more about joining?

1. Reforecast early. Don’t wait for carrier renewals. Model the potential 6-8% medical trend now and assess self-funded scenarios.
2. Reassess pharmacy coverage. Review GLP-1 and specialty drug policies to avoid exposure spikes.
3. Review compliance. The Big Beautiful Bill may change affordability rules and penalty thresholds. Align with Benecon’s compliance advisors to prepare for audits or reporting shifts.
4. Educate leadership. CFOs often view self-funding as riskier than it is; present real-world case data and demonstrate that stability. With the added support of a consortium like VERIS, many of the risks are mitigated, especially when working with a broker.
5. Partner strategically. The right broker-consortium partnership can neutralize volatility. The wrong one can amplify it.

The healthcare cost crisis of 2026 isn’t a passing wave, it’s the new reality of employer-sponsored benefits. Inflation, regulation, and innovation have converged to create a system that can add to the chaos.

But employers aren’t powerless. With the right broker and the right structure, they can convert volatility into opportunity.

That’s what Benecon delivers: stability through transparency, compliance through guidance, and leverage through collaboration.

If this renewal season has left you questioning your current path, it’s time to explore a better one.

Learn how Benecon can help you navigate 2026 with confidence.