2026 National Benefits Survey: Cost Pressures are Reshaping Strategy

        As healthcare costs continue to rise and economic uncertainty persists, employers are facing intensified pressure to rethink their benefits strategies. Findings from the 2026 National Benefits Survey reveal a clear shift in priorities—and signal that employers are entering a pivotal decision-making period.

               For the second year in a row, cost reduction has surpassed all other priorities in benefits decision-making—and its influence is accelerating. More than half of surveyed employers (54%) now identify cost as their top consideration, a notable increase from the prior year.

               At the same time, attracting and retaining talent has declined in importance, dropping to 19%. This shift reflects a broader reality: cost pressure is no longer just a factor—it is reshaping the entire benefits landscape.

               Despite the urgency, the survey shows that employers are not converging on one clear solution. Instead, organizations are testing a range of approaches, carefully balancing cost savings against employee impact. This lack of a dominant strategy underscores the complexity of today’s environment and highlights the need for deliberate, informed decision-making.

Employers are concentrating efforts across four primary areas:

• Plan Optimization: Improving purchasing efficiency and evaluating cost-sharing structures
• Network Strategies: Balancing access, cost, and quality through network design
• Eligibility Management: Adjusting eligibility rules and spousal strategies
• Pharmacy Benefits: Managing rising drug costs through plan design changes

Each approach exists on a spectrum—from lower-impact changes to more disruptive strategies that may deliver greater savings.