Health costs are projected to rise 9.5% per employee in 2026, according to Aon’s annual health survey. Most employers find out what that means for their budget at renewal — sitting across from a carrier with a thick actuarial deck and very little room to negotiate. The employers who are navigating this environment well didn’t get lucky. They came to that table differently.
The conversation about rising costs tends to start and end with pharmacy, specifically GLP-1 weight-loss medications. And yes, pharmacy is a real pressure point. But focusing exclusively on one drug class misses the broader picture, and it puts HR leaders in a reactive posture when the data to be proactive has been available to them all along.
What’s Actually Driving the Increase
The 2026 Business Group on Health Employer Health Care Strategy Survey identified three compounding cost drivers: the rise of obesity treatments, increased cancer prevalence among plan populations, and higher utilization of mental and behavioral health services. These aren’t temporary spikes. They reflect shifts in workforce demographics and healthcare utilization patterns that will persist well beyond this renewal cycle.
High-cost claimants, individuals with claims exceeding $100,000 in a single plan year, are the single largest variable in a mid-size employer’s annual trend. A plan covering 150 employees can absorb routine utilization comfortably. One catastrophic claim from a cancer diagnosis or complex surgical event can move the renewal number by 15 to 20 percent on its own. For employers on fully insured plans, that exposure lands directly on their premium. For those on self-funded or level-funded arrangements, it flows through stop-loss which is why stop-loss structure and attachment points deserve as much attention as the plan design itself.
The Lever Most Employers Aren’t Pulling
Here’s what separates the employers who consistently achieve better renewal outcomes: they use their own claims data strategically, not reactively. Data analytics and benchmarking give HR leaders the ability to see — before renewal — where their claims dollars are going, which claimant segments are driving trend, how their plan performs against peer benchmarks, and where plan design changes could reduce unnecessary utilization without reducing the value of benefits to employees.
According to SHRM’s 2026 benefits research, employers who actively use claims analytics in their renewal strategy consistently outperform those who rely on carrier-provided summaries alone. The difference isn’t access to data. Most employers have more data than they realize. The difference is how that data is organized and brought into the conversation.
A well-run employee benefits strategy and consulting process starts with claims review four to six months before renewal, not four to six weeks. It maps high-cost claimant activity, flags pharmacy utilization patterns, benchmarks deductibles and cost-sharing against comparable employer groups and identifies whether current stop-loss attachment points still reflect the plan’s actual risk profile.
What This Looks Like in Practice
Employers who go into renewal with their claims data already organized aren’t just better negotiators, they’re making better decisions. They’re asking the right questions about network performance, evaluating whether their current carrier relationship is still the best fit, and building a benefits strategy that balances cost containment with the employee experience. The employee benefits services model at Tooher-Ferraris is built around exactly this kind of proactive, data-informed partnership.
The employers winning in 2026 aren’t reacting to the market. They’re shaping their outcomes ahead of it.
Ready to take a closer look at what your claims data is telling you? The team at Tooher-Ferraris has been helping businesses build stronger benefits strategies since 1932. Contact us today to schedule a no-obligation consultation.
External Sources: Aon 2026 Health Survey | Business Group on Health 2026 Employer Survey
