U.S. employers are preparing changes to medical contributions and plan design for 2027-2028 as Brown & Brown projects average healthcare costs across its customer base will rise 10% in both 2026 and 2027. The insurance brokerage said that projection holds even after changes to plan design and benefit offerings.
The company's survey of 998 employers with at least 200 U.S.-based employees ran from July 21 to Aug. 28, 2026, and had a stated margin of error of ±3 percentage points. Among respondents, 44% ranked control of their organization's health-benefit costs as a top priority. That exceeded the 39% who prioritized controlling employee costs and the 33% who named attracting and retaining a competitive workforce.
Looking to 2027-2028, 82% expected moderate or significant changes to medical contributions, and 79% expected to change medical plan design. Claims, pharmacy or clinical audits, stronger data analytics, and evaluations of transparent pharmacy benefit manager vendors or pricing models each drew 83%. Medical stop-loss reviews and requests for proposals for medical or pharmacy services each drew 82%. Brown & Brown said at least that share of employers had adopted or planned each measure.
Some employers also planned to increase spending on worker support. Well-being programs featured in the healthcare strategies of 78% of respondents; among that group, 79% planned to raise related budgets. Respondents identified the challenge of controlling expenses while maintaining value for employees as their leading benefits-planning concern.
Forty-five percent of surveyed employers said they covered GLP-1 medicines for weight loss. Among employers offering coverage, more than 77% had restrictions. Among employers with GLP-1 coverage restrictions, 45% required additional clinical criteria beyond FDA guidelines and 33% required participation in a lifestyle, behavior or weight-management program. The findings follow earlier reporting on employers scaling back some GLP-1 coverage for 2027.
A June 2026 survey by Business Group on Health put the median projected 2027 healthcare cost trend at 9.2% before plan-design changes and 8% afterward. It covered 127 employers representing 8.7 million people in the United States and more than 11 million globally. The surveys involve different employer groups and measures, so their projections are not directly comparable.
Brown & Brown scheduled a webinar reviewing its survey results for Wednesday, Nov. 11, 2026, from 2 p.m. to 3 p.m. ET.
