In November 2026, Brown & Brown released the findings of its 2027 Employer Health and Benefits Strategy Survey, reporting that 44% of surveyed employers ranked controlling the organisation’s health benefit costs as their top priority. The November 9 release also cited a separate analysis of the brokerage’s customers, who anticipate average annual healthcare cost increases of 10% in both 2026 and 2027.
Put employer and employee costs in the same comparison
A renewal can reduce the employer’s contribution while making care more expensive for employees. Higher deductibles, narrower networks or different prescription coverage can change who pays and when. A useful renewal comparison therefore needs two views: the cost to the employer and the likely cost to members. Assess the latter for several household and treatment patterns rather than for an employee who uses only routine care.
This matters in multinational programmes because an apparently uniform savings target can have very different effects by country. Local statutory coverage, provider access, employment agreements and existing cost sharing determine what an employer plan actually does. A design change that trims duplicate coverage in one market could leave a significant gap in another. Ask local teams to describe what an employee would experience under each proposed change before combining the savings figures.
Test medical and pharmacy assumptions separately
Brown & Brown identifies pharmacy spending and GLP-1 coverage decisions among the pressures shaping employer strategy. The release does not show that restricting a particular medicine will improve total costs or health outcomes for a given workforce. A committee evaluating coverage options should ask for the expected utilisation, the assumptions behind it and the costs of administering any new eligibility rules. It should also examine how a transition would affect employees already receiving treatment.
For medical spending, distinguish higher prices from higher use and changes in the mix of care. If an insurer attributes a renewal increase to trend, ask it to separate trend from demographic change, high-cost claims and changes in contract terms. A purchaser cannot judge whether a proposed intervention addresses the cause of the increase without that breakdown. The analysis will be less precise for small groups, where one claim can materially change a year’s experience.
Agree what will be measured after renewal
Finance can track the employer cost against the approved forecast, while benefits teams monitor employee questions, changes in access and any significant claims or service issues. Neither set of measures is sufficient on its own.
Where a captive participates, separate the underlying plan’s claims performance from the financing effect of retaining more risk. A reduction in external premium can come with greater exposure to volatile claims and a higher demand on capital. Directors should ask how the proposal changes the range of outcomes and whether the captive has enough information to price the risk and monitor it. Independent non-executive directors can challenge whether projected savings still hold under an adverse claims scenario and whether the new risk sits within the captive’s approved appetite.
Ask each adviser to put the assumptions in writing, including participation and any changes in the provider network. If the options use different forecasts, rerun them on a common basis. Otherwise the committee may be comparing two projections rather than two plans.
Brown & Brown’s findings are useful evidence of what employers are prioritising, not a target for an individual renewal. Ask advisers to present each design option with its employer cost, member impact and the assumptions most likely to change the result. That makes it possible to distinguish a more efficient benefit from a redistribution of its cost.
Sources
Brown & Brown survey release
Share this:
- More [2]
