Employers are shifting health care costs to employees but also leveraging new approaches to minimize impact, according to Mercer research
June 11, 2026
United States, New York
Mercer, a business of Marsh (NYSE: MRSH) and a global leader in helping clients realize their investment objectives, shape the future of work and enhance health and retirement outcomes for their people, today released its Survey on Health and Benefit Strategies for 2027.
According to the survey, nearly half (48%) of US large employers, those with 500 or more employees, expect to make changes to their medical plans, such as raising deductibles or copays, that will result in higher out-of-pocket costs for employees next year.
Some employers are exploring alternative plans to offer employees more affordable options. Nearly one-third (31%) of large employers currently offer, or plan to offer, at least one non-traditional medical plan in 2027, such as a high-performance network or variable copay plan, and another 38% are considering one of these approaches. Typically, these plans offer members lower cost-sharing when they use pre-selected, high-performing providers.
“Employers are under intense pressure to manage another year of elevated health benefit cost growth, but they also know that affordability matters deeply to employees,” said Simon Camaj, Mercer’s US Health Leader. “What we’re seeing for 2027 is that employers are using different levers to manage costs — both traditional cost-sharing tactics and strategies that guide their people to higher-value care and provide support where it can have the greatest impact.”
Employers reassess GLP‑1 coverage and tighten utilization controls
According to Mercer’s latest National Survey of Employer-Sponsored Health Plans, total health benefit costs are expected to increase 6.7% in 2026, pushing the average cost above $18,500 per employee. Prescription drug benefits are one of the fastest-growing expense categories, rising about 9% in 2026. As a result, managing pharmacy benefit costs is an imperative for employers.
While employer coverage for GLP-1 medications for weight loss has increased in recent years — reaching 49% of large employers last year — the latest survey suggests the trend may be shifting, with 6% of large employers dropping coverage for these drugs in 2026 and another 5% planning to drop coverage in 2027 or actively considering it. In addition, 27% tightened utilization controls this year, or plan to in 2027, reflecting mounting concern about the long-term budget impact of these medications.
Employers are also evaluating different ways of working with their pharmacy benefit managers (PBMs). Two out of five large employers (41%) are evaluating different contracting models offered by major PBMs and 37% are evaluating new and emerging PBMs.
“The pressure created by specialty drugs, gene therapies, and GLP-1 medications is forcing employers to take a much harder look at their pharmacy strategies,” said Alysha Fluno, Mercer’s US Pharmacy Practice Leader. “For many plan sponsors, the priority now is not just managing pharmaceutical utilization by their health plan members, but gaining more transparency, control, and confidence that every dollar spent is delivering maximum value.”
Benefits and resources to support family life have become standard offerings
Meanwhile, employers continue to invest in benefits that deliver high value to members who need them, particularly support for family building and caregiving. Half (50%) of all large employers and 77% of those with 20,000 or more employees now cover IVF. In addition, 46% of large employers provide financial support for adoption expenses and 25% provide financial support for surrogacy expenses.
Caregiving support, for both child and elder care, has also become common. Just over half of large employers (51%) currently or plan to provide at least one childcare-related resource in 2027, such as backup childcare, childcare search platforms or concierge support, while 58% provide at least one elder care benefit or resource, such as backup elder care services and elder care leave.
Financial well-being programs scale as employees feel economic strain
Mercer’s recent Inside Employees’ Minds survey found that economic volatility continues to weigh heavily on US employees. Asked about the various challenges they face, "covering monthly expenses" was the top concern cited, particularly among lower-paid workers. Employers are responding by providing a range of financial wellness resources, such as one-on-one financial counseling (60%) and various forms of debt support (21%).
Employers have also taken steps to make behavioral healthcare available at no or low cost by expanding their employee assistance program (EAP) offerings to include therapy via text (39%), online self-paced cognitive behavioral therapy (35%), and AI chatbot therapy and coaching (11%). In addition, a third (33%) offer in-person counseling at one or more worksites or will in 2027.
Inside Employees’ Minds also revealed that 41% of US employees have experienced higher costs of living due to extreme weather, such as larger electric bills and insurance premiums. Some employers are helping employees affected by extreme weather by providing relief funding (19%) and paid leave (16%).