Data-driven benefits gain ground as employers face steep premium hikes

• Key Insight: Discover how brokers are evolving into strategic partners using claims data to redesign benefits.  
• What's at Stake: Rising premiums could force benefit redesigns, affecting employer competitiveness and employee access.  
• Supporting Data: Employer plans forecasted to rise 6–9% in 2026; ACA plans up to 26%.  
• Source: Bullets generated by AI with editorial review

With healthcare premiums expected to rise in 2026, many companies are looking for ways to save money without sacrificing quality of care. 
Brokers in this space are evolving from vendors to strategic partners, helping benefit leaders use data to make smarter choices and design plans that cut costs while improving care access, according to Al Marino, Trucordia's health and benefits practice leader.

"Clients have some serious fiduciary pressures now that they didn't have before," Marino says. "Employees are demanding more … so it's really on brokers to act as a strategic partner." 

Employer-sponsored plans are expected to see an average increase of 6-9% in 2026, while Affordable Care Act (ACA) marketplace plans are predicted to rise by as much as 26%, according to a recent analysis by KFF. The surge is being driven by the rising popularity of expensive GLP-1 drugs like Ozempic, the threat of tariffs and increasing hospital costs. 

Benefit leaders facing these hikes are increasingly turning to strategies built around data access and transparency, Marino says. For example, employers can now analyze claims data to see if a particular healthcare network's hospitals are actually delivering better outcomes for the cost.

Read more: How offering seamless healthcare can lower costs

Yet according to the Pulse of the Purchaser 2025 report released by the National Alliance of Healthcare Purchaser Coalitions, nearly one-third of employers still lack access to claims data. However, those with complete information were more likely to use high-value approaches such as direct contracting, centers of excellence and site-of-care redirection.

This puts employers in a position to be more proactive when shopping for healthcare plans instead of relying on an annual negotiation based on general trends. 

"Without data, we'd be lost at this point," Marino says. "We're really able to show a lot of reasoning why we're doing things so that an employer can see what's working and understand the return on investment."

Trucordia

Cost containment can be at odds with improving access to care, but Marino says that with all of the tools and data available to companies today it doesn't have to be. Shifting to value-based care, reducing waste and leveraging telemedicine and can improve access and quality while controlling costs. 

Read more: How to transform healthcare with employee-first benefits

For benefit leaders, the challenge lies in explaining how these strategies can be a positive for both the employer and employee. 

"Getting them to the best doctors who have the best outcomes, perform new surgeries 50 times a week, diagnose correctly right away and don't have recurrences — that's in the best interest of everybody," Marino says. 

Alternative funding programs

As prescription drug costs continue to rise, another strategy that employers and health plan sponsors are implementing is the use of alternative funding programs (AFPs). An AFP is a third-party entity that works with employer-sponsored health plans to identify alternative ways to cover plan participants' high-cost specialty drugs.

According to the American Medical Association, AFPs come with some risks for employees. The application process and administrative back and forth between the patient and the AFP can result in delays accessing lifesaving medication. Patients may also be deemed ineligible for assistance programs due to income limits, leaving them with no coverage under their health plan for the excluded drug and responsible for the entire cost.

"A lot of employers that aren't familiar with it just think it's too risky," Marino says. "They're a little skeptical about taking this leap. But I think in this day and age, it's the only way you're going to bend the cost curve."