This is part two in a series about lesson's learned from open enrollment for 2026.
In the benefits speak of open enrollment for 2026, two acronyms stood out more than others:
More employers are taking a cautious approach about deciding whether to cover GLP-1s for weight loss given the growing demand for these high-cost drugs, notes Chelsea Gates, regional employee benefits practice leader for USI's mid-Atlantic region.
She recalls how several partners at a law firm client had approached their HR department midway through last year about the possibility
"And so, we did all of our number-crunching, we did the analysis, we compared them against benchmarking and comparative norms, and talked about what we were seeing in our book of business," she reports.
After weighing the human and financial sides with the law firm's benefits committee, which included the CFO and CEO, everyone's conclusion was that the juice just wasn't worth the squeeze at that particular time.
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Robby White, U.S. benefits business line leader with Gallagher, compares the rise of GLP-1s for weight loss to statins for helping lower cholesterol. Both were very expensive when they came to market and no one thought that they would take a pill for the rest of their lives (this treatment recently became available in pill form). He could envision
Embracing predictable costs
A similar scenario played out with respect to ICHRAs. Nick Bellanca, a vice president and market leader at Lockton, noticed that some large clients were now strongly considering a move to an ICHRA, which just a few years ago drew the interest of smaller groups under 100 lives. Ownership structure also dictated whether organizations would institute this change, with many private-equity firms showing more interest in having their portfolio companies move to an ICHRA to maximize EBITDA.
Dozens of Lockton clients have made the transition to an ICHRA, Bellanca notes, while a much larger percentage have considered following suit. "They've asked us to do ICHRA feasibility studies," he reports, noting that new ICHRA partners are appearing almost daily. "It's definitely a tool that can be effective for the right groups at the right time." What helps is having an advocacy component in place to guide enrollees through their choices.
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However, it's not for everyone. In one case, he says a company that put it in a year ago is already considering plans to abandon the arrangement following employee complaints about the plan's administration.
Perry Braun, president and CEO of Benefits Advisors Network, questions whether earmarking funds for employees to pick insurance products best tailored to their own risk-management needs in the individual market diminishes the perceived value of benefits.
Eyeing agentic AI
While employers grapple with these decisions, what's clear is that
He sees an easy lift around benefits in either buying or creating an agentic AI tool capable of making decisions and taking action that is solely focused on a company's benefits package. "You load in all of your SPDs and plan docs and the HR team can leverage that agent in order to ask any questions it has throughout the year about benefits at open enrollment for new hires," he explains.
He singled out Avante as one of the pioneers in relating AI to benefits with an AI agent named Carly with an interface that allows employees to ask questions about their benefits and receive immediate responses.
There's clearly no turning back from the digital age of benefits communication. "The days of paper enrollment guides and people wanting that tangible piece in their hands is going away with all the different mediums that are available now from a digital standpoint in terms of educating employees," White believes.
Adds Gates: "We're in this 24/7, 365-day communication cycle with people used to having information at their fingertips, and so we need to find better ways of doing that for them with their benefits."
