Emerging Benefits Trends Every Broker Should Know for 2026

Employers across the US are entering 2026 with rising healthcare costs, shifting workforce needs, and growing expectations. While they are looking for clearer explanations and insights, members want simpler navigation, quicker support, and information that is easier to understand.

For benefit brokers and consultants, this creates both new challenges and meaningful opportunities, but understanding the forces behind that shift is essential.

These are the emerging trends for 2026 that are shaping self-funded and level-funded employers and what brokers need to know to guide clients with stronger strategies, clearer data, and more connected solutions.

1. Reference-Based Pricing Evolves to a Member-First Focus

Reference-based pricing is evolving. Instead of relying on aggressive repricing strategies, employers want models that support members throughout the care experience, emphasizing:

• Consistent member advocacy when billing issues occur.
• Clear reporting that identifies savings opportunities throughout the year.
• Simplified provider navigation to help members confidently find fair-priced care.

Employers pursuing RBP want partners that combine meaningful savings with strong member support, and brokers who understand this shift are better positioned to act as an expert partner.

2. Digital Platforms Become Essential

Digital tools are no longer considered extra. Members expect one reliable platform that offers quick access to:

• Benefits and claims.
• Telehealth options.
• Provider search tools.
• Spending details.

As employers upgrade their benefit strategies, broker guidance will play a major role in identifying digital platforms that support simpler navigation and stronger plan awareness.

3. Voluntary Benefits Strengthen Employer Plans

Facing budget constraints, employers are expanding voluntary offerings that enhance employee value without increasing their fixed costs. The most in-demand programs include:

• Supplemental health benefits.
• Mental health support.
• Caregiving assistance.
• Financial wellness tools.
• Lifestyle and wellbeing programs.

Employers want voluntary benefits that integrate seamlessly with their main plan, and brokers will be central to designing coordinated offerings that keep plans competitive moving forward.

4. Transparency and Accountability Are the New Priority

New regulations and high-cost claims are pushing employers to demand clearer reporting, predictable fees, and honest vendor accountability, and they’re prioritizing partners that can provide:

• Real-time cost pattern reporting.
• Clear vendor performance metrics.
• Transparent fee structures.
• Visibility into billing and network arrangements.

Brokers who champion transparency, interpret data, and flag issues early strengthen their advisory role and become the partners that employers can rely on.

5. Flexible Plan Designs Become a Must-Have

Rigid plans are becoming harder to maintain as workforces grow more diverse and healthcare expenses shift throughout the year. Employers increasingly prefer plans that allow:

• Mid-year adjustments.
• Testing or replacing vendors.
• Adding programs without overhauling the structure.
• Gradual transitions to self-funding or level-funding.

Flexibility is no longer a perk. It is a strategic advantage that helps employers manage spend and reduce renewal surprises.

6. Predictive Analytics Transform Cost Management

Employers are moving away from retrospective reporting and adopting tools that help them act earlier. Predictive analytics now enables brokers and employers to identify:

• Emerging chronic condition risks.
• Specialty drugs spend patterns.
• Preventive care gaps.
• Provider cost variation.

These insights help brokers proactively coordinate solutions, evaluate vendor performance, and support employers in minimizing major surprises at renewal.

Preparing Starts Now: How Should Brokers Prepare for 2026 Renewals?

To meet employer expectations and market pressures, brokers can strengthen their value proposition by focusing on:

• Transparent reporting that clarifies where plan dollars go.
• Stronger digital experiences that simplify member navigation.
• Flexible plan designs that accommodate changing employee needs.
• Data-driven recommendations based on predictive analytics.
• Vendor accountability, supported by a clear, early interpretation of trends.

Aither Health is committed to supporting brokers with the services and expertise needed to navigate these changes with confidence, including:

• Transparent, real-time reporting that clarifies claims, drivers, and cost trends.
• Member-friendly digital tools that simplify navigation and reduce confusion.
• Flexible plan structures built to evolve with employer needs.
• Predictive analytics and expert guidance to help brokers act earlier and stay ahead of rising costs.

As 2026 approaches, contact Aither Health to access the clarity, tools, and partnership needed to confidently guide employers through an adapting healthcare landscape.