The Advisor's Edge - February 2026
Difficult Renewals, News You Can Use, and a Few Items Worth Sharing
What the #@!! Just Happened? Understanding the 2026 Healthcare Cost Crisis
If you feel like you were just hit by a truck, you’re not imagining things.
The 2026 renewal cycle has been one of the most brutal in recent memory. Employers across the country are staring at double-digit increases, asking the same question: “What the hell happened?”
The answer isn’t simple. But it’s findable.
After 24 years in this business, I’ve seen plenty of challenging renewal seasons. This one stands out. Not just because of the size of the increases, but because of how many forces converged at once. Specialty drugs exploded. Mental health costs embedded themselves across every care pathway. GLP-1s went from niche diabetes treatments to mainstream metabolic therapy. And the post-pandemic catch-up care wave is still surging.
The data from Springbuk’s 2026 Employee Health Trends report makes it clear: this isn’t a temporary spike. These are structural shifts that will shape your benefits strategy for years to come.
Here’s what you need to understand about what’s driving your costs right now.
GLP-1s: From Disruption to Foundation
About 30% of current non-specialty brand-name drug spend is for GLP-1s used in diabetes treatment. Another 10% is for obesity treatment. While most employer plans exclude weight loss treatment options, we’re seeing some leakage.
GLP-1s have gone from niche to mainstream faster than almost any drug category in history. And demand shows no signs of slowing. Potentially lower price points, introduction of oral GLP-1s for obesity, greater use for cardiovascular risk reduction, and potential new indications like chronic kidney disease are all on the near-term horizon.
The increasing spend isn’t primarily from higher prices per prescription. It’s from more members taking these drugs. And that number will continue growing.
What’s critical to understand is that GLP-1s are becoming foundational metabolic therapies with cost implications that extend far beyond obesity. These drugs impact cardiovascular health, kidney function, and long-term diabetes management. The question isn’t whether to cover them. The question is how to structure coverage in a way that’s clinically appropriate and financially sustainable.
As of now, only 42% of users remain on their medications for more than 90 days. Until those compliance rates increase, the costs incurred make it difficult to justify additional investments.
Mental Health: Embedded Across Everything
Mental health costs are not episodic. They are embedded across care pathways.
Depression is the #1 driver, bigger than any behavioral health condition. Mental health condition group spend climbed from $8 PMPM in 2022 to $10.19 PMPM in 2025 for depression alone. Behavioral health overall went from $16 PMPM to $20.58 PMPM.
Therapeutic services, evaluation, and management are carrying most of the spending growth. Interestingly, telehealth did not drive growth, contrary to what many assumed. And the age group seeing the fastest rise in therapy utilization is 35-49, not younger employees.
What this tells us is that mental health isn’t a standalone benefit category. It’s woven into chronic disease management, musculoskeletal issues, gastrointestinal conditions, and productivity across your entire workforce.
The Visibility Problem
Here’s the underlying issue that makes all of this harder to manage: employers not only have a cost problem but they also have a visibility and prioritization problem.
Every missed opportunity adds up, driving costs 10-15% higher and leaving millions on the table. When you don’t have clear data on where your costs are clustering, you can’t design targeted interventions. You’re left making generic plan design changes that shift costs to employees without addressing root causes.
When you can see these patterns in your own population, you can act with precision. Self-funded employers have a significant advantage here. You have access to your data. You can see exactly where your costs are concentrated and design programs that address your specific population’s needs.
Five Strategic Trends to Watch in 2026
Beyond the cost drivers themselves, five broader trends are reshaping how employers need to think about benefits strategy:
1. Pharmacy strategy becomes central to overall affordability
Pharmacy is no longer a separate silo. It’s driving overall benefit plan affordability and patient experience. Integrated pharmacy strategies that address both medical and Rx channels, manage specialty drug utilization, and create clear coverage policies for GLP-1s will be table stakes in 2026.
2. Benefits as a talent lever intensifies
Benefits continue to be a key differentiator in hiring and retention, especially as employee expectations shift toward more flexible, personalized, and purpose-driven offerings. The organizations that treat benefits as a strategic talent investment will outperform those that treat it purely as a cost center.
3. Consumer experience expectations accelerate
Employee expectations for the healthcare experience will continue to accelerate, driving investment in AI-powered personalization, digital navigation tools, and integrated care experiences that deliver simplicity, clarity, and proactive support. Employees want healthcare to feel as seamless as every other consumer experience in their lives.
4. Advanced analytics become non-negotiable
As healthcare costs continue to grow more complex, advanced analytics, forecasting, and consumer-centric strategies will play a larger role in helping employers stabilize budgets and reduce year-over-year volatility. The organizations that invest in data infrastructure and analytical capabilities now will have a decisive advantage.
5. Health and Performance regain prominence
With these types of increases rocking employers, we have to revisit conversations about keeping your people well. If you haven’t made effort to remove barriers to care and explored incentives for primary care partnerships, it’s time to consider those. As well, “Know Your Numbers” campaigns that were once commonplace in the early 2000’s must be revisited. Trends indicate people are ignoring the blocking and tackling now that could prevent crisis conditions later.
Three Questions for 2026
As you process these trends and turn to your own data, three questions should guide your strategy:
1. Where are my costs really coming from?
2. Who in my population is being left behind?
3. Am I set up to adapt or just to react?
These questions don’t have easy answers. But they have findable answers when you have the right tools and the right approach to your data.
The 2026 renewal cycle was brutal. But it also created clarity. You now know exactly how much it costs to operate without visibility, without targeted interventions, without data-driven prioritization.
The question is what you do with that knowledge.
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Sources:
- Springbuk + Truven Health Analytics, Employee Health Trends 2026 Report
- Cigna 2026 Health Care Trends report
- Mercer 2025 National Survey of Employer-Sponsored Health Plans
News You Can Use
1. Understanding Benefit Use Gaps
HUB recently released our 2025 Workforce Vitality Gap Index report. One of the key topics address is why employees are not using your benefits and what to do about it. Check out the report here.
2. 2026 Compliance and Benefits Update
We’ll be hosting our 2026 Compliance and Benefits webinar on February 25th. Learn more and register here.
3. DisruptHR Northern Colorado on March 3rd
DisruptHR isn’t just an event, it’s a reset, and DHR Northern Colorado 6.0 is raising the bar even higher.
Yes, you’ll get fast-paced, thought-provoking presentations and a room full of people who love challenging the status quo, but what really sets the Northern Colorado event apart is the experience. During the event, we come together as a group to participate in a live fundraiser for a local cause, turning the energy in the room into real impact for our community.
Add in interactive games, meaningful networking, food and beverages, and the chance to win some seriously fun door prizes, and you’ve got an event that’s engaging from start to finish with multiple chances to get up and stretch your legs!
Past Door Prizes Have Included:
⌚ Apple Watch
📱 iPads
🧊 YETI Coolers
🍷 Wine Sampler Baskets
💳 Gift Cards
✈️ Grand Prize: $500 Southwest Airlines Gift Card
Stick around until the end. You might leave inspired and planning a getaway.
When? March 4th at 1 PM
Where? The Candlelight Dinner Theatre - 4747 Marketplace Dr, Johnstown, CO 80534
What to Bring? Just your disruptive self! Drinks and light food will be provided.
Click Here to get your tickets (only $25)
Worth Sharing
In the feature article above, I addressed revisiting “know your numbers” campaigns. The benefits of doing so are front and center for me, as my wife and I just signed up for Function Health.
While a number of testing companies are emerging, this one offered a nice mix of affordability and comprehensiveness.
Function’s website says, “A fulfilling life depends on health, and health depends on awareness. You are the source of your truth and we are here to enrich you with the deepest awareness of what is happening within you.”
Said another way, “A healthy person thinks about a lot of things. An unhealthy person mostly thinks about a single thing.”
If you’d like to know your own numbers, I’d be honored if you did so using my referral code. Function Health charges $365 for two tests a year that will exam over 160 biomarkers.
To your health,
Jim Sampson