Employers Prioritize Cost Control While Maintaining Worker Benefits

Faced with mounting health care expenses and macroeconomic headwinds, employers have fundamentally shifted their benefits strategy priorities, with controlling costs now dominating their strategic agendas, according to the second annual Brown & Brown Employer Health and Benefits Strategy Survey.

The survey of 1,241 employers with at least 200 U.S.-based employees found that cost management has jumped to the top priority (cited by 42%), displacing talent attraction and retention (37%) from last year’s number one position—a telling indicator of the financial pressures reshaping the benefits landscape, according to the report.

More than half (56%) of respondents report that inflation and economic volatility have substantially impacted their health and welfare strategies. In response, employers are deploying traditional financial levers, with 81% evaluating stop-loss plan designs while also conducting audits (79%) and requesting medical and pharmacy proposals (79%).

Beyond these conventional approaches, many are turning to digital health and wellness solutions (80%), while simultaneously increasing plan transparency (79%) to give employees greater visibility into their health care costs.

One emerging cost challenge is the popularity of GLP-1 medications for weight loss, Brown & Brown said.

Nearly half of survey respondents (48%) now cover these drugs, though 63% of this group have implemented coverage restrictions beyond standard prior authorization requirements. These restrictions include requiring members to meet clinical criteria beyond FDA guidelines (49%), participate in lifestyle programs (38%) and limit prescribing sources to a designated provider (35%)—a balancing act as employers attempt to manage access while controlling expenses.

Well-Being and Work-Life Benefits Remain Employer Investment Priorities

Despite the intense focus on cost containment, employers are maintaining their commitment to employee well-being and quality-of-life benefits, according to the report.

Three-quarters of respondents indicate that well-being programs remain central to their health care strategies, and 78% plan to increase their well-being-related budgets either slightly or substantially. This sustained investment reflects a “whole person” approach, with most employer programs addressing multiple dimensions of health and well-being, Brown & Brown noted.

Parental leave represents another area where employers are enhancing the employee experience. Seven in 10 survey respondents offer paid parental leave programs that exceed statutory or state requirements for at least some employees. Among those planning to modify their policies in 2026, a substantial number intend to increase benefit rates and amounts (69%) or leave duration (60%)—recognizing the positive associations between parental leave and employee retention, engagement and productivity.

Employers Embrace Active Role in Reshaping Health Care

A striking shift in employer sentiment reveals a growing willingness to drive healthcare system change rather than wait for external solutions. Only 6% of employers prefer a passive “wait and see” approach, a dramatic decline from 16% in the previous year’s survey. More than half of respondents report actively advancing with readily available or innovative solutions, indicating a fundamental mindset change as employers move from bystander to strategist in healthcare transformation efforts.

View the full survey here. &