2027 employer cost questions

What Is Driving 2027 Health Plan Costs?

Employers name catastrophic claims, specialty prescription drugs, GLP-1 drugs and cancer most often in the 2027 surveys. Pharmacy is growing about twice as fast as total cost of care, and hospitals take the largest share of each premium dollar.

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The drivers

Where the pressure comes from

The charts show how fast each cost line is growing and where the premium dollar goes.

Cost growth, 2026 (percent)

Bar chart of 2026 cost growth: pharmacy 14.8 percent, per person 7.9, family of four 7.2, KFF premium 5Milliman: pharmacy14.8%Milliman: cost per person7.9%Milliman: family of four7.2%KFF: average family premium5%

Sources: 2026 Milliman Medical Index; KFF 2026 survey. Milliman measures total cost of care and KFF measures premiums, so they are not the same measure.
Where the premium dollar goes (cents)

Bar chart of cents per premium dollar: hospitals 40.7, drugs 23.6, doctors 12, administration 4.5, taxes 3.1, profit 2.5Hospitals40.7Prescription drugs23.6Doctors and clinicians12.0Administration4.5Taxes and fees3.1Profit2.5

Source: AHIP, an insurer trade association, 2022 to 2024 averages across employer and Marketplace plans. PhRMA disputes the breakdown. The six items shown total 86.4 cents.

Pharmacy

The 2026 Milliman Medical Index shows pharmacy cost rising 14.8 percent against 7.2 percent for the family-of-four total. Specialty drugs are the reason employers name most often.

GLP-1 drugs

Employers are deciding whether to keep, limit or drop coverage for weight-loss GLP-1 drugs. In one survey of 105 large employers, 67 percent covered them and 10 percent of those were likely to stop.

Hospitals and large claims

In AHIP’s breakdown hospitals take 40.7 cents of each premium dollar. A few catastrophic claims can also drive a small group’s renewal.

Questions answered

2027 market outlook questions.

Why is pharmacy growing faster than other costs?

Milliman reports pharmacy cost up 14.8 percent in its 2026 index, and employers name specialty drugs and GLP-1 drugs among their top concerns.

Are hospital prices the biggest cost?

In AHIP’s breakdown hospitals take the largest share of the premium dollar at 40.7 cents. AHIP is an insurer trade association and PhRMA disputes its breakdown, so treat it as one view.

Can a small employer do anything about drug costs?

A fully insured small group has limited control over drug pricing, but plan design, formulary and tiering choices, and marketing the plan can change the cost. Larger and self-funded groups have more levers, including pharmacy benefit design.

Let’s Get to Work

Send us your renewal.

We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.

What to send

The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier

Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.

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