Dueling Pressures Push Employers to Reinvent Their Benefits Strategy

NFP's 2026 U.S. Benefits Trend Report reveals GLP-1 demand and AI readiness are forcing employers to consider tradeoffs across cost, risk and workforce

NEW YORK, Jan. 21, 2026 /PRNewswire/ -- NFP, an Aon company and leading property and casualty broker and benefits consultant, today released its 2026 NFP U.S. Benefits Trend Report based on separate employer and employee surveys. The report highlights employers' dueling challenges: rising benefits costs straining budgets and growing employee financial burdens impacting engagement and retention. The research shows that nearly half of employers expect healthcare budgets to rise in the next plan year.

"Across industries, leaders are shifting from a transactional view of employee benefits to a more purposeful approach that balances financial stewardship with the responsibility to support a workforce under growing strain," said Doug Hammond, CEO of NFP. "Employers that interpret this complexity and intently align their benefits offerings to organizational resilience and the employee experience will position themselves for success."

GLP-1s Reshape Pharmacy and Talent Strategy
Pharmacy benefits are evolving beyond legacy and specialty drugs into a three-pillar cost model: declining legacy medications, rising specialty prescriptions and fast-growing GLP-1s. This transformation is reshaping benefit design, affordability strategies and cost planning, with 70% of employers anticipating a pharmacy cost increase in the coming year.

Pharmacy cost remains one of the most volatile components of employer healthcare budgets, and four in ten employers are very or extremely concerned about sustainability. GLP-1 utilization for diabetes and weight-loss treatments is surging, with 51% of employers citing these drugs as a top driver of rising prescription spend.

The talent impact is real: nearly three in ten employees (29%) say they would consider changing employers for GLP-1 coverage.

"GLP-1s have created two markets: diabetes care with clear clinical justification and weight management where coverage decisions vary," said Kim Bell, EVP, head of Health and Benefits, NFP. "When nearly a third of employees say GLP-1 coverage could influence employment decisions, it's more than cost control. Employers treating coverage as a differentiator will gain an edge in a tight labor market."

The report highlights opportunities for employers to ease some dueling pressures by replacing outdated practices, leveraging technology and using data-driven insights. Nearly half of self-funded employers (49%) now carve out pharmacy benefits with a pharmacy benefits manager, up from 27% in 2025, while many tighten prior authorization, reinforce step-therapy and explore outcomes-based contracting.

Wellbeing Gaps Demand Integrated Solutions
Employee wellbeing is universally acknowledged as critical, yet survey data reveals a widening gap between intent and outcomes. Despite escalating behavioral health concerns, employer investment in mental health resources is uneven, with average spending per employee dropping by roughly 7% year-over-year.

While nearly all employers offer some form of mental wellbeing support, many lack a cohesive strategy to address stress and burnout. Fewer than half (40%) provide burnout prevention training. Meanwhile, strain is rising: more employees report feeling distracted, under-recognized, insecure about job stability, less cared for by their employer and unfairly compensated.

The findings also revealed a clear gap between employer intent and employee experience around wellbeing program communications. While 63% of employers rate their wellbeing communication as strong, only 42% of employees agree.

"A sustainable wellbeing strategy hinges on mental health, mental wellbeing and career wellbeing connecting every aspect of the employee experience through alignment and communication," said Bell. "But many employees remain uncertain about what wellbeing programs exist, how to access them or whether they're robust enough for the demands of modern work."

Financial Stress: The Silent Productivity Killer
Financial wellbeing remains the biggest disconnect between employer intent and employee reality. Two in five employees have less than $500 in emergency savings, and more than a quarter cite money as their top workplace stressor. Yet only 35% of employers offer structured financial wellbeing programs that provide the tools, coaching and confidence to manage income effectively.

Non-work distractions compound the challenge. Many employees who were surveyed point to debt, caregiving and affordability of basic expenses as barriers to focus. Elder care in particular is a growing strain, with reported distractions climbing from 22% to 28% in just one year.

"Financial wellbeing isn't about quick fixes. It's centered on connecting everyday choices to long-term security," said Beth Robertson, co-leader, Health and Benefits, NFP. "When employers expand wellbeing to address the broader systems that shape daily life, such as ensuring that financial education, coaching and plan design align, confidence soars, participation climbs and organizations gain stronger retention and stability."

AI Governance: HR's New Mandate
The report also examined HR trends around AI readiness and found only 28% of employers have a comprehensive governance policy in place. This gap creates a new AI governance risk rooted not in the technology itself but in the absence of rules to guide its use.

Many employers are experimenting with AI — 51% are testing it for performance analytics, and 52% are using AI-powered learning platforms. However, inconsistent preparation for working with AI tools is fueling career uncertainty for half of employees.

States like Colorado, New York and California are introducing legislation requiring algorithmic transparency and bias audits in employment decisions, pushing HR leaders into a shared responsibility for AI compliance alongside other business leaders.

"HR is no longer a back-office function. It's where AI governance, workforce strategy and employee trust converge," said Robertson. "Organizations that get this right should have HR leaders at the table shaping how technology is deployed responsibly across the business."

As employers enter 2026, the report points to a common thread that the most pressing benefits challenges, rising pharmacy costs, wellbeing gaps and AI readiness, are interconnected pressures that demand coordinated responses.

"Success won't come from reacting to each pressure in isolation," said Robertson. "It comes from connecting the dots of costs, wellbeing and technology to empower employees and businesses to thrive."

About the 2026 U.S. Benefits Trend Report
NFP's 2025 Benefits Trends Employer Survey and Benefits Trends Employee Survey were administered online in October 2025. They included 500 employer health insurance benefits decision-makers, as well as 1,012 full-time, part-time, self-employed or contract workers receiving benefits through their employer.

About NFP
NFP, an Aon company, helps companies and individuals address today's most significant risk capital and human capital challenges. 

With colleagues across the U.S., Canada, UK and Ireland, and global capabilities enhanced by the Aon advantage, NFP serves a diversity of clients, industries and communities. Our collaborative team provides specialized expertise and customized solutions, including property and casualty insurance, employee benefits, life insurance, executive benefits, wealth management and retirement plan advisory.

SOURCE NFP Corp.