5 Things Employers Should Know About Their Health Plans Going Into 2026
As employers prepare for another cycle of rising healthcare costs and shifting regulations, 2026 is already shaping up to be a year where strategy matters more than ever. From new transparency requirements to innovative plan design strategies, the groups that plan early will have the biggest opportunity to control costs and improve employee experience.
Below are the top five areas employers should keep on their radar as they get ready for 2026.
1. Your Renewal Strategy Needs to Start Earlier Than Ever
Delays in carrier data, rising pharmacy spend, and a more complex vendor landscape mean employers who wait until late Q3 lose valuable leverage. Early preparation helps ensure your team has enough time to evaluate options, negotiate effectively, and implement any plan updates before January 1. Employers looking for additional support as they plan for 2026 can access tools and guidance through ACS’s dedicated Employer Resources page.
What early preparation allows you to do:
- Negotiate from a stronger position
- Identify alternative funding or network options
- Complete plan changes without last-minute disruptions
2. New Transparency Rules Will Change What Employers Can Expect
Regulatory updates rolling out in late 2025 and 2026 are designed to make pricing and performance more visible across carriers, networks, and PBMs. Employers can expect clearer reporting on plan performance, pharmacy pricing, rebate structures, and justification requirements for certain cost trends. While these updates add administrative layers, they also unlock new opportunities for employers to understand and question the true cost of care.
3. Rising Pharmacy Costs Will Play an Even Bigger Role in 2026
Specialty drugs continue to drive a growing share of total spend, and many employers will see pharmacy account for nearly half of all claims costs. Specialty drugs now dominate the pipeline. In 2024, they accounted for 75% of all drugs in development, underscoring why pharmacy spend and plan strategy must stay front-and-center1. Understanding your PBM contract, evaluating alternative sourcing strategies, and reviewing which clinical programs are already in place will be essential. Pharmacy strategy will remain one of the most influential levers for controlling costs next year.
4. Plan Design Innovation Is Becoming a Competitive Advantage
More employers are exploring strategic plan designs that prioritize high-value care and simplify the member experience. Tiered networks, condition-specific care pathways, direct primary care integration, and redesigned incentives are all making meaningful differences in both outcomes and employee satisfaction. To explore the types of innovative benefit solutions employers are adopting, you can review ACS’s full suite of offerings on our Products & Services page. The employers who treat plan design as a strategic tool, rather than a once-a-year decision, will gain the most flexibility going into 2026.
5. Data-Driven Brokers Are Helping Employers Get Ahead
With more analytics available than ever, brokers who lead with data are giving employers a clearer picture of what’s driving their costs.
A strong broker should help you:
- Monitor monthly claims trends
- Model alternative plan designs
- Forecast pharmacy exposure
- Build a multi-year benefits strategy
Employers who rely only on renewal spreadsheets will find themselves reacting instead of planning. Data-driven partners help employers stay ahead.
Ready to Strengthen Your 2026 Strategy?
Your best opportunity to control costs next year starts with the actions you take today. If you’re new to ACS or want a deeper look at our philosophy and approach, the About Us page is a great place to start.
When you’re ready to build a smarter, more proactive plan for 2026, our team is here to help.