67% of companies with ten or more workers offer health benefits; 98% of companies with 200 to 999 employees do and 99% of those with more than 1000. 92% of all employees have access to an employment-based health plan. At firms that offer a plan, 80% of employees are eligible and 74% of those who are eligible enroll in the plan. Some organizations offer incentives to employees to enroll in a spouse’s plan or to otherwise not enroll in the plan.
The weight loss drugs known as GLP-1s are a big cost concern due to price and utilization. Employers haven’t been convinced that those medications provide a net cost benefit. Most employer plans don’t cover them and some which did have dropped coverage in 2026.
Employers continue to struggle with drug costs overall and are turning to vendors outside the traditional large pharmacy benefit managers to help with those costs. Encouraging generic use is very common and finding sources of low-cost drugs for employees is a focus. There is growing coverage of IVF services for couples seeking to become preganant.
Many employers are adding substance abuse and mental health providers and benefits.
Although prior authorization has become controversial and is limited in some states, most employers are keeping the number of services requiring prior authorization the same or are adding to that number. It is hard to control utilization without prior authorization or very high copays on services. Otherwise you are totally reliant on whatever a doctor decides to order.
Employers continue to feel frustration with the adequacy of information they get on service utilization, employees’ medical needs, and prices and price comparisons. I think the bigger problem is that most employers have no idea how to use the information that they get.
Employers are generally quite unhappy about the cost of services under their plan. They are more satisfied with the quality of care, although I doubt they know how to manage it. Generally there is “satisfaction” with employees access to care, with the information they receive, which seems contrary to other reported findings on information satisfaction, and with other aspects of their health plan. I think the reality is that most employers would dump health benefits if they could figure out how to do it without losing employees.
One of my doctors said that no practice can survive without private payers because Medicare/Medicaid payments are so low and that they must limit the number of government supported patients. I also have encountered practices that won’t accept a new Medicare patient.
How would it be possible to run a “Medicare for all” program without super strict rationing? I am amazed at the number intelligent (I guess) , educated adults who don’t understand how this works. Some advocate getting rid of private insurance entirely which aside from medicine and direct cost issues would have consequences for investors – particularly large investors like pension plans.
What about starting an education program so that voters understand possible outcomes here?
I’ve always thought that employers paying for healthcare makes about as much sense as them paying your rent or buying your groceries.