Employers pulling back on glucagon-like peptide-1 (GLP-1) weight management coverage now have a defined-contribution alternative that stops short of cutting access entirely.
Alight, Inc., a Deerfield, Illinois-based benefits administration company serving more than 30 million people, launched a health reimbursement account (HRA) product designed specifically for GLP-1 medications. The Alight GLP-1 HRA lets employers reimburse employees for eligible GLP-1 drug costs through a fixed, employer-funded structure rather than open-ended coverage embedded in the core health plan. It operates alongside HSA and high-deductible health plan combinations in compliance with Internal Revenue Service (IRS) rules. Employers can set eligibility criteria, contribution limits, and funding models, including utilization-based and pay-as-you-go options.
The launch comes as employer GLP-1 coverage is contracting. Business Group on Health’s survey of 127 large employers found the share covering GLP-1 agonists for weight management fell from 72% in 2025 to 60% in 2026, with 14% having already dropped or planning to drop that coverage by 2027.
Alight’s own data points to the scale of the demand driving that pressure. Across its Navigation book of business, GLP-1 drugs made up 42% of prescriptions reviewed for members in 2026, up from 32% in 2024, and 16% of those reviews had a lower-cost alternative available, with an average annual saving of $2,790 per drug when a substitute was identified. These figures are self-reported from Alight’s client base and have not been independently verified.
The structure Alight is offering is not new. WEX launched a comparable GLP-1 HRA in March 2026, and Alight’s entry signals the approach is moving from an emerging workaround into a product category that major benefits platforms are building infrastructure around.
The International Foundation of Employee Benefit Plans’ 2026 GLP-1 Drugs Pulse Survey, fielded June 2 to June 12 among US employers, found that 21% are already directing employees to use FSA, HSA, or integrated HRA accounts for GLP-1 costs, suggesting the demand for structured alternatives to open-ended coverage is already established.
An HRA carve-out removes GLP-1 medications from the main drug plan and funds them through a defined monthly or annual contribution, giving the employer a fixed, predictable cost ceiling. Employees retain access to the drugs within a capped reimbursement framework.
Two structures are commonly used. An integrated HRA ties the benefit to the employer’s existing group health plan, has no IRS-set contribution cap, and can be designed with higher annual limits, but requires plan integration and cannot coexist with an HSA-eligible high-deductible plan without careful structuring. An excepted benefit HRA stands separate from the group plan, can be offered alongside an HDHP, and carries a 2026 contribution cap of $2,200 per employee; the employer must still offer a traditional group plan to the same employees, though enrollment in it is not required.
“Employers are looking for practical ways to respond to growing demand for GLP-1 medications while balancing access, affordability and cost management,” said Karen Frost, senior vice president and health and navigation solution leader at Alight in Deerfield, Illinois. “Our solution provides the infrastructure, flexibility and insights to define the support employers want to provide, set clear guardrails and give employees a simpler path to eligible reimbursement.”
Plan design decisions around GLP-1 carve-outs carry a specific risk. As employers move toward direct HRA platforms administered by benefits technology companies, the conversation about program architecture may happen at the platform level rather than with the broker.
Rick Kelly, national pharmacy lead and senior vice president, employee health and benefits at Marsh McLennan Agency in Raleigh, North Carolina, described the GLP-1 HRA question as part of a broader structural shift away from uniform benefit packages and toward foundational coverage paired with flexible, employee-directed spending.
The employer clients most at risk of making that shift without advisor involvement are mid-size companies whose HR teams lack the bandwidth to evaluate HRA structures independently and who may default to whatever the benefits administration platform recommends. Employer clients who have already dropped or are considering dropping GLP-1 weight management coverage now have a product-level alternative to outright elimination. How meaningful that access is depends on the contribution limits set relative to the actual monthly cost of branded GLP-1 injectables, which currently run between $1,000 and $1,500 per month before rebates and discounts.
