US employers are absorbing record cost pressures rather than passing them on to workers but unless they fix a deepening benefits literacy crisis, the extra coverage they are stacking to bridge affordability gaps will go largely unused.
Nicole Negvesky, Executive Vice President of Employee Benefits at Alera Group in Chicago, spoke to Insurance Business Benefits building on Alera Group's latest benchmarking report.
"Cost pressures are off the charts coming from all angles," Negvesky said. "And we're not seeing employers pass that on to employees right now. They're seeing moderate increases in their paychecks, but they are probably seeing more benefit coverages added to bridge some of the gaps that are created."
According to Alera's benchmarking data, accident coverage alone jumped from 30 percent of employers in 2024 to 41 percent in 2025, a clear signal of how quickly supplemental products are being layered onto already complex plan menus.
Employees may now be choosing between as many as four medical plans, two dental options, and an array of voluntary coverages, each designed to fill a different financial gap. The problem, Negvesky says, is that the education infrastructure to support those choices has not kept pace.
"We've added such complexity that I don't know if we're supporting it well enough on the back end with education to really help the employee make a truly informed decision," Negvesky said. "Historically, we've seen very low utilization of supplemental plans. We've got to figure out a way, if we're spending money on these benefits, to make sure employees understand them."
She says responsibility is shared between employers and their brokers. A single open enrollment meeting or a benefits guide dropped in an inbox once a year is no longer fit for purpose.
"It can't be one time," Negvesky said. "It has to be continual education, concise, clear, and frequent. People need to hear something eight or nine times before they commit it to memory. If we're just teeing that up at open enrollment time, we're doing them a disservice."
The format of that education is important and Negvesky pointed to benefits brokers using short-form video to close the employee education gap as a practical starting point.
"An hour-long open enrollment presentation might not be a great thing," she said, "but a two-minute video that explains a piece of the benefits program might be more digestible to a lot of the population."
With up to five generations currently in the workforce, delivery channels must be tailored, though Negvesky noted that storytelling works across demographic lines as a universal bridge.
The opportunity for benefits brokers to enhance the trust placed in them by employers has been highlighted recently by Tony Greene, President of NFP Executive Benefits in New York, in an interview with Insurance Business Benefits.
Negvesky sees artificial intelligence playing a growing role in closing the navigation gap, not by replacing human expertise but by giving employees a clear starting point when they are unsure where to turn.
"I think AI can really be a front door for how we're going to access benefit information," she said. "You've got a situation: Do I go to the EAP? [Employee Assistance Program]. Do I go to my primary care? Do I call my accident provider? Being able to use AI to navigate that, I think, would resonate really well."
Perhaps the most pointed advice Negvesky offers is not about what employers should add to their benefits programs but what they should remove.
After years of layering products to plug perceived gaps, she says many employees have reached a point of benefits fatigue, disengaging from an overwhelming menu rather than engaging with it.
"We swung the pendulum. We said we're going to offer a hundred things and keep throwing things at employees until somebody says this feels good," she said. "And we find out we've created a lot of fatigue. People throw their hands up and say, I don't know where to go, so I'm just not going to do it."
Her prescription is a three-step portfolio audit: assess utilization on every program and point solution already in place; retire what is not being used; and only then evaluate what genuinely needs to be added for a specific employer population.
"If your benefits program isn't driving value to your employees, it's not doing what it's intended to do, which is attract and retain talent," she said.
That framework also applies to the hottest cost debate in group benefits right now. Negvesky expects more employers to pull GLP-1 coverage for weight loss specifically, distinguishing it from the medication's established and effective role in treating diabetes.
High utilization, unproven return on investment, and a significant abandonment rate (employees starting the drug, finding they cannot sustain the out-of-pocket cost, stopping, and regaining weight) make it difficult to justify the pharmacy spend.
"Nobody's coming out with a true ROI on it yet," she said. "And that's why we're seeing employers pull GLP-1s as a weight-loss tool right now because there's still too much to be seen."
Alera's benchmarking data adds another dimension to that cost picture: pharmacy copay tiers have remained unchanged despite large increases in pharmacy costs, meaning employers are absorbing the full incremental expense.
It is a pattern that Negvesky sees as consistent with a broader cultural shift. "While there are significant cost pressures on employers right now, we're not seeing them want to push that back on the employee," she said. "There's a structural change happening in employee benefits; we've got to move away from traditional cost-containment mechanisms."
For benefits brokers advising employer clients in the second half of 2026, Negvesky's message is that the competitive advantage is no longer in offering the longest list of benefits. It is in ensuring that employees understand what they have, know how to use it, and can access it when they need it.
"I think maybe the next generation of value creation is really in helping employees understand what they have so that they can be a better consumer," she said. "And then that's going to drive better value in the overall program to both the employer and the employee."
For further data on employer cost-sharing trends, the Kaiser Family Foundation 2025 Employer Health Benefits Survey provides a benchmark on premium contributions and cost-sharing across US plan types. Pharmacy cost trends are tracked in detail by the Department of Labor's Employee Benefits Security Administration (EBSA) health and welfare data resources.
