As employers wrestle with soaring healthcare costs and high-profile decisions like Starbucks pulling back coverage of glucagon-like peptide-1 (GLP-1) drugs for weight loss, the US group benefits industry is facing a fundamental question: what should a comprehensive employee benefits package actually look like in 2026?
"The conversation shifts from, can we cover everything, to how do we provide the right mix of coverage and financial protection," John Feeney, Vice President of Group Sales & Market Development at Renaissance Benefits in Washington D.C., told Insurance Business Benefits US. "This reinforces the need for employers to think beyond the medical plan alone and to build a more complete benefit package surrounding it."
The share of US employers covering GLP-1 drugs for weight loss dropped from 72 percent in 2025 to 60 percent in 2026, according to Business Group on Health survey data.
Starbucks' high-profile decision to withdraw coverage served as a flashpoint, but Feeney cautions against reading too much into any single employer's choice.
"I don't think it's a one-size-fits-all," he said. "Some employers are going to look hard at data with the help of their broker - look at what the employees are asking for, what they're demanding, probably the whole workforce demographics - and then make decisions, and they're not easy ones."
The complexity is compounded by genuine scientific uncertainty. The long-term clinical and financial implications of GLP-1 drugs remain unclear, even as their costs mount.
Feeney notes that brokers are uniquely positioned to help employers navigate this, not only because they see trends across multiple client accounts simultaneously, but because they carry their own utilization data and market intelligence that a single employer cannot replicate internally.
Coverage trends for GLP-1 drugs and the broader category of high-cost therapies, as tracked by the Kaiser Family Foundation's health cost research, point to the same structural pressure Feeney describes, that the question how benefits packages adapt as costs rise.
Feeney estimates that benefits brokers currently spend 90 to 95 percent of their bandwidth on medical plan design discussions and he does not expect that to change. But what has changed is the scope of what's expected on top of that.
"I think employers today are looking even more to brokers to help analyze those trends, evaluate emerging healthcare costs, educate employees on the overall benefits package, and identify solutions that align with what the company is looking to do," Feeney said.
He specifically emphasizes the broker's responsibility to help employers understand what he calls "unintended consequences of changes" - and to develop employee communication strategies that preserve trust when benefits are restructured or reduced. "Most importantly," he said, "communication."
That communication mandate extends beyond open enrollment season. Year-round engagement, Feeney says, is one of the most underutilized tools in a broker's arsenal.
"There should be more than just once a year," he said, noting that consistent outreach on benefits - from preventive dental's ability to detect emerging health issues to the income protection value of disability coverage - drives employee retention, supports recruiting, and creates a genuine sense of employer investment in employee wellbeing.
This echoes findings from the Society for Human Resource Management (SHRM) on benefits communication best practices, which consistently identify poor benefits literacy among employees as a root cause of low utilization rates.
One of the most consequential developments of 2026 in the group benefits space has been increased scrutiny of broker compensation, which Feeney notes has been accelerated by class action lawsuits filed at the end of 2025 targeting voluntary benefit consultants and some employer plan sponsors.
"Brokers need to take a very active role in discussions with the employer to make sure that what they are bringing to the table makes financial sense, that they do bring value, and disclose what they're being paid; not the types of commission levels that have been traditionally paid on voluntary products," Feeney said.
He describes a shift already underway among some larger brokerage firms, away from what were historically referred to as "heap commissions" - elevated upfront first-year commissions - toward flat, year-over-year structures more consistent with ancillary lines such as life, disability, and dental insurance.
In the larger-case market, Feeney expects the shift toward fee-based compensation models to continue. In the under-$1,000 market, commission-based structures remain dominant, though fee arrangements are increasingly plausible.
"If the broker is just transparent with their client on what those commission levels are, or fees, whatever way it goes, I think they're in a good spot," he said. "And then they can demonstrate the value; what they're bringing, which is an advisory role, a help in design role, a major data-providing role, and communication. They need to do all of those things."
As the Department of Labor's (DOL) fiduciary guidance continues to shape how plan advisors are compensated and disclose conflicts of interest, group benefits brokers are navigating a similar cultural shift where the quality of advice, not the margin on a product, becomes the primary measure of broker value.
For Feeney, the structural solution is to wrap the medical plan with meaningful ancillary and supplemental coverage. He cites the Bankrate 2026 survey statistic that 59 percent of Americans do not have $1,000 available to cover an unexpected medical expense.
"You need to surround the medical plan with these other types of products, which are not expensive, nowhere near the spend of the medical plan," Feeney said. "But it complements it in a very large way, and just kind of surrounds and provides a nice wrapper around the medical program."
Renaissance's flagship supplemental product, RenSecure Health, illustrates his point. The plan is a diagnosis-based supplemental health product that pays on more than 13,000 different diagnoses mapped to International Classification of Diseases, Tenth Revision (ICD-10) medical codes - not a fixed schedule.
For large enough groups, Renaissance can run a retrospective claims report showing what the plan would have paid in the prior plan year, giving brokers a concrete demonstration of value at the quoting stage.
Equally notable is the product's automatic claims payment feature. Rather than requiring members to initiate a claim, the claims administrator sends a report to Renaissance, and if a paid medical claim matches a covered diagnosis, benefits are deposited directly to the member's Venmo, PayPal, or bank account.
GLP-1 drugs will not be the last high-cost innovation to land on benefits brokers' desks with the pharmaceutical pipeline full of emerging therapies such as orexin sleep drugs.
Feeney says the group benefits industry needs a repeatable framework for evaluating them.
"The insurance carriers have a tough job because they have to evaluate these things," he said. "Number one, the cost of that prescription. But ultimately, what is the benefit? Will it limit additional surgeries, testings, and other types of treatments? When it all comes together, that's when the carriers have to decide."
The implication for benefits brokers and advisors is straightforward: build the analytical muscle and the client relationships now, so that when the next breakthrough arrives (and it will) the question of whether and how to cover it is answered with data and strategy, not reactionary cost-cutting.
