Employers face an 11.1% increase in healthcare costs in 2027 if they take no corrective action - the steepest projected single-year increase in nearly two decades - according to a preview of WTW's 2026 Best Practices in Healthcare Survey reported by CFO Dive. Plan redesigns could reduce that figure to 9.7%, but the survey found most employers are either unwilling or unready to make the structural changes required to get there.
Nearly half of respondents, 49%, expect significant changes to their healthcare programs within the next three years, up sharply from 34% in the prior year's survey. But a little over half, 56%, said they are unwilling to take "disruptive" actions to achieve the necessary savings - WTW's own framing for the kinds of structural changes, including self-funding transitions, reference-based pricing, direct contracting, and pharmacy carve-outs, that move costs meaningfully rather than at the margins.
The survey covered 471 employers at companies ranging from 100 to more than 25,000 workers, collectively representing 7 million employees. It was conducted between June 22 and August 7, 2026, with full results due in September.
Jeff Levin-Scherz, population health leader at WTW, told the Wall Street Journal: "Employers are telling us that this is utterly unsustainable."
Aon's August 2026 cost analysis, drawing on data from more than 1,100 US employers representing $135 billion in health spend, projects a 9.5% increase in employer healthcare costs for 2027, pushing average per-employee costs above $19,000. That figure is Aon's projection of what costs will actually rise by after employers take whatever actions they take. WTW's 11.1% is what costs would rise by if employers took no action at all; its 9.7% is the outcome if they implement plan redesigns. The two firms are not disagreeing - they are measuring different points in the same decision chain.
What both numbers confirm is the fourth consecutive year of near double-digit cost growth. Aon recorded employer healthcare cost growth of 8.3% in 2026, up from 8.8% in 2025 - more than double the 3.7% rate recorded in 2022. Employees paid an average of $5,297 toward their own healthcare in 2026, covering both premium contributions and out-of-pocket costs, with out-of-pocket expenses rising 10.2% year over year.
GLP-1 coverage has become one of the most contested line items in large employer health plans, and the trajectory of those costs is tightening the overall picture.
Among corporate employers that cover GLP-1s for weight loss, the drugs represented an average of 11.4% of total annual claims in 2026, up from 6.9% in 2023, according to the International Foundation of Employee Benefit Plans' 2026 pulse survey of nearly 300 US health plans. Despite that claims burden, overall employer coverage of GLP-1s for weight loss remained flat at 36% in 2026, unchanged from 2025, as employers balk at extending coverage while costs are still compounding.
Starbucks confirmed it will stop covering GLP-1 medications for weight loss from October, while retaining coverage for diabetes and other approved indications. Joe Nadglowski, president and CEO of the Obesity Action Coalition, called on Starbucks to reverse the decision: "An employee should not lose access to a treatment simply because the diagnosis is obesity."
For benefits advisers, the WTW and Aon data together frame the same challenge in the 2027 renewal cycle. The 1.4 percentage point gap between WTW's 11.1% baseline and 9.7% post-redesign figure is real but limited. Employer clients who have already absorbed consecutive years of near double-digit increases through incremental plan design adjustments - tighter formularies, higher deductibles, narrower networks - are reaching the boundary of what those changes can achieve.
The WTW finding that 56% of employers are unwilling to take "disruptive" action is the specific client conversation this data prompts. An employer running a fully insured plan who has seen four straight years of high single-digit or double-digit renewals and refuses to explore self-funding, reference-based pricing, or pharmacy carve-outs is making a structural choice - and a broker who does not surface those alternatives before the 2027 renewal is leaving both value and leverage on the table.
The 14% median small group premium requests already filed for 2027, reported by KFF earlier this year, signal that the rate environment advisers will be operating in for the next renewal cycle is not softening. The 2027 renewal season begins now.
