Howden has appointed John Zern as vice chair of health and benefits at Howden US, bringing in a 35-year industry veteran whose career has been built specifically around the lines of spend now driving the steepest employer health cost increases since 2010.
Zern joins from Ryan Specialty Benefits, where he served as president and CEO from 2021. Before that he spent six years at Aon as CEO of Global Health Solutions and CEO of North America Commercial Risk and Health Solutions, with earlier responsibility as executive vice president and global health leader at the firm. He also served as senior vice president of Marsh & McLennan Companies' health business. In the new role he will oversee Howden's Health and Benefits practice and join the firm's senior American leadership team.
The appointment is not incidental to the market moment. Total health benefit cost per employee is projected to climb 6.5% on average in 2026, the largest single-year increase since 2010, according to Mercer's 2025 National Survey of Employer-Sponsored Health Plans, which polled more than 1,700 employers. Without cost-management intervention, that increase would have approached 9%. The Business Group on Health's 2026 Employer Health Care Strategy Survey, covering 121 large employers and 7.4 million US employees, puts the median employer projection at 9%, offset to 7.6% through plan design changes - the largest annual increase forecast the group has recorded since it began surveying employers in 2010. On a compounded basis, health costs in 2026 are running approximately 62% higher than 2017 levels.
Both surveys point to the same three underlying pressures: rising use of GLP-1 drugs for obesity and diabetes management, higher cancer diagnosis and treatment rates, and increased mental health service utilisation. These are not new categories. They are the categories Zern has been managing at scale across global and North American books for the better part of a decade.
Sunit Patel, Mercer's US chief actuary for health and benefits, described the dynamic precisely: both healthcare price and utilisation are rising simultaneously, which removes the usual option of offsetting one against the other. Ellen Kelsay, president and CEO of Business Group on Health, said employers remain committed to health investment but will need to make genuinely strategic moves to contain costs rather than incremental adjustments.
For benefits brokers, the practical implication of that environment is that employer clients are approaching renewals with more scrutiny than at any point in the past fifteen years, and are increasingly looking for advisers who can navigate the clinical and data dimensions of cost management rather than simply presenting renewal terms.
Zern's appointment builds on Howden's stated commitment to scaling its US health and benefits capability through a specialist rather than generalist model. The firm has made a series of acquisitions and senior hires in this space over the past two years, positioning itself as an alternative to the major broking consolidators for employers who want dedicated health and benefits expertise rather than a broadly distributed service team.
Mike Parrish, CEO of Howden Americas, said Zern's experience building and scaling benefits businesses would prove instrumental as the firm develops its health and benefits offering. Zern said Howden's specialist-led, data-informed and technology-forward service model is what the current market moment requires, citing the pressure employers face to deliver benefits that work for their people while managing rising healthcare spend.
The combination of Zern's specific background and the market conditions he is walking into signals a competitive posture worth tracking. A Howden US health and benefits practice led by the former CEO of Ryan Specialty Benefits and the former head of Aon's global health solutions business is not a generalist operation. For brokers advising mid-market and large employers on plan design, GLP-1 formulary management, cancer care navigation or mental health benefit architecture, Howden is now a more credible conversation partner than it was twelve months ago.
The question for employers and their advisers is whether Howden's specialist model translates into meaningfully better outcomes in the three cost categories now driving double-digit trend. Zern's track record suggests the capability to engage at that level. Whether the platform behind him scales to deliver it will become clear over the next few renewal cycles.
