If you’ve been feeling like the benefits landscape is getting harder to navigate—you’re not wrong. I’ve spent more than two decades advising employers, and I can say with confidence: The headwinds we’re seeing today are some of the strongest we’ve faced. Costs are rising, volatility is increasing, and the margin for error is getting smaller.

Let’s break down what’s actually happening—and what it means for you.

The numbers tell a pretty clear story.

Medical cost inflation has been climbing since 2024 and is now outpacing broader inflation trends. Based on what we’re seeing across MJ’s client base, we’re projecting a 9% total plan trend for 2027, with medical at 8% and pharmacy at 12%—up from 6.7% in 2026.

But the bigger issue isn’t just cost—it’s volatility. Pharmacy is a great example. What used to represent 10–15% of plan spend now makes up 30% or more for many employers, driven by GLP-1s, specialty drugs, and biologics.

That shift alone is fundamentally changing how plans perform year over year.

Where I’m seeing the most disruption right now is in large claims. Across MJ’s book of business, both the frequency and severity of high-cost claims are increasing—and that’s what’s driving a lot of the unpredictability.

A few areas stand out:

And then you layer in treatments like gene therapy, which can range anywhere from $400,000 to over $4 million. That’s not theoretical—that’s real exposure employers are carrying today.

Pharmacy isn’t just growing—it’s evolving quickly. Specialty drugs, emerging therapies, and continued GLP-1 utilization are all pushing spend higher. And at the same time, employers are being asked to take on more responsibility in understanding and managing that spend.

Another area where I’m spending a lot of time with clients is site-of-care strategy. A report referenced in our session showed that hospitals can charge up to 300% more for infusion therapies than independent or at-home sites. Same drug. Same outcome. Very different cost. That’s a massive opportunity—but only if you’re actively managing it.

For those of you who are self-funded, you’re likely already seeing this show up in your stop-loss renewals.

Carriers typically target a 70–75% loss ratio, but recent years have blown past that—reaching 86% in 2024 and 91% in 2025, based on data shared during our session.

In response, we’ve seen:

Even with those corrections, early signals suggest we’re heading into another tough renewal cycle—especially here in Indiana, where healthcare costs already run high.

Here’s the reality: There’s no silver bullet. But there are strategies that can make a meaningful difference—especially if you take a proactive approach.

Some of the more immediate, less disruptive options I’m talking through with clients include:

Beyond that, we’re seeing more employers explore strategies that require a shift in how care is accessed:

These can drive real impact—but they do require alignment, communication, and, frankly, some courage.

One of the biggest challenges I see today is point solution fatigue. There are a lot of solutions out there—and many of them are good. But leaving them disconnected creates confusion for members and missed opportunities for the plan.

That’s why we’re seeing more employers invest in advocacy, concierge models, and technology to help guide members to the right care at the right time. Because strategy isn’t just about what you offer—it’s about whether your employees actually use it effectively.

It’s a tough environment. There’s really no way around that.

The trends we’re seeing—rising costs, higher-acuity claims, and ongoing volatility—aren’t going away anytime soon. But that doesn’t mean you’re stuck reacting to them. What we’ve seen time and time again is that employers who stay engaged, lean into the data, and are willing to challenge traditional approaches are the ones who come out ahead.

If you’re not sure where to start—or if you’re feeling the pressure heading into your next renewal—that’s exactly where having the right partner matters. At MJ, this is what we do every day: helping employers make sense of the complexity, build more intentional strategies, and put themselves in a stronger position for what’s ahead.

If you’re looking for a more proactive, data-driven approach to managing your benefits plan, let’s connect.

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