This Just In ...
Group Health Premiums on the Rise: What Employers Need to Know
In 2025, rising group health premiums are becoming a central concern for employers. Carriers like UnitedHealth, Anthem, and CVS Health have issued projections showing significant cost increases—driven by escalating claims severity, specialty drug costs, and continued labor shortages across provider networks.
These hikes pose challenges to affordability and enrollment, particularly for small and mid-sized employers. Workers may face higher contributions, reduced plan options, or shifts in network design as companies grapple with budget constraints.
What's Driving the Surge?
- Medical inflation continues to outpace general inflation, fueled by advances in diagnostics and treatment technologies.
- Chronic conditions and high-cost claims are up, especially in post-COVID care environments.
- Pharmaceutical spending, especially on gene therapies and biologics, is testing plan sustainability.
Employer Strategies Emerging
In response, many companies are exploring alternative funding models to maintain plan viability:
- Level-funded and self-funded arrangements offer flexibility and potential savings.
- Captive stop-loss groups are gaining traction for mid-sized employers seeking pooled risk protection.
- Value-based network contracting and narrow provider networks are being deployed to control spend without sacrificing quality.
Beyond funding mechanisms, employers are also leaning into benefits education, wellness engagement, and digital navigation tools to maximize value for employees.
With costs mounting, strategic benefits planning is no longer optional—it’s essential. Employers need actionable insights, and those who move now will be best positioned for sustainable coverage and stronger workforce outcomes.
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