Open enrollment for employer-sponsored health insurance is either starting soon or already underway.
Most workplace health plans hold open enrollment once a year, typically in the fall, and employees usually have a short window to pick coverage for the coming year for themselves and any family members they insure.
Costs for both employers and workers are higher than they were last year, extending a four-year upward trend. Average expenses are projected to climb another 9% to 10%, and the issue has become a major talking point before the midterm elections.
More than 150 million Americans get health coverage through an employer. Workers at small companies with fewer than 200 employees are expected to feel the strain most. Employers will have to examine service prices and how often employees use care, which could influence where workers go for treatment and which providers they see.
Several factors are pushing costs higher, including greater use of health services and technology such as artificial intelligence, along with the price of specialty drugs and weight-loss medications. Coverage for weight-loss drugs has declined since 2025.
Employees should look back at what they spent on health care over the past year and think about what services they may need next year before choosing a plan. They should compare monthly premiums, deductibles, copayments, and annual out-of-pocket maximums. For some workers, a plan with a higher deductible and a health savings account may make more sense. Money in a health savings account can be used for a range of expenses, including medication bought through a drugmaker’s cash-pay program, though that spending does not count toward a deductible or out-of-pocket cap. Employees should contact their employer’s benefits manager for additional guidance.