Marsh projects the steepest increase since 2003, and slow claims reporting leaves HR teams deciding on old data
Employer health costs are on track to rise 8.2 percent per employee in 2027, the steepest increase since 2003, and many employers say they cannot get the claims data needed to explain why.
Marsh, the benefits consultancy formerly known as Mercer, reached that figure in its 2026 National Survey of Employer-Sponsored Health Plans, which collected responses from more than 1,800 US employers between June 10 and August 10, 2026. Employers said costs would climb 11 percent if they took no action, and 59 percent plan cost-cutting changes such as higher deductibles. A separate Marsh survey found that about two-thirds of employers with 500 or more workers expect to raise employees’ share of premiums, so many workers will see paycheck deductions rise by more than the average. Aon and Business Group on Health have published similar pre-mitigation forecasts of 9.5 percent and 9.2 percent for 2027.
Our report on Marsh’s 2027 health benefit cost projections covers the three newer drivers. Marsh’s actuaries attribute roughly one percentage point each to glucagon-like peptide-1 (GLP-1) weight loss drugs, artificial intelligence (AI)-enabled claims submission software and disputes under the No Surprises Act’s Independent Dispute Resolution (IDR) process.
Why renewal numbers are hard to explain
Knowing the national drivers does not tell an employer what is happening inside its own plan. Larry Hightower, founder and CEO of Vxtra Health in Atlanta, which runs a healthcare model for self-insured, middle-market employers, says the problem sits in the systems that hold plan data. Self-insured employers pay claims directly instead of buying coverage from an insurer, and Hightower describes a typical pattern in which they receive claims updates every 90 days or every six months, well after most of the spending has occurred.
Hightower said, “All the old systems are transaction systems. They’re not analytics.”
The delay has a workforce cost. “What happens is they don’t make any decisions until they understand what’s happening with their employee benefits,” Hightower said. “In the case of this year, they delay hiring decisions, they don’t give promotions.”
Claims data access separates action from intent
The National Alliance of Healthcare Purchaser Coalitions’ 2026 Pulse of the Purchaser survey polled 408 employers in May and June 2026. Employers with full access to medical and pharmacy claims data deployed an average of 11.9 high-value purchasing strategies, compared with 7.9 for employers with limited, no or uncertain access. In the 2025 edition of the survey, a third of employers said they could not access complete claims data, and four in ten said vendors had refused to provide it. Fully insured employers, who typically have the weakest data rights, showed the widest gap between cost expectations and cost-containment activity.
The same push for transparency shows up in pharmacy benefits, where self-funded employers are moving business away from the three largest pharmacy benefit managers ahead of federal rebate pass-through requirements that apply to plan years beginning on or after August 3, 2028.
Data access also matters more as self-funding spreads. Following the expiration of Affordable Care Act (ACA) subsidies, self-funded employer plans grew as the individual market shrank, which leaves more employers carrying claims risk directly.
How stop-loss pricing adds to the problem
Stop-loss insurance protects self-funded plans against catastrophic individual claims, and carriers price it partly on the employer’s overall claims exposure. “If the stop-loss carrier doesn’t have accurate data to manage their exposure to a large catastrophic claim, they’re going to price the market higher in order to protect themselves,” Hightower said.
What HR leaders can do before renewal
Hightower’s argument is that near-real-time visibility into pharmacy and medical claims gives care management teams an earlier chance to see where spending is developing and to step in before it compounds. For HR directors, that points to contract terms. Claims data access belongs on the negotiating list when vendor contracts are set or renewed, and fully insured employers may need to start that conversation before the next renewal cycle instead of during it.
HR directors at self-insured organizations can ask their third-party administrator how often claims reports arrive, how detailed they are, and whether the stop-loss carrier sees the same data on a similar timeline.
Vxtra Health did not provide client outcomes or independently verified cost savings data to support its claims about its model’s performance.
