Transamerica’s 2026 survey of 100 healthcare organizations also finds most plan participants save only 1% to 3% of pay
Medical bills top the list of financial worries that healthcare employers see among their own workers, ahead of living costs and basic budgeting, according to a 2026 survey from Transamerica.
The 17th annual Retirement Plan Trends in Healthcare survey drew responses from 100 healthcare organizations in June 2026, most with more than 10,000 employees. Respondents cited healthcare costs as a pressing participant need at a rate of 86 percent. Nondiscretionary living expenses followed at 82 percent, and basic budgeting and money management at 78 percent.
The figures come from employers, not workers. Respondents were describing what they see among their participants.
Retirement plans show the strain
Respondents said 61 percent of participants contribute just 1 to 3 percent of pay, and only 11 percent contribute more than 7 percent. Automatic enrollment is common, with 77 percent of plans using it, up from 62 percent in 2024. Default rates tend to be low, so thin contributions may reflect defaults as much as financial pressure. The survey does not test whether medical costs are the cause.
Other data points the same way. A Gallagher employee assessment paired with a survey of 3,717 US organizations found 27 percent of workers have no emergency savings and another 24 percent have less than three months. Vanguard reported a median hardship withdrawal of $1,900, with 31 percent taken to pay medical expenses.
SECURE 2.0 lets plans offer non-highly compensated employees a pension-linked emergency savings account of up to $2,500, funded with after-tax Roth contributions, as HRD America reported.
Coverage that goes unused
Cover meant to ease medical bills often goes unclaimed. A Nayya review of 6.7 million medical claims found 1 in 4 enrolled employees leave supplemental benefit payouts unclaimed, with the average unclaimed hospital admission payout at $1,080. Separate research found that more than half of workers with a recent medical event paid at least $1,000 out of pocket. Only 28 percent said they were very prepared to cover a bill that size.
What respondents asked for
Transamerica’s report said survey comments showed a recurring theme. Employees need simpler, more personalized and more accessible planning support.
For employers, the practical gap sits between the benefit and the person using it. Filing help for supplemental claims, plain-language enrollment materials and an emergency savings option all target the same pressure the survey describes.
