Open enrollment feels distant in midsummer, but this is exactly when 2027 benefits planning gets decided. With health benefit costs once again climbing faster than wages and inflation, employers who map their strategy now keep far more options on the table. Reporting for HRMorning, Carol Warner breaks down new data from Mercer's survey of 604 U.S. organizations — and the picture shows employers pulled between cutting costs and protecting their people.

The Old Playbook: Shift Costs to Employees

Mercer's Survey on Health and Benefit Strategies for 2027 found that 48% of large employers (500+ employees) plan to raise deductibles or out-of-pocket maximums next year. It's the most familiar lever — and the most dangerous one. When care becomes unaffordable, employees postpone or skip treatment, which circles back to the employer as higher downstream claims, more absences, and rising turnover.

A Smarter Alternative Is Gaining Ground

Cost-shifting isn't the only play. Per the same survey, 31% of large employers already offer or plan to offer a non-traditional medical plan in 2027 — such as a high-performance network or variable copay design — and another 38% are weighing one. High-performance network plans reward employees with lower costs when they pick providers from a curated, high-value network, steering people toward better care instead of simply charging them more.

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The Cost Curve Keeps Bending the Wrong Way

Health plan actuaries are projecting a 9% medical cost trend for 2027, according to PwC's annual Behind the Numbers report — and that follows an upward revision of the 2026 estimate to 9% as well. That makes five consecutive years of cost growth running well ahead of both inflation and wages. The question for HR isn't whether costs rise; it's which response you choose.

GLP-1 Drugs: The Line Item Forcing Hard Calls

Pharmacy spend is climbing even faster, driven largely by GLP-1 prescriptions that have nearly doubled in a year. At roughly $1,000 per patient per month, even modest uptake strains budgets — and Maven Clinic's research adds a wrinkle: 41% of providers say they lack the visit time to properly follow up after prescribing, and coverage without clinical follow-through tends to inflate claims over time. Employers are responding: 6% of large employers dropped GLP-1 obesity coverage in 2026, another 5% plan to or are considering it for 2027, and 27% have tightened utilization controls through prior authorization, narrower eligibility, and tougher scrutiny of PBM contracts. If GLP-1s are in your plan, they deserve a dedicated line in the budget review — not a passive renewal.

Financial Stress and Caregiving Are Retention Problems

Mercer's 2026 Inside Employees' Minds survey found that covering monthly expenses is now the top concern of U.S. workers, especially lower-paid staff. Employers are answering with support: 60% now offer financial wellness benefits like one-on-one counseling, 21% offer debt support, and more are adding text-based therapy through expanded EAPs. Caregiving is the other pressure point — return-to-office mandates are colliding with school-age kids and aging parents. For 2027, 51% of large employers plan at least one childcare resource and 58% provide an elder care benefit. That's not generosity; it's arithmetic. These employers have priced caregiving-driven attrition and concluded the benefit costs less than the turnover.