This post draws on data from a live webinar hosted by Helpside and GBS on June 15, 2026, featuring Helpside Senior Business Consultant Dave Ashby and Broker Relationship Manager Greg Williams alongside GBS Vice President of Employee Benefits Trent Sanders, Insurance Broker Tyler Gee, and Account Executive Katie Peacock — a combined panel with over 150 years of experience in the employee benefits industry.
If you run a small business and your benefits renewal is coming up in the next twelve months, there is something your broker may not be telling you: the window to act is already closing.
The 2026 benefits renewal environment is the most challenging many industry veterans have ever seen. Premium increases of 20 to 25 percent were not uncommon over the past two years, and projections for the coming renewal cycle while officially cited at around 8.5 percent for medical trends nationally (PwC Behind the Numbers 2026) — are widely expected to land higher once the actual renewal data rolls in. Pharmacy costs are trending at 11 to 12 percent and rising (Business Group on Health). Specialty drug spending is reshaping plan economics at a pace that most small employers haven't begun to account for.
"We're coming off of probably the last couple of years of being the most challenging we've seen from the health insurance increase perspective as challenging as probably any we've seen in all of my career," said Trent Sanders, Vice President of Employee Benefits at GBS, who has worked in the industry since 1994. "And that's generally echoed by everybody that I know that's in this business."
Tyler Gee, a licensed group benefits broker since 1991 with thirty-five years in the industry, put it even more directly: "In the past twenty years, I've never seen renewals as high as they have been. That's been very frustrating for a lot of employers, and we expect it's going to continue."
The businesses that come out ahead are not necessarily the largest or the most sophisticated. They are the ones that start asking questions early — ideally six months before their renewal date — and work with brokers who have access to the full range of solutions available today.
If you are reading this and you haven't started that process yet, you are already behind. But you still have time to act.
To understand why urgency matters, you need to understand what is actually happening to healthcare costs in 2026. This is not a normal cycle of modest annual increases. Several structural forces are converging simultaneously.
During the COVID-19 pandemic, utilization dropped sharply as elective procedures were postponed and in-person care was avoided. Those deferred needs didn't disappear — they came back with interest. Medical claim trends stabilized near 7 percent in 2024 and 2025, reflecting that elevated post-pandemic baseline. As Trent Sanders explained on the webinar: "Coming out of COVID, we saw a lot of increased utilization. We saw a lot of increases — the last two years have been challenging."
Prescription drug costs rose 9.4 percent in 2025. Specialty drugs rose 8.9 percent (Mercer). Pharmacy cost trends ran 2.5 percentage points higher than medical trends over the same period (PwC). Large employers are projecting an 11 to 12 percent increase in pharmacy costs for 2026 alone (Business Group on Health).
The structural reality behind those numbers is stark: specialty drugs represent just 2 percent of total pharmacy prescription volume but account for more than half of total pharmacy spend. The specialty pharma market grew from $92.5 billion in 2023 to $129.23 billion in 2024, and projections estimate it will reach $965.5 billion by 2030 (Marsh McLennan Agency, 2026). Seventy-five percent of drugs currently in the development pipeline are specialty therapies (Marsh McLennan Agency, 2026).
GLP-1 medications — originally approved for type 2 diabetes and now widely used for weight management and cardiovascular risk reduction — are among the top cost drivers employers are contending with heading into 2026. In 2025, 11.8 percent of U.S. adults reported using a GLP-1 medication, with an additional 14 percent expressing interest in starting treatment (RAND, 2025).
"Specialty medications — you can have one person on a specialty medication that just really blows up your plan in a hurry. You're talking thousands of dollars a month for one particular drug," Trent Sanders said. "And then we're seeing a lot of utilization increasing. Just the overall cost of care is going up, and it's very pricey."
ACA insurers are raising premiums by an average of 20 percent in 2026 — the steepest increases since 2018 (Marsh McLennan Agency, 2026) — driven by rising costs of care, adverse selection, legislative changes, and the expiration of enhanced tax credits under the American Rescue Plan. Out-of-pocket premiums for ACA marketplace enrollees are expected to rise by an average of 75 percent due to tax credit expiration alone (Marsh McLennan Agency, 2026).
This is not a minor adjustment. It is a structural repricing of the ACA market that directly affects how employers evaluate their options.
According to Mercer's National Survey of Employer-Sponsored Health Plans, 51 percent of employers say they are likely or very likely to shift plan costs to employees in 2026. That means higher deductibles, higher employee contribution percentages, and reduced plan richness all passed on to the people your business depends on most.
Healthcare costs in 2026 are 62 percent higher overall than they were in 2017 (Business Group on Health), a result of compounding annual increases that have built on each other for nearly a decade. For small businesses without dedicated HR teams or benefits specialists, this trajectory is unsustainable on its own. Without a deliberate strategy, absorbing or passing on those increases is not a plan — it is a default.
Here is the single most important thing to understand about benefits renewals: by the time you receive your renewal notice, most of your options have already expired.
For employers with January 1 renewals — the most common renewal date — insurance carriers typically don't release renewal rates until October 1. That gives you, at best, 90 days to evaluate, quote, and implement an alternative. In practice, it's often less. As Tyler Gee pointed out during the webinar: "We even see some renewals not even coming out until the middle of October, and that puts you even more behind the eight ball."
Three months is not enough time to thoughtfully evaluate your options. It is enough time to panic and accept the increase.
The employers who consistently find better outcomes — lower rates, richer benefits, and less disruption — are the ones who start six months before their renewal date. That means if your renewal is January 1, you should be having this conversation in July. If it's October 1, you should be having it right now.
"Getting ahead of it earlier has been a huge advantage for businesses to take a look at some of the options that are out there," said Dave Ashby, Senior Business Consultant at Helpside with over 26 years at the company. "We've been able to bring forth options over and above — not just health savings, but other things that can maybe be a benefit to companies."
There is another practical reason to start early: broker bandwidth. "If they need another reason to move now — brokers have a lot more time now than they're going to have as we get closer to the first of the year," noted Greg Williams, Broker Relationship Manager at Helpside. "You'll get their undivided attention."
Understanding what is driving your costs is the first step toward doing something about them. The increases you are seeing are not random. They reflect four identifiable cost drivers, each of which responds to different strategic interventions.
The fastest-growing component of most employer health plans is pharmacy spend — and specifically, the segment of pharmacy spend driven by specialty drugs and GLP-1 medications. Most small employers have no visibility into what they are actually spending on prescription drugs or why. PBM markups and structural opacity in drug pricing mean that the number on your invoice often has no meaningful relationship to what a drug actually costs to produce or distribute.
Alternative plan designs, PBM contract reviews, and pooled purchasing models can all reduce pharmacy spend — but only if an employer starts the conversation with a broker who understands this landscape.
A single employee or dependent on a specialty medication — an oncology drug, a biologic for an autoimmune condition, or a GLP-1 for obesity — can dramatically change the economics of a small group plan. This is particularly acute for plans with 10 to 50 enrolled employees, where one high-cost claimant can represent a disproportionate share of total claims.
Dave Ashby spoke directly to how Helpside addresses this: "One of the things that we've done that is creative with our plan is that the number of employees affected by specialty meds is relatively low. That's been one of the key factors that we've used to help minimize the risk for companies by finding other solutions — carving that out of our plan."
Post-pandemic healthcare utilization has normalized at a higher level than pre-pandemic baselines. Deferred elective procedures, increased mental health utilization, and higher chronic disease prevalence in the working-age population are all contributing. Early-onset cancers are a particularly significant emerging driver: cancer incidence has increased notably among younger adults. Seventeen out of 34 major cancer types are increasing among Gen X and millennial adults (American Cancer Society, The Lancet Public Health, 2024), with some cancer types two to three times more common in people born in 1990 than in those born in 1955. According to Marsh McLennan Agency's internal claims data analysis, diagnoses among people ages 20 to 29 have nearly doubled since 2018 (Marsh McLennan Agency, 2026) — a trend that carries direct implications for employer health plan costs as this cohort moves into the workforce.
Employers cannot control utilization directly, but plan design — including preventive care incentives, network selection, and care navigation support — can meaningfully reduce high-cost utilization patterns over time.
For most small businesses, the true cost of managing benefits is not just the premium — it is the 30 to 40 hours per month that owners, office managers, and operations leaders spend on HR and benefits administration. That is time not spent on the business itself, and it compounds every time there is a compliance question, a mid-year life event, an employee dispute, or an open enrollment cycle.
"So many businesses have come to us because of health savings but have stayed for many other reasons — whether it's payroll, human resource support, or just services that we provide for our clients," Dave Ashby explained. "It has been surprising how many hours a company may save on just the administrative burden of handling all this other stuff that, again, they didn't get into business to deal with."
Let's be direct about what "absorbing the increase" actually means for a small business.
If your health plan costs $8,000 per employee annually and you see a 12 percent renewal increase, you are adding roughly $960 per employee to your annual payroll cost — without any change to what your employees receive. For a 20-person company, that is $19,200 per year in additional cost, every year, compounding forward.
If you have absorbed 12, 15, or 20 percent increases in each of the last two years, the compounding effect is significant. Healthcare costs have risen 62 percent since 2017 (Business Group on Health). An employer who has absorbed those increases without exploring alternatives has paid substantially more than a peer who engaged a broker and found a better structure.
The alternative — passing increases to employees — creates a different kind of risk. In a competitive labor market, employees who see their healthcare costs rise while their salary stays flat will look elsewhere. Benefits are consistently ranked among the top three factors in employee retention decisions. For small businesses in industries where skilled labor is tight — construction, healthcare, legal services, nonprofits — losing an experienced employee over benefits can cost far more than the renewal increase that drove them out.
As Katie Peacock, Account Executive at GBS, put it: "If you do that [pass costs to employees], then in a competitive job environment that we are in now, employees may be looking at other companies that offer richer plans or pay more towards the cost."
The good news is that the current environment, while challenging, is also one of the most solution-rich in recent memory. Alternative plan structures have proliferated, pooled purchasing options have expanded, and brokers with the right specialization can access options that were simply not available five years ago. Here are the five strategies that the Helpside and GBS team recommend and that the most successful employers are already implementing.
The most powerful thing any employer can do is start the conversation now, regardless of when their renewal date is. This is not about being premature — it is about having options.
"Let's meet before you get that renewal so we can see what's working with your plan, what's not working," Katie Peacock explained. "It's easier to have those conversations before we get the renewal, so we're ahead of the eight ball."
Starting early does not mean committing to a change. It means gathering information, understanding what is available, and being in a position to make a thoughtful decision rather than a rushed one. The quoting process itself typically takes one to two weeks. Implementation from decision to go-live is typically three to four weeks. If you want to be ready to implement a new plan by January 1, you need to start no later than September and ideally, you start now.
Most employers have no idea whether their current plan is competitive. They know what they pay, but they don't know whether that is above or below market for their industry, geography, and employee profile. Benchmarking changes that.
"Have you looked at how your benefits compare to other employers in your industry, in your group size, just in the state of Utah as a whole? How is that impacting your retention with your employees? Are you losing employees because of your benefits?" Katie Peacock asked. "There's a lot to see in those benchmarking reports."
A benchmarking report can reveal one of two things: either you are reasonably competitive and your broker is doing their job, or there is a gap that is costing you money or talent. Either outcome is useful. If you haven't seen a benchmarking report from your current broker in the past 12 months, that is the first conversation you should have.
When costs rise, the instinctive response is to cut benefits, raise the deductible, reduce the employer contribution, eliminate a coverage tier. This is understandable but often the wrong move. There are structural changes to how a plan is funded and purchased that can reduce costs without reducing what employees see or experience.
The landscape of plan types available to small and midsize employers has expanded significantly. Greg Williams outlined the range on the webinar: "There are PEOs with a master plan. There are PEOs like Helpside that have a self-funded plan. There's self-funding, level funding, ICHRAs, association plans, all these different options that, again, you don't have your renewal yet, but if you can start to lay some groundwork on what's important to you and what you need as an organization, these brokers can help guide you."
According to industry research (Marsh McLennan Agency, 2026, citing McKinsey), alternative plan designs can improve member experience and reduce costs by 10 to 30 percent when implemented correctly. The right structure depends on group size, health profile, and business objectives — which is exactly why starting the conversation early matters.
Prescription drug costs are the fastest-growing component of most plans and often the least understood. The reality is that most employers are paying more than they need to on pharmacy spend — not because of the medications their employees take, but because of how those medications are priced and administered within their current plan structure.
A broker or PEO with the right pharmacy management approach can identify lower-cost alternatives, review PBM arrangements, and in some cases carve out high-cost specialty medications to a separate structure that doesn't affect the core plan's risk profile. This is one area where the specific capabilities of your benefits partner matter significantly.
Not all brokers have access to the same solutions. A broker who can only offer ACA community-rated plans cannot benchmark your plan against level-funded options. A broker without a PEO relationship cannot bring that as an alternative. The breadth of what your broker can access directly determines the breadth of what you can consider.
"If you have a broker, ask them: what creative solutions do you have? If they don't have those, you may want to look for a broker that does have access to plans and options and the expertise to find the right fit for you and your organization," Greg Williams advised.
This is not a criticism of any particular broker. It is an acknowledgment that the benefits landscape has become complex enough that specialization matters. The best outcome for your business requires a partner who can place everything on the table and help you understand the tradeoffs.
Helpside operates as a Professional Employer Organization (PEO) with a self-funded health plan that currently covers between 6,500 and 7,000 enrolled employees — approximately 20,000 individuals when dependents are counted. That scale creates a pooled purchasing advantage that individual small employers cannot replicate on their own.
Professional employer organizations are specifically cited in recent healthcare economics research as one of the primary alternative funding models enabling small and midsize employers to access large-group purchasing power. By pooling employees from hundreds of businesses, a PEO can negotiate rates, access plan structures, and manage pharmacy spend in ways that are structurally unavailable to a 15- or 25-person employer operating independently.
"One of the things that Helpside brings to the table — we have a unique solution. We have a pooled model. We have our own large group health insurance plan. And so we've been able to help buffer some of those costs just with that pool," Dave Ashby explained.
Beyond the health plan, Helpside provides HR administration, payroll, compliance, and a dedicated service team — which addresses the administrative burden cost driver directly. As Dave Ashby described it: "So many businesses have come to us because of health savings but have stayed for many other reasons."
Helpside has been in business for over 35 years. The onboarding process for most groups takes three to four weeks, and the company's implementation team is specifically designed to minimize disruption for employees through the transition.
Beyond the immediate renewal environment, several longer-term trends are beginning to shape the benefits landscape in ways that employers should understand now — because they will influence plan costs and employee expectations over the next two to five years.
Cancer incidence among workers ages 20 to 29 has nearly doubled since 2018. Across 34 major cancer types, 17 are increasing among Gen X and millennial adults. This demographic shift in cancer risk has direct implications for employer health plans — and for how employers think about preventive care benefits, early detection programs, and the value of comprehensive coverage for younger employees.
GLP-1 medications were approved initially for type 2 diabetes and more recently for obesity and cardiovascular risk reduction. They are currently being evaluated for obstructive sleep apnea, metabolic dysfunction, and several other conditions. In 2025, 11.8 percent of U.S. adults were using a GLP-1 to lose weight or manage a chronic condition. Coverage for GLP-1 obesity treatment continues to rise among employers of all sizes. This is not a temporary trend — it is a structural shift in how chronic conditions are managed, and its cost implications for employer health plans are only beginning to be understood.
U.S. employee engagement dropped to 30 percent in 2025 — the lowest point in more than a decade (Gallup). Employee dissatisfaction and career stagnation are well-documented realities in today's workforce. In this environment, benefits are one of the most tangible ways an employer signals investment in its people. A benefits package that is visibly deteriorating year over year — higher deductibles, less coverage, more employee cost-sharing — is a retention risk that shows up in attrition data before it shows up in exit interviews.
Post-pandemic hybrid work arrangements have become a permanent feature of the American workforce, not a temporary accommodation. A majority of remote-capable employees now work hybrid schedules, and the evidence is clear that hybrid arrangements meaningfully reduce voluntary turnover compared to fully on-site roles. This matters for benefits strategy because the administrative infrastructure required to manage a distributed workforce — multistate compliance, flexible enrollment systems, HR support that doesn't require in-person access — is exactly what a PEO relationship provides. Small businesses navigating hybrid work without dedicated HR support are absorbing that complexity on their own.
At the end of our live webinar, employers asked the questions they'd been holding back all session. Here are the direct answers from the Helpside and GBS panel.
"The biggest mistake you can make is just accepting your renewal for what it is, and thinking that you don't have options, and just absorbing that cost year over year," said Katie Peacock. "That's not sustainable."
Trent Sanders added a counterintuitive point: "A lot of times we will talk to a group that says, 'We're really happy — we just got a two percent increase.' But I think one of the mistakes a lot of companies make in those years is not to quote it out. Because in those years when you're getting an increase like that, the carrier has likely made money on you and is likely charging you too much. That's often the best time to take it out and fully quote the market."
Dave Ashby: "The process typically takes about three to four weeks. We'll gather underwriting information and underwrite the group. As far as disruption — we've been doing this for thirty-six years and our main goal is to make the disruption as minimal as possible. We have a great team that helps walk through every step. Where it might seem a little bit overwhelming, we've just found we're able to minimize and alleviate a lot of that stress."
Tyler Gee: "A lot of plans renew January 1 and renewals aren't going to come out from the insurance carriers until about October 1. That doesn't give you a lot of time to make decisions without making it really messy. Get on it now. Don't wait until October 1 or October 15. We even see some renewals not coming out until the middle of October — and that puts you even more behind the eight ball."
While specific savings vary by group, industry research indicates that alternative plan designs can reduce employer healthcare costs by 10 to 30 percent when implemented correctly. Helpside's pooled model has enabled clients to buffer increases that would have been significantly higher on the individual market. The best way to find your specific number is to get your plan benchmarked and quoted. As Trent Sanders noted, the quoting process takes "a week and a half, two weeks at the longest" to get to a point of "really looking at the numbers and making some decisions."
Trent Sanders: "The biggest thing that you're really going to need is your most up-to-date employee census. That's something that, if you have ready to go initially, helps streamline the process. And then just have a lot of questions and look at it. A lot of times, just getting quotes on paper that look good gives us leverage to go out and negotiate the best rates."
Greg Williams: "If I were to recap the whole purpose of this webinar — we anticipate a pretty tough renewal. And there are options out there. There are brokers that are specialized in finding those. So reach out, find the options that are right for you, because it doesn't have to be the way it always has. And there's probably something where you can get creative and unique and find something that'll work for your group."
Dave Ashby: "It's never too late. I've had groups that were sizable that we went through the quoting process just three months after they renewed. A lot of people have that mindset thinking, 'Well, I just went through it, I guess I'll have to wait until the beginning of the year.' But I've had many companies that maybe just renewed in January and they're thinking that they're stuck — but they're not. We're bringing companies on all throughout the year."
Trent Sanders reinforced the point: "You can look at it anytime. We're really writing new groups and moving new groups the first of about every month of the entire year."
The only way to know is to benchmark. A benchmarking report compares your premiums, contribution structure, plan design, and total cost against employers of similar size in your industry and geography. If your broker hasn't provided this in the past 12 months, ask for it. If they can't provide it, that is useful information.
As Greg Williams noted: "If you have a broker, ask them what creative solutions they have. If they don't have those, you may want to look for a broker that does have access to plans and options and the expertise to find the right fit for you."
Greg Williams closed the webinar with something that has stuck with many of the employers who watched it: "The definition of insanity is doing things the way you've always done them and expecting things to change. If you don't get anything else out of this, it's that there are creative solutions out there. You need to align yourself with a broker that has access to all of those solutions so they can throw everything on the table and let them know what your objectives are and concerns."
Healthcare costs are not going down. Pharmacy spend is not moderating. The employers who come out ahead will be the ones who treat their benefits strategy as a proactive business decision — not a reactive annual administrative task.
The six-month window is real. If your renewal is in the fourth quarter of this year, that window is open right now, but it is not open for much longer.
The most effective first move is a free 15-minute benefits audit with Helpside. In 15 minutes, you will get a clear picture of where your costs are coming from, how your current plan compares to what is available in the market, and what options may be available before your next renewal.
There is no obligation. There is no pitch. There is just a conversation that gives you information you can actually use.
Book your free benefits audit with Helpside →
You can also watch the full on-demand recording of our June 15 webinar — Renewals Are Rising: What Employers Must Do Now — which covers all five strategies in detail, including real client examples and a live Q&A with the full panel.
Watch the on-demand webinar here →
Data in this article is sourced from the following publications. Direct quotes are drawn from the Helpside and GBS webinar transcript, June 15, 2026.