Trends in the U.S. Healthcare Industry, Part 3: Employer-Sponsored Health Benefits and Plans

Our Founder and Principal Consultant, Mike Rawaan, is joined by Megan Sowa, MPH to discuss U.S. Healthcare trends, focusing on the Employer-Sponsored Health Plans space.

Nearly 164 million Americans receive Healthcare Benefits from their employer, which makes up ~54% of the insured population in the U.S.

The year-over-year cost of the employer-sponsored insurance has grown by 7% over the past two years and is projected to grow by 8% in 2025. In 2025, employers will pay an average of $25,000 to cover the average American family. Most of the increased cost can be attributed to:

• Utilization of health benefits by covered employees

• Broader benefits covering greater medical expenditure

  • Fertility benefits coverage went from 45% to 47% in 2024

  • Coverage of IVF among large employers has increased from 62% to 70% in one year

  • 4 out of 6 Employees expect their employer to offer Mental Health benefits

• Growing cost of prescription drugs

• Coverage of GLP-1 drugs costs employers $9,000 to $16,000 per year

Employers desperately seek strategies to reduce this spending, including offering employees Individual Coverage Health Reimbursement Arrangement (ICHRA) plans.

Finally, the saturation of ancillary benefits and digital tools markets creates confusion, resulting in employers paying twice for the same or a similar service.