5 Open Enrollment Trends Impacting Employee Benefits in 2026

Benefits renewal and open enrollment remain the most critical and complex periods in employee benefits planning. Rising healthcare costs, evolving plan designs, and increased employee expectations are pushing employers to rethink traditional approaches and explore smarter, more innovative strategies.

In Vita’s recent webinar, 5 Key Lessons from Open Enrollment, benefits experts Caroline Barkley and Erik Hansen shared key open enrollment trends and strategic insights to help HR teams strengthen renewal negotiations and plan a more effective employee benefits strategy in 2026.

Five Open Enrollment Strategies HR Teams Can Use to Improve Renewal Outcomes: 

•   How data-driven negotiations improve open enrollment outcomes
•   Managing outlier renewals and high-cost claims risk
•   The evolution of consumer-driven healthcare and HDHP alternatives
•   When alternative health plan funding makes sense for employers
•   Post open enrollment best practices for compliance and communication

1. Data Driven Negotiation Strategies Are Becoming Critical

With the highest health benefit cost increases seen in over 15 years and national medical trends projected around 9%, renewal negotiations are becoming increasingly challenging. For HR leaders, this means traditional renewal approaches are no longer enough to meet cost containment goals.

Rather than relying solely on carrier-provided projections, HR leaders need to root their benefits renewal strategy in data to strengthen their approach.

What HR Leaders Should Know:

• Medical and pharmacy trend assumptions are often negotiable and should be validated against your organization’s data.
• Predictive claims modeling can help assess risk and inform renewal strategy, even when full claims history is unavailable.
• A small number of high-cost claims typically disproportionately impacts total healthcare spend, making early analysis essential.

Action item:

• Before renewal, partner with your advisor to review claims projections, demographic risk, and benchmark data to support negotiations and identify potential outlier exposure.

2. Outlier Renewals Are a Growing Cost Risk

An outlier renewal occurs when a health plan renewal includes a significant rate increase due to unusually high claims experience. A small percentage of employers are impacted each year, but outlier renewals can result in dramatic cost spikes. Understanding your outlier risk management plan early is critical to managing these situations effectively.

What HR Leaders Should Know:

• Outlier renewals only apply to certain market segments, which means not all employers are at risk.
• Understanding known and emerging claims early allows HR teams to plan proactively because outlier renewals are typically driven by high claims that exceed carrier projections.
• Benchmarking benefits spend as part of total rewards provides important context during renewal discussions.

Action item:

• Develop an outlier renewal strategy early by understanding your risk and negotiating priorities in the event more extreme cost mitigation measures are needed. 
  
  

3. Consumer-Driven Healthcare Is Evolving Beyond HDHPs

While high-deductible health plans help control employer costs, data shows that the impact on employees has largely been confusion and deferred care. That shift has paved the way for the next generation of consumer-driven healthcare, which focuses on value-based decision-making rather than simply shifting costs to employees. 

What HR Leaders Should Know:

• Tiered and narrow networks can be used to steer employees toward high-quality, lower-cost providers.
• Incentive-based plan designs encourage more optimized healthcare utilization without relying solely on higher deductibles.
• Emerging tools and solutions are reshaping the consumer-driven healthcare experience.

Action item:

• When introducing consumer-driven healthcare options, invest in employee education and communication to drive adoption and reduce confusion.
  
  

4. Employers Are Considering Alternative Health Plan Funding Models

As healthcare costs rise, more employers are evaluating alternatives to fully insured health plans, including self-funding, captives, level funding, ICHRAs, and PEO arrangements. The risk-reward spectrum of these options emphasizes that flexibility often comes with increased risk sensitivity.

What HR Leaders Should Know:

• Alternative funding models vary widely in risk, flexibility, and administrative complexity.
• Workforce demographics, risk tolerance, and internal resources should guide funding decisions.
• Brokers continue to play a critical advisory role, including helping employers assess funding solutions to meet shifting corporate priorities. 

Action item:

• Assess alternative health plan funding strategies through a long-term lens, balancing cost containment with employee experience and organizational goals.
  
  

5. Post Open Enrollment Planning Is Gaining More Attention

Errors discovered after OE can lead to compliance and payroll issues, employee frustration, and costly corrections. That’s why post-open enrollment auditing and communication is an essential part of the open enrollment process.

What HR Leaders Should Know:

• Post-open enrollment audits help identify errors that can lead to compliance, payroll, or employee experience issues.
• Particular attention should be paid to reviewing election logic behind HSA and FSAs.
• Ongoing, targeted communication after open enrollment supports better plan understanding and smoother plan administration.

Action item:

• Schedule a formal OE debrief to review enrollment outcomes, audit results, and opportunities for improvement before the next renewal cycle.

What HR Leaders Should Do Next:

To extend the value of your open enrollment strategy:

• Review the full webinar recording
• Identify which open enrollment trends will most impact your next renewal
• Incorporate OE debriefs and mid-year check-ins into your annual employee benefits planning calendar