The more things change, the more they really do stay the same, to which any organization trying to effectively manage employee benefits in an unceasingly volatile environment will attest.

On one side, we continue to see health benefit costs on an unrelenting rise. More claims are trending from high to jumbo. Then, too are the near-miraculous, life-saving cures through gene therapy and specialty drugs with price tags that are out of reach for most who need them—and a worrisome burden for employers.

Then, there's the other. Everyone wants solutions, and finding them has become more urgent, and not only due to the ongoing competition for fewer people in today's full employment economy. Financial stress has become a way of life for a large group of workers; only recently has wage growth reflected the strong economy. Employers that find ways to provide relief will be better positioned for the long term.

Welcome to the world of employee benefits, 2020 style, where such forces are driving the following trends:

1. Employers explore their options on health plan.

More employers will start to shoulder more of the burden of plan cost increases and also explore plan options that will meet both affordability and health needs.

Health care costs are one reason for the financial stress that pressures a big percentage of today's workers, and it's understandable: Since 2009, according to the Kaiser Family Foundation, average family premiums have advanced by 54 percent and workers have paid 71 percent of the total. Over that period, though, wages have only grown by 26 percent, only slightly better than inflation's 20 percent.

Meanwhile, the average single deductible for workers who have one has also risen sharply—doubling to $1,655—in the last decade. Look for more employers to respond to this untenable squeeze by taking on a bigger share of premium increases. While it may hit their bottom lines, it will help relieve some of that financial pressure on their workers. And it's also an increasingly important move for recruiting purposes.

Employers and their people are also united in the quest for plan options that offer better health and financial benefits. One such likely possibility are Individual Coverage Health Reimbursement Arrangements (ICHRAs). Expect small and mid-sized employers to adopt such consumer-directed, account-based health plans, thanks to expanded government rules on their use.

On another front, employers that are increasingly comfortable with self-funding route to health benefits are finding new opportunities to pare back costs. Larger concerns are contracting directly with health care providers to negotiate savings; mid-sized firms are similarly using vendors to help them put reference based pricing strategies in place (in markets that can support them).

2. High cost drugs create cures but costly claim headaches, too.

The big pain point for employers is with their pharmaceutical contracts, especially given the explosive growth in new specialty drugs. While they come with amazing curative capabilities, or at least will prolong lives, they also come with breathtakingly high price tags. By 2016, specialty drugs accounted for nearly half of the drugs we pay for, and some experts believe will comprise two-thirds of all drug launches by 2021. Small wonder employers are increasingly crying, "Mercy," and asking their advisors if they really have to pay these claims. Compassion can be hard to come by when an unexpected claim stands to break a budget.

In this environment, prescription carve-out programs have become essential, though be warned that carriers are rewriting their contracts to block them and avoid losing the profits. It's also making outside pharma and benefits advisors hot commodities as intermediaries between pharmacy benefit management services and manfacturers' assistance programs to successfully reduce high cost claims. A third alternative of amending plans to exclude such drugs is getting talked about more, but remains the riskiest option for compliance issues if nothing else.

3. Middle-market employers reap enhanced benefits insights with predictive analytics.

The ability harness the power of data with advanced, predictive analytics has up until recently been something only big business could afford to tackle. But in the last few years, a class of vendors has emerged that's geared to the needs of smaller, self-insured employers. They have overcome security and HIPAA confidentiality concerns to aggregate and analyze a customizeable range of benefits data.

For example, predictive analytics enable benefits management to put a finger on current benefits costs, what's driving them and, more importantly, whether the trends will continue given changing demographics of the workforce. That helps on cost management, but also on identifying employee needs and the appropriate product mix moving forward. It's opening an exciting opportunity not just to make sure benefit dollars are being put to their best use, but that the side goal is also accomplished of creating healthier and happier employees—with less turnover.

As we usher in the first year of a new decade, a lot of what we are seeing on the benefits front will look familiar. It's how we respond that will make things interesting.

Mike Barone is the president of employee benefits at HUB International.

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