Even as health care costs continue to rise, employers remain committed to their benefits programs, with only 4% decreasing their health care spend this year and 43% increasing it, the 2025 NFP U.S. Benefits Trend Report found. Among other key trends.

Various pieces of health care transparency legislation have identified areas requiring employers to meet their fiduciary responsibilities, such as designing an evaluation process for selecting vendors to deploy their health and welfare benefits strategy.
Recent high-profile litigation has heightened awareness of fiduciary obligations in pharmacy benefit management. Employers now are seeking more sophisticated approaches to their PBMs, with 70% prioritizing the control of prescription drug spend. To help control pharmacy costs, employers are shifting toward independent benefit management, with 64% choosing either direct PBM carve outs or coalition participation.
As employers struggle to manage the complexities of leave requirements, more than 7 in 10 spend more than four hours on administration for each leave request. Tools such as technology-supported or outsourced leave management are growing in popularity to help employers remain compliant.

Many employers are expanding their mental health offerings, in part, through support for employees and their families across various life stages, from pediatric and dependent-children mental health services to increased offerings for the “sandwich generation” of caregivers.
Employers also are focused on physical and social wellbeing programs. The emergence of GLP-1 drugs has drastically shifted attention to comprehensive health and weight management initiatives. There is a particular emphasis on holistic wellness programs that emphasize sustainable lifestyle changes through nutrition, education and exercise. In addition, employers are looking to social wellbeing programs to strengthen workplace connections through approaches that support remote and in-office employees.

“To deliver solutions that meet employee needs, employers should allocate resources where they’ll have the greatest impact,” said Kim Bell, head of health and benefits for NFP. “A targeted approach focusing on comprehensive wellbeing can strengthen employee engagement, align organizational priorities and provide support across the entire workforce.”

Instant Insights /

Employers grapple with rising health care costs and fiduciary concerns

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