As we approach 2026, the world of employer-sponsored health benefits is on the brink of major changes. New regulations, rising costs, and evolving employee expectations are reshaping the landscape. Now more than ever, employers are looking beyond traditional group plans for solutions that offer cost control, personalized packages, and tools that ease administrative burdens.
This will be a pivotal enrollment season, providing brokers with a unique opportunity to redefine what competitive benefits look like for both employers and employees. Staying up to date on regulatory changes and ahead of emerging trends will be key to delighting current clients and winning new business in 2026.
2026 Regulatory Change
Health Savings Account (HSA) enhancements
President Trump signed what has been nicknamed the “One Big Beautiful Bill” into law on July 4, 2025. The new legislation includes HSA enhancements aimed at expanding access and simplifying use.
- Affordable Care Act (ACA) Bronze and Catastrophic plans will be HSA-eligible, enabling millions more to open HSAs.
- Like last year, HSA contribution limits will increase to approximately $4,400 for individuals and $8,750 for families, adjusted for inflation.
- Telehealth services will remain HSA-compatible. The COVID-era safe harbor allowing first-dollar telehealth coverage under High-Deductible Health Plans (HDHPs) without affecting HSA eligibility is now permanent. It is retroactive for plan years beginning on or after December 31, 2024.
- Fixed-fee primary care subscriptions (up to $150/month for individuals, $300 for families) will no longer disqualify HDHP coverage and can now be tax-free through HSAs.
Key Affordable Care Act (ACA) changes:
Beyond simplifying and expanding HSA access, the bill includes changes to the ACA focused on reducing fraud and improving program integrity. The most noteworthy changes are listed below.
- Enhanced premium tax credits introduced during COVID will expire at the end of 2025.
- Beginning in 2027, open enrollment will end on December 15th. This change shortens the open enrollment period by one month.
- Starting with the 2028 coverage year, most enrollees will be required to re-verify their eligibility annually, which will end the current auto-renewal system.
- Individuals who previously qualified for Special Enrollment Periods (SEPs) based on low income will need to apply for coverage during open enrollment to be eligible for premium subsidies or cost-sharing reductions.
The full list of changes published by Kaiser Family Foundation (KFF) can be found here.
Affordable Care Act (ACA) affordability percentage increase:
To account for inflation and rising health care costs, the ACA affordability percentage will increase to 9.96% in 2026, up from 9.02% in 2025. This means that to meet the ACA employer mandate, Applicable Large Employers (ALEs) must offer self-only health coverage that costs employees no more than 9.96% of their household income.
Cost pressures will drive smarter health benefits designs
In 2026, cost containment will be a top priority for employers. Increased minimum wages, employer payroll taxes, and national insurance contributions play a role in many regions, but across the board, increased healthcare costs pose the biggest challenge.
Preliminary filings suggest that traditional group health plans are projected to increase between 6.5% to 8% in 2026.
Many employers will find themselves stuck between a rock and a hard place this enrollment season. While costs continue to rise, they remain under immense pressure to attract and retain top talent. And studies show that in today’s competitive job market, few things matter more than health benefits. According to a recent survey by the Society for Human Resource Management (SHRM), 88% of employers ranked health-related benefits as “very important” or “extremely important,” above retirement savings, leave, family care, education, and transportation benefits. The success of their businesses in 2026 will rely on being able to lower costs while at the same time, offering competitive benefits. Brokers need to ensure their portfolios include solutions that support this.
Defined contribution models that offer cost predictability, like Individual Coverage Health Reimbursement Arrangements (ICHRAs), have been one of the most significant trends in employer-sponsored health benefits in recent years, and the momentum is expected to continue through 2026 and beyond. Through this model, employers offer their employees a set monthly dollar amount, known as a defined contribution, and the employees use these funds to buy individual coverage that best fits their needs. Unlike traditional group plans, defined contribution health benefits make it possible for employers to set and stick to a budget that supports their long-term financial goals, regardless of employees’ claims or market changes. The ability to control spending can result in big savings, which is game-changing for employers. Nexben recently helped a community hospital make a mid-year switch from a traditional group plan to an ICHRA offering, resulting in over 60% savings in annual premiums. (Read the full case study here.)
Employees also benefit from the defined contribution model because they get to choose the health plan that best meets their needs, often saving money along the way. For too long, many have been stuck with costly group plans that attempt to play to the masses, but ultimately satisfy very few.
Prioritizing employee well-being through robust, personalized benefits that drive engagement, loyalty, and thriving workplaces
Unlike their more conventional predecessors, today’s workforce is happy to forgo a one-size-fits-all group health plan for benefits more personalized to their needs and lifestyles.
According to Gallup research, employees who feel their employer genuinely cares about their overall well-being are significantly more engaged, loyal, and satisfied. They are 4.4 times more likely to be engaged at work and 7 times more likely to recommend their organization as a great place to work. Additionally, these employees are 53% less likely to be actively seeking new job opportunities and are 50% more likely to be thriving in their personal and professional lives. Prioritizing employee well-being drives both retention and a positive workplace culture.
Innovative companies like Nexben make it possible for employers to offer their employees choice when it comes to health coverage alongside additional benefits that enhance their lives.
Popular add-on benefits include dental insurance, vision insurance, life insurance, a variety of wellness programs, and more.
Next-gen tech is transforming health benefits from a burden into a breeze, simplifying everything from financing to administration
In the world of employee health benefits, keeping up with technology is no longer a nice-to-have—it’s a strategic necessity, and traditional manual processes simply can’t keep up.
According to a 2023 PwC survey, 77% of business leaders say they’re investing in digital tools to improve operational efficiency, and the health benefits space is no exception. A report by MetLife found that 73% of employees consider technology an important factor in selecting and managing their workplace benefits. These numbers reflect a clear shift: both employers and employees expect seamless, tech-enabled experiences.
This enrollment season, brokers have an opportunity to meet that demand. Companies like Nexben offer cohesive solutions that include access to real-time data, seamless system integrations, and end-to-end automation across benefits financing, administration, and management.
Former back-office tasks are now strategic priorities. The right technology not only saves time; it boosts accuracy, ensures compliance, and empowers brokers to deliver smarter, more scalable health benefits strategies. It’s time to embrace the tools that are reshaping employee health benefits—for good.
Help clients not only survive, but thrive in 2026
As open enrollment approaches, a perfect storm of regulatory changes, rising costs, emerging technologies, and evolving employee expectations is reshaping the health benefits landscape. Employers are under growing pressure to offer meaningful benefits without breaking the bank—and they’ll be looking to brokers for guidance.
The future lies in defined contribution models that strike the right balance: cost control for employers, flexibility and choice for employees, and technology that streamlines everything from funding to administration.
Nexben is dedicated to delivering innovative benefits solutions that keep pace with a rapidly changing market, ensuring your clients are well-positioned to succeed in the year ahead. The 2026 enrollment season isn’t just a challenge—it’s a defining opportunity.
Interested in learning more? Let’s talk.
About Nexben
Nexben is a financial technology company that makes defined contribution health benefits simple, seamless, and powerful. Connect with us to learn how partnering with Nexben can help you deliver smarter, more cost-controlled solutions to your clients.