2024 Benefits Outlook

A new year brings new dynamics in employee benefits. Here's our outlook for 2024—what's changing, what's stable, and what to watch.

Cost Pressures

Healthcare cost growth will remain elevated:

• Expect 6-8% trend for most employers
• Specialty pharmacy driving disproportionate share
• Provider labor costs flowing through to pricing
• Utilization fully recovered from pandemic lows

Active cost management will be essential. Passive approaches won't contain costs.

The GLP-1 Question

2024 will be the year employers grapple with GLP-1 coverage:

• Ozempic, Wegovy, Mounjaro, and similar drugs forcing decisions
• Significant cost implications either way
• Employee expectations often exceed coverage
• No clear industry consensus yet

Every employer will need a policy, whether coverage, exclusion, or restriction.

Mental Health Maturation

Mental health benefits continue to evolve:

• Telehealth mental health now standard
• Digital tools increasingly common
• Focus shifting to quality and access, not just availability

Employers below the new baseline will feel competitive pressure.

Self-Funding Momentum

Self-funding growth continues:

• More mid-size employers exploring self-funding
• Stop-loss market offering more options
• Captive arrangements becoming accessible to smaller groups
• Greater appreciation for cost transparency

The 100-500 employee segment is where the action is.

Regulatory Landscape

Key regulatory developments to watch:

• Mental health parity enforcement intensifying
• Price transparency requirements maturing
• ACA reporting continuing
• Potential state-level surprises

Compliance burden remains real but manageable with good systems.

What to Do

For employers and consultants heading into 2024:

1. Benchmark early — Know where you stand before renewal season
2. Model GLP-1 scenarios — Understand cost implications of different approaches
3. Audit mental health — Ensure you meet evolving expectations
4. Consider self-funding — If you haven't evaluated it recently, the math may have changed
5. Plan for cost increases — Build budgets that accommodate realistic trend

The employers who plan ahead will navigate 2024 better than those who react.