Curing Sticker Shock: Employer Fixes for 2026 Healthcare Costs

Employer-sponsored healthcare is bracing for a wave of affordability challenges as open enrollment arrives for 2026. Costs are expected to surge again, forcing employers and employees to revisit their benefit strategies and budgets. With U.S. healthcare costs again expected to be well above general inflation, new plan designs and affordability solutions are emerging as critical tools for companies aiming to preserve coverage and control expenses.

How Rising Costs Are Shaping Employer Strategy

Healthcare affordability is no longer a side issue for employers—it is now central to workforce well-being and business planning. Analysts are forecasting medical cost for employer-based plans rising by as much as 10% in 2026, with average annual employee premiums for family coverage already reaching $6,850 in 2025 according to KFF. As federal government subsidies face uncertainty and the ACA landscape evolves, both large and mid-sized employers are introducing innovative solutions to cushion workers against “sticker shock” and reduce their own bottom-line exposure to rising claims.

Several models have emerged to help better employers and employees manage rising medical costs. One addresses fundamental plan design. A second gives employees access to low cost credit to help pay for healthcare under any type of healthcare plan.

Affordability Innovators: Plan Design

Two new health plans, both based in the Minneapolis, MN area, illustrate a new approach to bend the curve of group medical costs. Surest Health Plan, was founded in 2016 as Bind and is now owned by UnitedHealthcare. Coupe Health was founded in 2021 and is owned by Stella Health, parent of Blue Cross and Blue Shield of Minnesota. Both plans employ copay only models, focus on high-value providers, and tout lower overall employer medical cost (Surest reports lower employer spend of 15%, while Coupe Health saw claims costs drop by 12%):

• No Deductibles or Coinsurance: Both plans utilize up-front, fixed copays that apply to almost every service, removing the “first dollar” barrier for basic care while still exposing members to some costs, but in a predictable and manageable way
• Copay-Only, Price-Transparent Shopping: Members know the price before care – apps or online tools allow users to see and compare exact copays for providers and procedures, steering them toward higher-value and often lower-cost options​
• Emphasis on High-Value Providers: While both plans still offer broad national networks (via UnitedHealth and the BCBS network, respectively), they also incentivize selection of high-value (efficient/ high-quality/ low-cost) providers by dynamically setting lower copays for these options.​
• Plan and Claims Simplicity: These models streamline how bills are paid and how members interact with their plans. Coupe Health bundles payments and pays providers in full at time of service, which reduces provider bad debt and billing confusion, lowering overall system costs.​
• Member Education and Steering: Continuous digital “navigation” and up-front cost clarity mean members are less likely to unintentionally use high-cost, low-value providers or do so only with full knowledge of financial exposure. ​

Another approach that has emerged to make employer-sponsored healthcare more affordable is to give employees access to no-interest financing. Milwaukee, WI-based PayMedix is a healthcare payments and financing company founded in 2021. It is a division of Health Payment Systems (HPS), a privately-held healthcare technology and services organization. PayMedix differentiates itself by providing guaranteed, 0% interest financing for patient out-of-pocket costs, and is now available nationwide no matter what HMO or PPO network is used. The PayMedix solution:

• Consolidates all in-network bills into a single, easy-to-understand monthly statement
• Pays providers promptly, reducing billing friction and administrative costs
• Improves equitable access, helping those who can’t qualify for traditional credit

Columbia, MO-based Paytient is a healthcare-focused fintech company founded in 2018 and owned by investors including Inspired Capital, Mercato Partners, and Bertelsmann Investments. Paytient is known for its Health Payment Account (HPA), which allows patients to pay out-of-pocket healthcare costs over time with no interest or fees, helping employers, payers, and health systems remove financial barriers to care. The Paytient solution:

• Provides flexible, zero-interest payment plans via a dedicated health card
• Improves adherence and reduces overall claims by enabling patients to pay over time
• Enables patients to access care they would have delayed or skipped

Why Employers Should Act Now

With 2026 health costs poised to climb considerably faster than inflation, employers must vigorously pursue solutions that simplify benefit usage and payment transparency, while equipping employees with tools for managing expenses. Innovative partners such as Surest, Coupe Health, PayMedix, and Paytient exemplify the shift from legacy insurance models to value-driven, user-friendly benefits. These types of strategies will be central to sustaining workforce health in the years ahead.