What’s Ahead for 2026: Smarter Plan Design Starts Now
For years, employers and brokers have been chasing a health plan that delivers affordability, broad access, and high-quality benefits. But as we head into 2026, that pursuit is becoming even more complex.
The data is clear: health costs aren’t slowing down. Prescription drug prices have risen three times faster than inflation since the late 1980s, health premiums are projected to rise 12%+, and we continue to see groups shift from fully insured plans in search of flexibility and savings. To stay ahead, brokers and employers will need smarter strategies and innovative partners to navigate what’s next.
As a leading TPA with a national footprint, 90 Degree Benefits provides unique plan design solutions to help brokers deliver long-term sustainability for their clients.
Top Plan Design Trends for 2026
Here are four key trends we see on the horizon for 2026 and how 90 Degree Benefits helps employers and brokers stay in control:
1. Smarter Care Navigation
Traditional broad PPO networks drive up costs by failing to direct members to the highest-value providers. With CareConnect, 90 Degree Benefits creates a virtual narrow network, steering employees to high-quality, lower-cost providers while simplifying the member experience.
Impact: Up to 15% savings
2. Pharmacy Oversight Becomes Essential
Since the late 1980s, drug prices have increased at nearly triple the pace of inflation. Employers can no longer afford to rely on standard PBMs. RightTurnRx provides PBM oversight, contracting support, clinical cost containment, and alternate funding strategies that save employers up to 30%.
Impact: Up to 30% savings
3. Rising Premiums Demand Innovative Access
With premiums expected to climb 12%+, employers are looking for new ways to deliver affordable, accessible care. Access2Day Health near-site clinics offer zero-copay primary and urgent care, reducing ER visits and improving overall health outcomes.
Impact: Up to 10% savings
4. Shift Away from Fully Insured Plans
According to the 2024 KFF Employer Health Benefits Survey, just 36% of covered workers were in fully insured plans, while the majority were in self-funded or level-funded arrangements. The shift reflects a growing demand for flexibility, transparency, and cost control. With stop-loss advantages gained through programs like CareConnect, RightTurnRx, and Access2Day, 90 Degree Benefits clients often see 15%–25% savings on stop-loss costs.
The 90 Degree Advantage
By integrating these strategies, employers and brokers can finally balance cost, quality, and access without compromise. Our approach isn’t just about reducing spend, it’s about building sustainable, smarter benefits plans that support healthier employees and healthier bottom lines.
2026 will bring new challenges, but with the right TPA partner, brokers and employers don’t have to face them alone.
Ready to get ahead of what’s coming? Let’s Make the Right Turn™ for your plan together.