2026 Benefits Planning Starter Guide

Healthcare benefits are no longer a “once-a-year HR task.”

As we head into 2026, multiple forces are converging:

• Expiring ACA subsidy enhancements

• Rising healthcare and prescription costs

• Tighter labor markets for experienced talent

• Increased employee sensitivity to total compensation

For business owners and executives, this means one thing:

Benefits strategy is now people strategy and financial strategy.

This guide is designed to help you:

• Understand what’s changing

• Anticipate how it impacts your workforce

• Avoid reactive, expensive decisions

• Build a benefits plan that supports growth instead of derailing it

This is not legal advice or a pitch.
It’s a planning framework.

What’s Changing?

Expanded ACA premium subsidies that helped keep individual marketplace insurance affordable are set to expire unless extended by legislation.

If they expire as scheduled:

• Many individuals will see higher monthly premiums

• Out-of-pocket costs may increase

• Marketplace plans may feel less viable for some workers

This does not just affect individuals without employer coverage.

It changes:

• How employees evaluate employer-sponsored plans

• How competitive your benefits feel

• How much pressure lands on your total compensation strategy

Why Business Owners Should Care

1. Employee Behavior Will Shift

Employees who previously relied on marketplace coverage or spouse plans may:

• Seek employer-sponsored insurance

• Re-evaluate whether their current job meets their needs

• Factor benefits more heavily into job decisions

This can quietly affect retention and engagement.

2. Benefits Become a Stronger Recruiting Lever

As individual coverage becomes more expensive:

• Employer-sponsored plans gain relative value

• Candidates compare benefits more closely

• “Good enough” plans may no longer feel competitive

If your benefits haven’t evolved in years, you may feel this first in hiring conversations.

3. Unplanned Cost Pressure Hits Budgets

Many companies get caught in this cycle:

• Premiums increase

• Leadership reacts late

• Decisions are rushed

• Costs rise with little strategy behind them

Smart companies model scenarios before renewal season.

Common Benefits Mistakes SMBs Make (And How to Avoid Them)

❌ Treating benefits as a broker-only decision
❌ Looking only at premiums instead of total value
❌ Waiting until renewal to think strategically
❌ Failing to communicate benefits clearly to employees
❌ Assuming “more expensive = better”

Benefits strategy should align with:

• Workforce demographics

• Hiring plans

• Multi-state considerations

• Financial forecasts

• Company growth stage

How to Get Ahead of 2026: The Executive's Checklist

1️⃣ Understand How Your Workforce Is Actually Covered

Ask:

• How many employees waive coverage?

• How many rely on marketplace or spouse plans?

• Are cost concerns driving opt-outs?

• Do employees understand the value of what’s offered?

You cannot plan what you don’t measure.

2️⃣ Model Scenarios Before Renewal Season

Consider:

• What happens if premiums increase 10–20%?

• What is your benefits “breaking point” financially?

• How would changes affect retention or hiring?

This turns benefits into forecasting, not guesswork.

3️⃣ Re-Evaluate Plan Design (Not Just Carriers)

Rising costs don’t always require higher spend.

Sometimes they require:

• Adjusted employer contributions

• Smarter plan tiers

• Clear eligibility strategies

• Supplemental benefits that add perceived value

The goal is intentional design, not default renewals.

4️⃣ Communicate Early and Clearly

Silence creates anxiety.
Surprise changes damage trust.

Strong companies will:

• Explain why decisions are made

• Frame benefits as part of total compensation

• Give employees clarity, not confusion

Good communication can reduce backlash even when costs rise.

Benefits Are Infrastructure, Not Perks

Benefits affect:

• Retention

• Engagement

• Employer brand

• Financial predictability

• Leadership credibility

They are not a perk.
They are infrastructure, just like payroll, finance, or operations.

Companies that treat benefits strategically weather change.
Companies that treat them reactively scramble.

Final Thought for Executives

If benefits suddenly became a deciding factor for your workforce in 2026, would you be ready?

Planning now gives you options.
Waiting later limits them.

Want Help Turning This Into a Strategy?

If your company is growing, multi-state, or navigating increasing people costs, a structured benefits roadmap can help you protect both your people and your margins.