How plan sponsors are approaching cost savings
While more aggressive cost-saving options can create disruption, when implemented thoughtfully, targeted plan design and strategy adjustments can drive savings while still maintaining stability for members.
In today’s high-cost environment, the most disruptive decision may be to do nothing at all. Taking action, even in small steps, can better position you over time. Here are just four examples of how employers can approach benefits cost savings:
Eligibility management
Managing plan eligibility through targeted strategies can align with your plan's philosophy and manage costs effectively. As spouses disproportionately contribute to costs (with 36% higher average cost per person, according to Infolock®), this is an impactful area for cost management.
20% of employers are using eligibility strategies to save costs.
Employers have different philosophies on whom they cover and how they subsidize spouses. Among those 20%, foundational and progressive tactics are growing in prevalence, while more disruptive options remain less common.
Source: 2025 Lockton National Benefits Survey
impose a spousal charge
exclude spouses with access to other coverage
exclude all spouses
Source: 2025 Lockton National Benefits Survey
Population health
Effectively managing chronic conditions, one of the most consistent benefit cost drivers, can lower long-term costs while also improving employee health and wellbeing. However, the majority of surveyed employers are not implementing solutions beyond traditional carrier programs for chronic condition management, across all conditions.
CHRONIC CONDITION MANAGEMENT
Cancer
Cardiometabolic
Digestive health
Musculoskeletal
Renal/chronic kidney disease
Source: 2025 Lockton National Benefits Survey
Purchasing efficiency
Savings can also be driven not just from what, but how, benefits are purchased.
- Group purchasing organization (GPO) arrangements dominate the rebate market.
- Pharmacy is the most common place to find purchasing efficiency value, as 30% of health plan costs are connected to pharmacy benefits.
of employers are focusing on specialty pharmacy areas to save costs
SPECIALTY PHARMACY (SELF-FUNDED ONLY)
Mandatory specialty site-of-care management
Specialty management carved out from the carrier/PBM
Specialty medicine can only be obtained from a specialty pharmacy
of surveyed employers use a narrow or high-performing network
Network design
Strategic structuring of providers within the health plan is effective at reducing costs but introduces more potential for disruption if employees must change providers or adapt to new care options.
- 32% of surveyed employers use a narrow or high-performing network
- 8% of self-funded direct contract
- 6% self-funded reference-based pricing
- <1% ICHRA
Source: 2025 Lockton National Benefits Survey
