Specialty drugs have been a major cost driver for years, but 2026 marks a significant shift in both scale and urgency. With GLP 1 medications expanding into new indications, gene therapies entering the market at record pace, and oncology drugs continuing to rise in both cost and utilization, specialty medications are projected to account for more than 60% of total pharmacy spending this year. That’s a dramatic change for employers, especially considering that specialty drugs represent fewer than 5% of total prescriptions.

Health benefit costs are projected to rise nearly 9% in 2026, putting significant pressure on employers to balance affordability with employee satisfaction. Against this backdrop, artificial intelligence (AI) is emerging as a transformative tool in the benefits space.

In our January issue, we outlined the major compliance themes shaping 2026. This month, we build on that foundation with a deeper look at the annual updates, effective dates, and action steps employers need as the new year begins.

Over the past two months, several major surveys — including the 2025 SHRM Employee Benefits Survey, the ADP TotalSource Employee Benefits Survey, and the 2025 National Benefits Survey — have painted a clear picture: employees are demanding more meaningful, more personalized, and more supportive benefits than ever before. Employers, facing a tight labor market and rising competition for talent, are responding by reshaping their benefits strategies around five core themes.