As Marketplace health plan premiums rise and subsidies shift, employers are seeing more requests from employees (and their spouses) to drop Marketplace coverage and enroll in an employer-sponsored health plan mid-year. While this may feel straightforward, Marketplace rules and employer plan rules do not always work the same way.

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.