Open enrollment brings rising costs and uncertainties

By Erika Illiano

This year’s open enrollment season for employer-based health insurance comes with a difficult reality: Health care costs are climbing at the steepest pace in more than a decade. According to the Business Group on Health, employers expect an average 9% increase in medical plan costs, the most significant jump in years.

Employers have long believed they had already “cost-shifted” as much as possible through higher premiums, copays and deductibles. But with costs reaching historic levels, that thinking is changing. Employers are rethinking their strategies and placing renewed emphasis on shared responsibility by asking employees to play a more active role in both managing expenses and improving health outcomes.

These dynamics are already reshaping benefit strategies. As organizations are in the midst of open enrollment this year, several key trends are emerging that reflect the pressure of rising costs and the need for employees to engage more directly in their health benefits.

Higher premiums. Nearly every employer is grappling with significant increases. The challenge is balancing affordability, sustainability and transparency while acknowledging that employees will feel the impact.

New plan designs. Employers are testing new approaches to control costs, from narrower networks to “open access” models. For many employees, these changes may feel substantial, similar to when early adoption of high-deductible health plans began, making healthcare navigation support essential.
Preventive care and eligibility rules. More organizations are linking preferred pricing to proactive health behaviors such as annual primary care visits or screenings. Similarly, access to costly GLP-1 medications is increasingly tied to participation in lifestyle programs.

The message is clear: Health care affordability is now a shared effort. Yet without care, rising costs and new requirements can feel punitive. Against this backdrop, the challenge is not only what to communicate, but how.

Communicating changes across generations

A diverse, multigenerational workforce means communication strategies must be ongoing, empathetic and tailored. What resonates with a 25-year-old just starting their career may fall flat with a 55-year-old managing chronic conditions, or vice versa. Add in cultural differences, varying levels of health literacy and differing comfort with digital tools, and it becomes clear: there’s no one-size-fits-all approach.

With rising costs and new plan requirements, clear and compassionate communication isn’t just helpful, it’s essential. Employers and their brokers who tailor their messages to meet people where they are can reduce anxiety, build trust, and ultimately drive better enrollment decisions. Four practices stand out.

Acknowledge the impact
According to the American Psychological Association, health care is already one of the top three stressors for adults. The way that stress is felt can vary by age and life stage. Younger employees may focus more on affordability, while older employees may prioritize access to specific providers or medications. Acknowledging this reality, showing understanding and emphasizing available support go a long way toward easing concerns.
Choose platforms wisely
Different generations engage with information in different ways. A multichannel approach - including email, intranet, videos, webinars and in-person meetings - ensures broad reach. However, when the message is sensitive, face-to-face conversations are most effective, whether in live town halls or manager-led discussions. Matching the channel to the audience improves comprehension and signals respect for employee preferences.
Empower managers to deliver the message
Employees want to hear from leaders and their managers. Research shows that employees, regardless of their age, are more than seven times as likely to trust leadership during change when managers provide space for honest feedback. Training managers to deliver consistent, authentic messages builds credibility.
Connect the dots for employeesClarity matters, but context is critical. Employees deserve to understand not just what is changing, but why. Explaining the drivers - such as rising costs, eligibility requirements and timing - helps people connect the dots and providing a rationale increases both trust and acceptance.

A phased approach for open enrollment success

After defining what to communicate and how to adapt messages for a diverse workforce, the next consideration is when those messages should be delivered, and in what sequence. I’ve found that an effective open enrollment communication plan in a year of substantial change unfolds in three phases.

Executive briefings. Senior leaders must understand key messages and potential employee reactions several weeks before rollout. This prepares them to lead with confidence.

Manager previews. Managers and human resource partners should be equipped with FAQs, talking points and presentation decks. Since employees often turn to their direct supervisors first, this step ensures consistency across the organization.
Employee communications. Engage the full workforce using multiple channels: email, intranet, town halls, team meetings, videos and workplace signage. Layering channels helps maximize reach and comprehension.

Throughout all three phases, transparency and empathy remain central. Employees may not welcome every change, but when the rationale is clear and delivered thoughtfully, they are more likely to respect the process and maintain trust in leadership.

Meeting the moment

Open enrollment has always been a pivotal part of the employee experience. With record cost increases and new plan requirements, it is also a test of communication. Employers and brokers who approach the process with clarity and care won’t only guide employees through change; they will strengthen trust and engagement in the process.