Employee Benefits Trends for 2025: What Employers Should Know

Health care costs are climbing again in 2025—driven by prescription drugs, chronic conditions, and an aging workforce—while employees continue to expect more from their benefits. From financial wellness to mental health support and evolving family planning needs, the pressure is on to deliver meaningful value without breaking the budget.

At the same time, compliance requirements are shifting fast. Transparency regulations, new state mandates, and the potential sunsetting of Affordable Care Act (ACA) subsidies are reshaping the rules.

Let’s look at the key trends shaping employee benefits in 2025 and how your organization can adapt with confidence.

1. Rising Health Care Costs: A Pressing Concern

Health care costs are projected to rise by 7–8% in 2025. Employers are feeling the squeeze from several angles:

• High-cost prescription drugs, including GLP-1s like Ozempic and Wegovy, remain a major driver of rising health care costs. These medications often require special handling and clinical oversight, and their use is rapidly expanding beyond diabetes. With additional FDA approvals expected, GLP-1 utilization and associated spend is likely to increase even further.
  
  
• Gene therapies represent a different kind of financial risk. While rare, these treatments can exceed $1 million per course and create significant volatility in a single plan year if even one member requires them.
  
  
• Chronic conditions now account for 90% of U.S. health care spending, highlighting the need to rethink what “preventive care” really means—standard approaches are no longer enough.
  
  
• An aging workforce is driving higher utilization and long-term cost exposure.

What You Can Do

• Revisit plan design. Move beyond traditional models by exploring direct primary care (DPC), condition-specific partnerships for managing and even reversing chronic illnesses like diabetes and obesity, and creating steerage to high-value providers who deliver better outcomes at lower cost.
  
  
• Evaluate your pharmacy benefits. Look for a pharmacy benefit manager (PBM) that prioritizes transparency and total net spend. The right PBM partner should be aligned with your goals, seeking the lowest overall cost for both the member and the plan, rather than maximizing profits through rebates and other indirect compensation. Some progressive PBMs are replacing high-cost specialty brand drugs with biosimilars, achieving staggering reductions in spend. Others are exploring bypass programs and alternative channels to improve access and affordability.
  
  
• Lean into virtual care. Virtual care is evolving rapidly, with expanded hours and access to high-quality subspecialties. It remains a practical, accessible tool for cost control and employee satisfaction, and it's only getting better.

2. Health Care Transparency Is Here to Stay

New federal rules in 2025 require employers and health plans to provide more pricing information and reporting. For employers, it’s not just about compliance, it’s about helping employees make better, more informed care decisions.

Key requirements include:

• Self-service price comparison tools for covered services.
  
  
• Prescription drug cost reporting to the federal government.
  

What You Can Do

• Ensure your vendors are aligned and compliant. Mishandling transparency rules can pose real fiduciary risks under ERISA.
  
  
• Educate your employees. Transparency tools are only useful if people use them—clear, simple communication is critical.

3. The Future of Telemedicine

Telemedicine continues to offer convenience and cost savings—but regulatory changes could limit its availability in certain plan types. If pandemic-era relief expires, employees with high-deductible health plans (HDHPs) could lose HSA eligibility if they use no-cost telehealth before meeting deductibles.

What You Can Do

• Stay ahead of policy shifts and keep your team informed.
  
  
• Emphasize value. Promote telemedicine as a first line of care, especially for acute care, mental health, chronic condition management, physical therapy, and follow-ups.
  
  
• Prioritize digital access and experience. With more subspecialties becoming available via telehealth and expanded hours improving access, employers should ensure their virtual care options align with employee needs.

4. Reproductive Health and Family Planning Benefits Are Evolving

Employee expectations around family planning are growing, and state and federal regulations are evolving quickly. In California, a new law requires large employers to offer fertility benefits by mid-2025. Meanwhile, national legislation could redefine how infertility is classified under employer-sponsored plans.

Data shows that:

• 42% of large employers now offer fertility medication benefits.
  
  
• 47% cover in-vitro fertilization (IVF).

What You Can Do

• Review your current policies. Make sure you’re aligned with emerging mandates and employee expectations.
  
  
• Consider travel stipends or standalone benefits to support employees in restrictive states.
  
  
• Understand the trends. Even if not required in your state, these benefits are becoming a competitive differentiator.

5. Labor Market Trends: Compensation, Transparency, and Talent

Compensation is still top of mind, but employees—especially Millennials and Gen Z—are also looking closely at transparency, purpose, and flexibility. In 2025, these two generations make up over 67% of the workforce.

Key trends:

• Pay transparency laws are expanding. Salary ranges in job postings are now expected in many states.
  
  
• Financial wellness is a priority. More than a third of employees are considering a job change, often tied to financial stress.
  
  
• Student loan support is becoming a must-have—not a nice-to-have.

What You Can Do

• Audit your pay practices. Regular benchmarking and clear communication build trust.
  
  
• Offer voluntary benefits that matter. Loan repayment, tuition reimbursement, and financial coaching go a long way.
  
  
• Strengthen your culture. Benefits are part of your brand. Make sure they reflect your values and your people.

6. Employee Wellness Is Now Business Strategy

Burnout. Obesity. Financial strain. In 2025, these aren’t just employee issues, they’re business risks. Wellbeing is no longer a side conversation. It’s a strategic investment.

Key statistics:

• 40.3% of adults are classified as obese, increasing risks and claims.
  
  
• 62% of Americans live paycheck to paycheck, which impacts productivity and retention.
  
  
• 82% of employees report burnout, regardless of industry or role.
  
  

What You Can Do

• Be clear on the 'why.' You don’t have to track ROI to make a difference, but be intentional about what you’re trying to solve.
  
  
• Build a wellness strategy with purpose. Go beyond check-the-box programs. Focus on what your team actually needs, whether it’s mental health access, financial literacy, or work-life flexibility.
  
  
• Make it inclusive and practical. Wellness looks different for everyone. Meet your people where they are—on the job site, on the road, or in the office—and design support that fits their career and lifestyle.

7. Regulatory Shifts Under a New Administration

With new leadership in the White House, several policy changes are on the horizon:

• ACA subsidies are set to expire at the end of 2025. This could raise premiums and shift enrollment patterns.
  
  
• Medicaid funding changes may affect lower-income employees’ access to care.
  
  
• PBM reform is gaining momentum, which could reshape how prescription drug pricing works.

What You Can Do

• Monitor the landscape. Regulatory changes move fast, and having a partner who can interpret and adapt is essential.
  
  
• Model different scenarios now, especially if your workforce includes a wide range of income levels.
  
  
• Explore PBM alternatives. There’s opportunity here, and McClone dives deep into this space to identify savings without compromising care.

Looking Ahead: Empower, Educate, Adapt

The benefits conversation today is about more than just checkboxes and coverage levels. Strategies aren’t one-size-fits-all, and in 2025, proactive planning can make all the difference.

We walk alongside our clients, offering tailored strategies, high-quality alternatives, and most importantly, education that empowers employees to become better consumers of care.

Keeping pace with rising costs, shifting regulations, and evolving workforce needs isn’t easy. But it’s essential to supporting your team and staying competitive in the year ahead.