If your 2027 health insurance renewal arrives with a double-digit increase, you may hear a familiar explanation: medical costs are up, prescription spending is up, and expensive GLP-1 drugs such as Ozempic are putting pressure on the plan.
That explanation may be partly true. It is not a complete renewal strategy.
You should not simply absorb a large premium increase because someone says “Ozempic” and moves on. You should demand three specific numbers from your broker: then use them to compare affordable group health insurance options, plan designs, and carriers.
The timing matters. On August 6, 2026, KFF reported that nearly 300 insurers across all 50 states and the District of Columbia had proposed a median 14% premium increase for small-group coverage in 2027. These are preliminary filings, not a guaranteed increase for every business, but they confirm what many owners are already seeing: renewal pressure is real.
Your increase may be lower: or higher: depending on your state, carrier, enrollment, plan design, claims, and prescription use. Either way, “GLP-1 costs” should be the beginning of the conversation, not the end.
Why Ozempic is showing up in your renewal discussion
Ozempic is a brand-name GLP-1 medication approved for treating type 2 diabetes. Other drugs in the same general category, including Wegovy and Zepbound, may be prescribed for obesity or weight management.
These medications can be clinically valuable for eligible patients. They can also be expensive, especially when coverage expands to include weight management for a larger number of plan members.
That creates a difficult business decision. If you exclude coverage, employees may face significant out-of-pocket costs or lose access to a treatment their doctor considers appropriate. If you cover the medications broadly, your pharmacy spending may rise and the carrier may reflect that increase in your premiums.
The answer is not automatically “cover everything” or “cover nothing.” The answer is to understand what your plan is paying, how the rules work, and what alternatives are available.
For additional renewal planning, review our guide to preparing for 2027 small-business health insurance premium increases.
Number 1: The total renewal increase before and after negotiation
Ask your broker:
“What is my carrier’s proposed increase, and what increase do you believe is reasonable after comparing the market?”
You need both numbers.
If your renewal shows a 16% increase, that is the carrier’s opening position. It is not necessarily the best available option. Your broker should compare that offer with competing plans that have similar provider access, deductibles, prescription coverage, and employee contributions.
Also ask your broker to separate the causes of the increase. Request a plain-English breakdown showing how much comes from:
- Hospital and physician prices
- Increased use of medical services
- Prescription drug costs
- GLP-1 coverage
- Changes to the provider network
- Changes to the plan’s benefits or deductible
- Small-group market adjustments
The national 14% median proposed increase reported by KFF is useful context, but it does not justify every renewal. A 14% increase may be reasonable in one market and uncompetitive in another.
You should also ask whether your plan is fully insured, level-funded, or another arrangement. A fully insured carrier generally sets your premium using broader market factors. A level-funded plan may offer more detailed information and a different pricing structure, but it can come with additional risk and renewal considerations.
Do not compare premium alone. Compare the total cost to your business and your employees.
Number 2: The exact percentage GLP-1 drugs add to your renewal
Ask:
“What percentage of my proposed increase is specifically tied to GLP-1 medications, and what evidence supports that number?”
This is the number that separates a real analysis from a convenient talking point.
One 2027 small-group rate filing in New York reportedly included a 2.4% rate adjustment for medically necessary anti-obesity medications, including GLP-1 drugs. That does not mean every business should expect a 2.4% increase. It is a useful benchmark showing that GLP-1 coverage can appear as a specific component of a carrier’s pricing.
Your broker should tell you whether the quoted impact applies to:
- Ozempic for diabetes only
- Wegovy, Zepbound, or similar drugs for weight management
- All GLP-1 medications combined
- Current members using the medications
- Expected future use across the entire covered population
These distinctions matter.
A plan that covers GLP-1 drugs for diabetes may have a different cost profile from a plan that also covers obesity treatment. A plan requiring prior approval, clinical eligibility, ongoing results, and periodic renewal may have a different cost profile from a plan with broad access.
Ask your broker to model at least three choices:
- Continue current coverage rules.
- Cover weight-management medications with clear clinical requirements.
- Exclude weight-management coverage while continuing medically necessary diabetes coverage, where permitted and appropriate.
Each option should show the estimated premium impact and the effect on employee access.
There is also an important warning: a lower list price does not automatically mean a lower employer cost. Novo Nordisk has announced a $675 monthly list price for certain semaglutide products beginning January 1, 2027, but rebates and negotiated prices can change at the same time. As Mercer explains, employer plans may not receive the full benefit of public-program or direct-to-consumer price changes immediately.
You need your plan’s number: not a headline number.
Number 3: The net monthly cost per GLP-1 user
Ask for this in writing:
“What is the net monthly cost to the plan for each GLP-1 prescription in 2026, and what is the projected net monthly cost in 2027 after discounts and rebates?”
This is the most important dollar figure.
The list price is what a manufacturer publishes. The net cost is what remains after negotiated discounts, rebates, and other adjustments. Your plan may be paying something very different from the price shown in a news article or on a pharmacy website.
Recent employer-plan analyses have estimated net GLP-1 costs in the range of approximately $617 to $766 per 30-day supply, although your actual cost can vary by medication, dose, contract, pharmacy arrangement, and indication.
Ask for four related figures:
- Current net cost per prescription
- Projected 2027 net cost per prescription
- Current number of prescriptions per month
- Projected number of prescriptions per month
Then ask your broker to calculate the annual impact.
For example, if your plan has 10 covered GLP-1 users at a net cost of $650 per month, the annual prescription expense would be approximately $78,000 before considering member cost-sharing, rebates, or other adjustments. If utilization grows to 15 users, the annual cost could rise to approximately $117,000.
That does not mean you should deny coverage. It means you should budget honestly and compare alternatives.
What to do if your broker cannot provide these numbers
If your broker cannot show the GLP-1 impact, ask why.
For a small fully insured group, you may not receive individual claims information because of privacy rules and limited group size. However, your broker or carrier may still be able to provide aggregate prescription trends, utilization estimates, renewal assumptions, and the general pricing effect of GLP-1 coverage.
If the answer is simply “the carrier does not provide that information,” you still have options:
- Request competing carrier quotes.
- Compare a different plan design.
- Review pharmacy coverage and clinical requirements.
- Explore a level-funded arrangement if appropriate.
- Consider a defined contribution strategy.
- Evaluate an Individual Coverage Health Reimbursement Arrangement (ICHRA) when it fits your workforce and compliance needs.
A sole proprietor with no common-law employees may not qualify for traditional small-group coverage. In that situation, you should ask your broker to compare individual ACA coverage and other legally available options instead of treating a group renewal as your only path.
Your broker should help you understand the trade-offs: not merely deliver the carrier’s invoice.
The affordable group health insurance test
Affordable group health insurance is not always the plan with the lowest monthly premium.
You also need to consider:
- Employee payroll deductions
- Deductibles and out-of-pocket maximums
- Prescription access
- Provider and hospital networks
- Employer contribution levels
- Coverage for dependents
- Administrative workload
- Compliance responsibilities
- Whether employees can actually afford to use the plan
A plan that saves your company $20,000 but forces employees to pay thousands more for essential care may create retention problems. A plan with a higher premium may deliver better value if it provides dependable access and predictable costs.
Your renewal decision should protect both your business budget and your employees’ ability to use their benefits.
Total Benefit Solutions can help you challenge the renewal
You do not have to accept a premium increase without asking what is driving it or comparing other options.
Total Benefit Solutions acts as an independent broker and health insurance advocate for small businesses and sole proprietors. We can help you review your renewal, separate general medical trend from GLP-1 costs, compare carriers, and evaluate plan designs that may better fit your budget.
Before you approve your 2027 renewal, demand these three numbers:
- The total proposed increase: and the increase after market comparison.
- The exact percentage attributed to GLP-1 medications.
- The net monthly cost per GLP-1 prescription today and in 2027.
Call Total Benefit Solutions at 215-355-2121 or visit www.totalbenefits.net to schedule a renewal review. We will help you understand the numbers, compare your options, and advocate for a better answer.
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