Healthcare costs are a top concern across the United States, with 2025 anticipated to be the most expensive year for employer-sponsored insurance yet. Employers are expected to face an 8 to 9% increase in health plan costs, according to SHRM. A plan that previously cost employers $10,000 per member would now cost $10,800. For employees, that means paying over $100 more in premiums, based on KFF’s data showing the average individual employee contribution was $1,368 in 2024.
Think of it this way: nearly five weeks of an average employee’s annual salary is now going toward medical coverage, and that’s before a single doctor’s visit or prescription. Despite these soaring costs, many employers and employees don’t see a corresponding improvement in the quality of care. Nearly 40% of employers are considering changing their health insurance carriers within the next two years, according to a survey by the Business Group on Health.
At CBIZ, I directly, and indirectly, support more than 1,000 employers, helping them navigate the complexities of today’s healthcare environment. One question I often hear is: “I know that healthcare is expensive, but why is it so expensive?” Here’s how I typically respond, and how I help businesses take action.
Broker vs. Consultant: Understanding the Difference and Selecting the Right Partner
While employers provide healthcare to their employees, managing the health plan isn’t their primary expertise. That’s why external support is essential. In the search for external advisors, there are two distinct archetypes: brokers and consultants.
Wikipedia defines a broker as an intermediary who sells, solicits, or negotiates insurance on behalf of a client for compensation. Conversely, a consultant is defined as an advisor who helps individuals and businesses understand and choose suitable policies, providing guidance on risk assessment, claims management, compliance, and more. Consultants tend to offer ongoing support beyond the initial policy purchase.
A broker focuses on identifying and recommending the right insurance products and plans. This product-centric, blanket approach can be a good fit for small businesses seeking a streamlined, straightforward approach, but for organizations facing complex cost and benefit challenges, consultants offer a higher level of strategic insight.
Consultants go beyond the product. Before recommending a path forward, they dive into the business to gain an in-depth understanding of their clients’ unique challenges and problems. Consultants evaluate the use of claims data, contractual language, risk tolerance, and more — then they offer tailored solutions designed to meet the client’s unique needs. Many advisors call themselves consultants, but few truly embody this consultative mindset.
Understanding what separates consultants from brokers isn’t just semantics — it’s the difference between renewing an existing strategy and completely rethinking it. Ultimately, employers should look for an external advisor whose mission is to improve and enrich the employee health plan without increasing deductibles or out-of-pocket costs for members.
Managing Costs: A Strategic Approach
As a consultant, I see my role as that of a boxer. Managing a health plan is like stepping into a 12-round title fight. It’s not just about brute strength — it’s about timing, strategy, and staying agile. Top employers know when to jab (negotiate fees), when to dodge (avoid inflated networks), and when to strike with a bold new plan.
Containing benefits costs requires a punch and counter-punch approach. Employers who wait to adapt, sticking to the same strategy year after year, often miss their opportunity for cost mitigation. Why? Because the industry has already counter-punched their cost-containment tactics by the time they’re implemented.
To ensure effective cost mitigation, employers can’t wait for the market to adjust — they have to punch first. My most successful clients are those who make bold moves and embrace innovation.
Bleeding Edge vs. Breaking Edge Innovation
When I meet with clients, I explain the two sides of healthcare innovation: the bleeding edge and the breaking edge. At the bleeding edge, risks often outweigh rewards. However, the breaking edge is where innovation and data come together to produce proven results.
Leading alternative health plans incorporate cost-containment strategies that help employers proactively manage year-over-year increases. While many of these strategies were considered bleeding edge 10 years ago, their effectiveness has now been proven across the country. Great consultants will present breaking-edge solutions, like alternative health plans, to businesses where it makes sense.
Employers who leverage these breaking-edge solutions are ultimately able to make smart moves before costs spiral out of control.
Harnessing the Power of Data
While innovation is essential to mitigating costs and solving other key healthcare challenges, it must be backed by data to be truly effective.
Combing through mountains of data and countless plan analyses, our team has determined data should be categorized into three key buckets: actionable, influenceable, and observable. Many advisors only focus on data in aggregate form, which often only fills the “observable” bucket, leaving the other two empty. In working with clients, I go beyond the surface and dig into member-level data, filling each of the key buckets. This allows me to gain a holistic understanding of the client’s current strategy and provide data-driven recommendations centered on their goals, whether they’re striving to maintain employee premiums, reduce deductibles, or manage their overall spend.
Strategic data analysis paired with innovation drives measurable, impactful results.
The Path Forward
Managing healthcare costs effectively requires more than just renewal season decisions — it demands a thoughtful strategy rooted in data, driven by adaptability, and aligned with real-world outcomes. By embracing proven innovations and working with a consultant who acts as a true partner, organizations can control costs while enhancing employee satisfaction and improving plan performance.
To learn more about leveraging data to drive health plan decision making, please visit: CBIZ Data-Driven Cost Containment.
Cole Harris serves as the President of CBIZ Benefits & Insurance of Tennessee, as well as the National Practice Leader for CBIZ’s Health Innovations practice. With extensive experience in the benefits and insurance industry, Cole has played an integral role in major corporate strategies, offering consultative services that include evaluating current practices and recommending comprehensive, data-driven solutions. His expertise spans a wide range of areas, including healthcare reform, compliance standards, pharmacy benefit management, value-based purchasing, benefit design, and more.