Alight, Inc. says rising healthcare costs are changing how employees choose benefits, with more workers enrolling in alternative medical plans during the latest open enrollment period.
The company reviewed enrollment activity from 9.5 million users on its Alight Worklife® platform during the 2025 annual enrollment season. The data shows that cost pressures, digital tools, and income differences are increasingly shaping benefits decisions across the workforce.
“Open enrollment trends this year show incredible opportunity for employers to implement benefits strategies that help serve employees of all income levels,” said Karen Frost, Vice President, Health Strategy at Alight. “By implementing AI-powered tools for personalized guidance, organizations can deliver stronger health strategies and support overall employee wellbeing while balancing rising medical costs.”
According to Alight, employees are paying closer attention to healthcare expenses than in previous years. Medical and dental costs continue to rise, and many employers have passed a portion of those increases on to workers. For single employees, median medical costs are projected to increase nearly 10% in 2026, following a 5% rise in 2025. Family medical costs are climbing even faster, with median increases approaching 17% next year.
The analysis also points to a widening divide between income levels and medical plan participation. Employees earning between $20,000 and $39,999 enrolled in medical coverage at lower rates than in prior years, while enrollment among employees earning $80,000 or more remained steady. Alight noted that age did not appear to influence enrollment patterns.
Healthcare Costs and Enrollment Trends Reshape Benefits Decisions
A significant change of the most was the involvement of alternative medical plans. Enrollment in these plans was doubled from 2025 to 2026 in almost all the salary ranges, and the growth has been the fastest for the lower-income workers. Usually, these plans depend on features of the design like copays instead of high deductibles, primary-care-focused models, reference-based pricing, or value-based care. Hence, while the price may be the same as in traditional plans, employees get more predictability of their out-of-pocket expenses.
Technology is also helping employees to make benefits decisions in a better way than before. Users of AI chatbots on Alight’s platform were more than 8.5 million times engaged in a conversation with the bot from October through December 2025, which is almost three times the volume during the same period a year ago. Alight’s 2025 Employee Mindset Study has revealed that 43% of employees believe that AI can bestow them with the most appropriate benefits suggestions, which is a sign of a shift in employee trust towards digital guidance.
Although organizations continue to expand AI and self-service tools, many employees still value access to human support. Employees rely on human assistance when they need reassurance or clarity. Phone-based enrollment remains limited and stays in the low single digits. Meanwhile, digital enrollment continues to dominate overall activity. Alight believes that this fact is proof of the necessity of the combination of digital-first experiences with personalized assistance.
Together, these findings show that rising healthcare costs push employees toward more predictable plan options. As costs increase, employees also seek clearer guidance during benefits decisions. For employers, the data highlights a growing challenge. They must balance affordability, technology, and human support when designing benefits strategies.
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News Source: Businesswire.com
