For many employers, the 2026 medical renewal season brought a familiar but unwelcome headline: costs were going up, and in many cases, often fast. More than three‑quarters of employers saw increases above 6%, and a significant share faced double‑digit jumps. In a year where budgets were tightening before the calendar even turned, the natural question became: What’s going to give?

But the answer wasn’t what most expected. Instead of scaling back, employers overwhelmingly chose to protect — and often expand — their wellbeing programs. Sequoia’s 2026 Wellbeing Trends Report reveals a quiet but meaningful shift in how organizations are thinking about wellbeing, especially when financial pressure is high.

Together, the trends point to a story of stability, sharper focus, and rising expectations.

A Tough Renewal Year That Didn’t Trigger Cuts

There’s no question that renewals were difficult. The most common increases fell in the 6–10% range, with another large portion of employers experiencing 11–20% hikes. These kinds of jumps often prompt companies to revisit anything seen as discretionary.

Yet 68% of employers made no changes to their wellbeing programs — no cuts, reductions, or restructuring. Even more striking, 22% added new programs without eliminating anything, while only a very small minority (3%) chose to eliminate a program.

This level of stability in a challenging financial year signals that wellbeing has crossed an important threshold. Employers increasingly see it as integral to the employee experience and to long‑term cost management, rather than a perk that can be adjusted when times get tough.

Stability Across Company Sizes

One of the most consistent themes in the data is how similar employer behavior was across company sizes. Small, midsize, and large organizations all leaned heavily toward maintaining their wellbeing programs. Notably, midsized employers (especially those with 501–1,000 employees) were among the most likely to add new offerings this year.

This trend held steady even when we looked specifically at employers with the highest medical increases. You might assume that companies facing double‑digit renewals would be the first to scale back. Yet “no change” was still the most common response, and “add‑only” decisions appeared across every renewal tier — even among those with the steepest cost jumps.

The takeaway: Employers believe cutting wellbeing hurts more than it helps. Whether because they’ve adjusted medical plan designs, are seeing greater employee need, or are taking a long-term view on managing chronic conditions and medical utilization, wellbeing support feels increasingly non‑negotiable.

Sharper Priorities: What Employers Expect From Vendors Now

While employers largely kept their programs intact, they did become more specific in how they evaluated partners. Cost continues to matter. It was the top factor for 58% of employers selecting wellbeing vendors, but it’s no longer the only point of focus.

The second‑most important factor this year was demonstrated ROI or outcomes, selected by 22% of employers. Employers aren’t looking to reduce wellbeing programs, but they are demanding clearer evidence of value.

Vendors that can articulate measurable outcomes, integrate smoothly with other systems, and provide transparent reporting have an advantage. In a year where budgets are tight, the pressure isn’t to cut, it’s to prove impact.

A More Strategic Lens: Targeting High‑Cost Conditions

Finally, the report shows that employers are getting more intentional with where they invest. Instead of spreading resources thinly, many are directing wellbeing budget toward areas fueling their medical costs: mental health utilization, obesity treatment demand, increased overall utilization, and chronic condition management.

This reflects a more strategic approach to wellbeing — one that aligns supportive programs with areas of highest medical spend. Rather than deprioritizing wellbeing during a tough renewal year, employers are using it as a tool to address the very cost drivers that influenced their budgets in the first place.

What This Year’s Renewal Decisions Really Signal

It wasn’t an easy year for medical renewals, but the response from employers was clear and consistent: wellbeing programs aren’t going anywhere. Even under real cost constraints, companies chose continuity over contraction, refinement over reduction, and value over volume.

As wellbeing benefits continue to mature, their role is becoming more foundational as a core part of how employers support their people, protect their culture, and manage long‑term health trends.

If you’d like to dig into more data, including insights related to GLP-1 coverage, mental health support, and AI in wellbeing programs, join us for our webinar, Employer Approaches to Wellbeing in 2026: GLP-1, Mental Health, Cost Containment, AI and More, on Thursday, March 5.

Shannon Arens — Shannon is Director of Wellbeing at Sequoia, specializing in market insights, industry trends, and strategic initiatives to enhance employee wellbeing for clients. With a keen eye on the ever-changing wellbeing landscape, Shannon is focused on helping employers prioritize what will best address the needs of their people. Outside of work, Shannon enjoys spending quality time with family, staying active through exercise, and connecting with friends.