2027 benefits strategy: advice from Aon, Howden, and WTW

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What Aon, Howden, and WTW consultants say employers should prioritize in 2027

Employer healthcare costs are projected to rise 9.5% in 2027, pushing the average above $19,000 per employee. That makes four straight years of near double-digit increases, and CFOs have started asking much harder questions about where the money goes.

So we asked three people who spend their days helping employers answer those questions. On October 21st, Castlight hosted a panel discussion, Building Your 2027 Benefits Strategy: Cost, Consolidation, and How Your Consultant Can Help, with Alex Tiligadas of Howden, Monica DeGraff of WTW, and Serafina Miller of Aon. Below are the biggest takeaways (plus a few lines you’ll want to hear in their own words).

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Key Takeaways: 

• You can’t negotiate your way out of the cost increases. The lever employers still control is where care happens and which providers employees choose.
• Employers are getting more comfortable guiding care. Navigation and provider steerage are replacing “here’s our network, good luck”.
• AI nearest-term wins are practical: early risk identification, personalized outreach, and reaching spouses and dependents
• Simplifying doesn’t have to mean cutting vendors. It means one clear front door and real accountability for all vendors. 
• Prove your value isn’t going away. Basic registration stats are out. Avoided surgeries, avoided ER visits and lower cost of care is in. 

What’s driving employer healthcare costs into 2027?

Pharmacy spend (especially specialty drugs and GLP-1s), cancer and chronic conditions showing up at younger ages, and provider consolidation top the list. The panel agreed employers can’t negotiate those pressures away, but they can influence where and how care happens.

Serafina called GLP-1s “the perpetual elephant in the room” and pointed to provider consolidation and contract renewal increases pushing up the underlying cost of care. Alex flagged a trend that concerns all three panelists: chronic conditions and cancers, including breast and colon cancer, are being diagnosed in younger populations.

Monica added one more driver, with a terminology update. What the industry has long called “upcoding,” her clients prefer to call “right coding” (whatever you call it, it shows up on the claim). Aon’s latest report flags the same pressure, noting that new documentation and coding technology, including AI, is contributing to higher billed charges in some cases.

The numbers back up the urgency. Alex noted that employers are facing the highest trend in 17 years. So where’s the lever? He put it plainly:

“It’s not about negotiating harder. It’s about truly, fundamentally thinking about where care happens, what are we paying for it, is it appropriate care, and are we intervening early enough.”

Alex Tiligadas, Managing Director, West Region Leader, U.S. Health and Benefits, Howden

Serafina agreed: employers can’t control which new drugs and therapies come to market, but they can help employees get to high-quality, lower-cost providers at the appropriate level of care. In her words, “We can’t negotiate away those healthcare costs. It’s much more about how do we influence those healthcare decisions.”

How are employers approaching 2027 differently?

Employers are more data-driven, more focused on outcomes, and more committed to making sure their people can get the right care. A big reason: CFOs are getting more involved in the decisions, and HR wants to avoid cutting benefits or shifting more cost to employees.

Alex described a real mindset shift. Employers are more open to challenging the status quo, whether that means alternative funding arrangements, new networks, or different care delivery models. They’re also more willing to call underperforming vendors out and expect more from the partners they keep.

For Serafina, the biggest change is comfort. Employers used to be reluctant to get in the middle of how care is delivered. Now they’re actively pairing navigation with provider steerage, instead of “just giving employees a network to access and hoping that they’re making the best choice.”

The result is a different conversation entirely. As Serafina put it, her clients have started asking how to fundamentally improve the way employees and their families access and experience care.

Where can AI actually improve engagement and outcomes? 

The panel’s answer was very practical: spotting health risks earlier, sending personalized outreach to the people who need it, and reaching more spouses and dependents who rarely see an HR email. 

Monica sees AI-driven early identification and targeted messaging making the biggest difference for her clients today. Reaching spouses is one of the hardest problems in benefits communication, which makes it one of the most valuable. 

Alex shared a story that we can all relate to. After 25+ years in the industry, he’s never felt more engaged with his own health, thanks to a platform that handles his labs, connects to his wearables, and lets him ask questions through AI chat. According to Alex, “we’re entering a new era of hyper-personalization that will really help us impact claims cost before they even register on the claims radar”. 

There’s still plenty of runway. Only 37% of employers are relying on their core vendor ecosystems to integrate AI into their benefits programs. Serafina sees AI becoming a trusted front door, replacing WebMD and Google. She also raised a very good point that can often get overlooked: AI has to work for a diverse workforce. “The AI is only going to be as effective as its ability to understand and support those diverse populations; their backgrounds, their healthcare conditions, and their care needs. If we’re going to rely on AI to personalize those healthcare journeys, it needs to be equitable for everybody.”

Do employers have too many point solutions, or no clear front door? 

A bit of both, but findability is the bigger issue to solve. Employees can’t use a benefit they can’t find at the moment they need it. 

Monica put it in terms every benefits team will recognize.

“It’s one thing to have a great open enrollment communication, but six months down the road when an issue arises, is that employee going to remember what the solution is that they need to plug in?

Monica DeGraff, Managing Senior Director, Health & Benefits, WTW

Her answer is the need for a home base: one place employees know to go, plus a renewed focus on preventive care and earlier intervention.

Alex talked about what he believes to be the root cause of point solutions fatigue. Vendors that didn’t deliver on their promise, and the need to go deep in one area when a broad solution couldn’t, led employers to keep adding more programs. His fix? Start with the employee: 

“We’re designing these programs for employees that don’t understand benefits the same way we do. So we need to make it simple. We need to make it timely, We need to meet them where they are.”

Alex Tiligadas, Howden

However, simplifying doesn’t automatically need to mean cutting. Point solutions still serve a purpose. The job is to inspect the data, get commitments up front, and monitor whether each partner is delivering. 

What does proof of value look like? 

Outcomes measured against baseline. Registration and engagement stats alone no longer earn a vendor its place in the benefits ecosystem. 

Serafina used musculoskeletal (MSK) care, which is a major cost driver for many of her clients, as an example. A strong proof story goes beyond app downloads. It shows that registered users avoided unnecessary surgeries, tried conservation treatments first, and had a lower cost of care than similar members who did not participate. 

“We have enough data at this point to understand what a cost of care is for an untreated member, an unsupported member. To understand those cost savings differentials is really where the proof points are, not just showing engagement stats.”  

Serafina Miller, Senior Vice President, Account Executive, Health Solutions, Northern California, Aon

Monica pushed the conversation one step further: don’t just take a vendor’s word for it. Dig into the data to understand what is driving the outcomes, and weigh long-term clinical and financial impact over near-term wins. 

Alex made sure nobody gets a free pass. Hold all your vendors and partners accountable for performance, and he said “that includes your consultants too”. 

Can cost control and a better employee experience coexist? 

Yes, and the panel argued that that is the goal. When healthcare works well, employees get better outcomes and a better experience, and the employer pays less. 

The goal is cutting wasteful, unnecessary care, and that only works if the better choice is also the easy one. We can’t expect employees and their dependents to become benefits experts in a system that confuses even the people who work in it. 

Serafina described cost control and experience as a venn diagram, with the sweet spot right in the middle (or the overlap). The strongest strategies start by understanding the population’s needs, then use data and navigation tools to help employees and family members make the right choice. Prevention and early intervention do a lot of the heavy lifting, because a healthier population is a lower cost employee population. 

Where Castlight fits in

Across every question, the panel kept landing on the same theme. Employers have already made smart investments in networks, programs, and point solutions. What’s missing is a way to make that strategy perform: one front door, guidance at the moment of decision, and proof you can take back to your CFO. 

That’s where Castlight comes in. We connect the benefits you already have into a single experience, then use claims, plan, and engagement data to spot health risks and gaps in care before they become high-cost claims. Every member gets guided to high-value providers and the right program at the right time. When things get complicated, Care Guides step in. And employers see engagement, utilization, and outcomes all in one place.   

Finish the sentence: which employers will win in 2027?

We closed out the session with one rapid-fire fill in the blank for the panelist: In 2027, the employers that get the most out of their benefits investment will be the ones that….

Monica DeGraff: “…understand their cost drivers and proactively engage their covered population to choose high-quality providers and take ownership of their health.” 

Alex Tilligadas: “…stop reacting to healthcare costs and start actively managing the health of their people and the performance of their healthcare investments.” 

Serafina Miller: “…stop measuring success by what they offer and start measuring success by the health decisions that they influence.”

Want to hear more?

There’s plenty we couldn’t fit in one recap, watch the full webinar on demand or connect with our Alliances Team directly.

*Quotes in this article have been lightly edited for clarity.