{"id":896797,"date":"2026-10-27T21:34:11","date_gmt":"2026-10-27T21:34:11","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/896797\/"},"modified":"2026-10-27T21:34:11","modified_gmt":"2026-10-27T21:34:11","slug":"glp-1-coverage-is-being-dropped-by-employers-2027-weight-loss-options","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/896797\/","title":{"rendered":"GLP-1 coverage is being dropped by employers: 2027 weight-loss options"},"content":{"rendered":"<p><img decoding=\"async\" class=\"InlineVideo-videoThumbnail\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/108345946-5ED1-REQ-080626-GLP1.jpg\" alt=\"Bank of America CEO Brian Moynihan: We spend 'about $250 million or more' on GLP-1 drugs each year\"\/><\/p>\n<p>With <a href=\"https:\/\/www.cnbc.com\/2026\/10\/12\/health-insurance-open-enrollment.html\" rel=\"nofollow noopener\" target=\"_blank\">open enrollment<\/a> season in swing, many employees may notice something conspicuously missing from their benefits menu \u2014 coverage of GLP-1 drugs for weight loss.<\/p>\n<p>More companies are dropping coverage completely or offering employees less generous payouts. In some cases, they&#8217;re shifting to a different model altogether \u2014 offering employees a consolation prize of sorts \u2014 access to a weight management program through a third party.<\/p>\n<p>Coverage of these drugs for weight loss is pricey for employers \u2014 typically costing in the mid-$500s to mid-$600s per user monthly. Some companies say whatever the price, covering the drugs is worth it based on employee health. &#8220;We spend about $250 million or more on GLPs, and that&#8217;s up from zero&#8221; four or five years ago,  <a href=\"https:\/\/www.cnbc.com\/2026\/08\/05\/bank-of-america-ceo-glp-1-drugs-cost.html\" rel=\"nofollow noopener\" target=\"_blank\">Bank of America CEO Brian Moynihan<\/a> told CNBC&#8217;s Andrew Ross Sorkin in August. &#8220;We see a great impact on the employees. &#8230; Believe me, we&#8217;re pounding everybody on price and trying to get as cheap [as possible]. But our view is that [because of] the long-term health benefits, plus there may be more short-term health benefits &#8230; it&#8217;s a good investment.&#8221;<\/p>\n<p>Nevertheless, as healthcare costs continue to climb, more employers have been looking for an exit ramp on GLP-1 coverage for weight loss, and that includes bigger companies. A WTW annual <a href=\"https:\/\/www.wtwco.com\/en-us\/insights\/2026\/09\/us-healthcare-costs-are-projected-to-climb-11-percent-by-2027-is-your-strategy-ready-for-whats-next\" target=\"_blank\" rel=\"nofollow noopener\">health benefits survey<\/a> fielded over the summer and being released in full on Wednesday found that 53% of employers with more than 100 employees cover GLP-1s for weight loss, down from 57% in 2025. That&#8217;s the first decline in three years. What&#8217;s more, 16% of employers said they cover the drugs now but are considering removing them, up from 9% last year.\u00a0<\/p>\n<p>According to a <a href=\"https:\/\/www.mercer.com\/en-us\/about\/newsroom\/employers-expect-health-benefit-costs-to-jump-in-2027\/\" target=\"_blank\" rel=\"nofollow noopener\">recent Marsh survey<\/a> of over 1,800 US employers, health insurance cost per employee is expected to rise 8.2% on average in 2027, the biggest increase since 2003, with GLP-1 use accounting for a full percentage point of the overall cost growth. Its experts have cited the soaring costs among reasons employers are <a href=\"https:\/\/www.cnbc.com\/video\/2026\/09\/03\/rising-costs-of-health-benefits-total-cost-per-employee-expected-to-rise-8-point-2-percent-in-2027.html\" rel=\"nofollow noopener\" target=\"_blank\">considering dropping coverage<\/a> for 2027.<\/p>\n<p>&#8220;Employers are really balancing empathy with economics,&#8221; said Caroline Susie, principal in Marsh&#8217;s total health management practice.<\/p>\n<p>Some workers who use employer-sponsored health plans are being provided with options in the event of GLP-1 coverage being dropped, though nothing may match full health insurance coverage. Here are alternatives to expect.<\/p>\n<p>Direct-to-consumer programs\u00a0<\/p>\n<p>Some employers are directing workers to buy GLP-1s through direct-to-consumer options like Novo Nordisk&#8217;s <a href=\"https:\/\/www.cnbc.com\/2025\/03\/05\/novo-nordisk-offers-discounted-wegovy-through-direct-to-consumer-pharmacy.html\" rel=\"nofollow noopener\" target=\"_blank\">NovoCare<\/a> or Eli Lilly&#8217;s  <a href=\"https:\/\/www.cnbc.com\/2026\/04\/09\/amazon-to-stock-lillys-new-weight-loss-pill-at-us-kiosks-offer-same-day-delivery.html\" rel=\"nofollow noopener\" target=\"_blank\">LillyDirect<\/a>. WTW&#8217;s survey showed that 8% of employers have gone this route, and 28% were planning or considering it. <\/p>\n<p>Seth Friedman, pharmacy and health plans practice leader at Gallagher, estimated that 20% to 30% of the firm&#8217;s clients have dropped coverage for 2027 and are sending employees the direct route. For employers, this move can mean significant savings. The percentage of U.S. adults who take GLP-1 medications for weight loss purposes climbed to 11% in 2026, up significantly from 3% in 2024, according to <a href=\"https:\/\/news.gallup.com\/poll\/712157\/glp-usage-reaches-new-high.aspx\" target=\"_blank\" rel=\"nofollow noopener\">Gallup<\/a>. What&#8217;s more, 15% report having used the medicine for weight loss at some point, a nine-percentage-point boost.<\/p>\n<p>&#8220;Many people will choose to pay for this on their own even if it&#8217;s not covered by the plan,&#8221; said Jeff Levin-Scherz, population health leader at WTW.<\/p>\n<p>The <a href=\"https:\/\/www.novocare.com\/patient\/medicines\/wegovy.html\" target=\"_blank\" rel=\"nofollow noopener\">starting price<\/a> for the lowest dose of Novo&#8217;s Wegovy for self-pay individuals is currently $149 a month for the pill and $199 a month for the shot. Those prices are subject to change in 2027; Novo Nordisk says current promotional pricing may be modified or canceled. Lilly&#8217;s Zepbound <a href=\"https:\/\/www.lilly.com\/lillydirect\/zepbound?utm_source=GOOGLE&amp;utm_medium=cpc&amp;utm_campaign=22744483082&amp;utm_content=paid_search&amp;utm_keyword=zepbound+lillydirect&amp;gclsrc=aw.ds&amp;gad_source=1&amp;gad_campaignid=22744483082&amp;gbraid=0AAAAAqAD4intkDx2D_F89j-JXweZA1znU&amp;gclid=CjwKCAjwl4HXBhAjEiwAHlpWhCk1FXpJyaFfyZGNGf0blHSmUPSEdn-cUEF3PQGlgn78ng1rGRC5-BoC-OAQAvD_BwE\" target=\"_blank\" rel=\"nofollow noopener\">starts at $299<\/a> a month for a single-dose vial or multi-dose KwikPen.<\/p>\n<p>Direct-to-employer programs<\/p>\n<p>Some companies are moving to a <a href=\"https:\/\/www.mercer.com\/en-us\/insights\/us-health-news\/will-direct-to-employer-glp-1s-be-the-start-of-something-new\/\" target=\"_blank\" rel=\"nofollow noopener\">direct-to-employer model<\/a>, where they drop coverage through their traditional pharmacy program, but offer to reimburse some portion of an employee&#8217;s out-of-pocket costs. <\/p>\n<p>&#8220;These &#8216;alternative coverage&#8217; models enable employers to access more advantageous pricing and greater control over their contributions, without covering the drug on their PBM formulary,&#8221; said a spokesperson for Vida Health, one of multiple vendors that works with employers in this area. Others include Noom and GoodRx.<\/p>\n<p>Employers can often design the program that works for their employees&#8217; needs, at a significant savings from paying for GLP-1 drugs through a pharmacy benefit manager, said Alysha Fluno, national pharmacy practice leader at Marsh. A PBM is a third-party administrator that manages prescription drug benefits for health insurers and employers.<\/p>\n<p>Based on direct-to-consumer prices, employers could fully subsidize, pay a vendor fee, and still spend much less than they would to purchase Wegovy, for example, through a PBM, according to WTW&#8217;s Levin-Scherz.<\/p>\n<p><img decoding=\"async\" class=\"InlineVideo-videoThumbnail\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/108328219-1782751789876-gettyimages-2279484892-64393_48_ms_4772.jpeg\" alt=\"This new Medicare program offers obesity drugs for $50 a month. Here&#x2019;s what you need to know\"\/>Weight-management programs<\/p>\n<p>Some employers are dropping coverage and contracting with third parties like CVS Weight Management, Noom, Omada Health, UnitedHealthcare, Vida and Virta, to offer weight-management programs to employees. Some employers offered these types of programs before, while others made them available only after dropping GLP-1 coverage for weight loss.\u00a0<\/p>\n<p>According to <a href=\"https:\/\/www.mercer.com\/en-us\/about\/newsroom\/employers-and-workers-face-affordability-crunch-as-health-insurnace-cost-is-expected-to-exceed-18500-per-employee-in-2026\/\" target=\"_blank\" rel=\"nofollow noopener\">2025 data from Marsh<\/a>, 25% of employers of 500 or more employees had a vendor partner for lifestyle modification and nutrition support. Employers, not employees, typically foot the bill for these programs, at a significant savings compared with GLP-1 coverage. Services can vary by member, but offerings generally include live or online coaching on behavior change, diet, exercise, nutrition and other health topics. Costs for these programs can run about $65 to $100 per employee per month, depending on what&#8217;s offered, according to Marsh&#8217;s Susie. Employers who choose a vendor that offers prescription services as well could pay $150 or more per month per participating employee.\u00a0<\/p>\n<p>Service providers cite good results from their programs in recent years. <a href=\"https:\/\/www.omadahealth.com\/resource-center\/weight-maintenance-is-possible-after-glp-1s-with-the-right-support\" target=\"_blank\" rel=\"nofollow noopener\">Data from Omada Health<\/a> show that 63% of members evaluated at 12 months after stopping a GLP-1 maintained or continued to lose weight. <a href=\"https:\/\/www.uhc.com\/agents-brokers\/employer-sponsored-plans\/products-solutions\/wellness-programs-services\/weight-loss\" target=\"_blank\" rel=\"nofollow noopener\">UnitedHealthcare&#8217;s Real Appeal program data<\/a> show that 88% of at-risk participants lost weight during the 52-week program designed to promote healthy eating, physical activity, improved well-being and a better health outlook. What&#8217;s more, 37% of participants lost 5% or more in body weight. Meanwhile, initial program results reported by CVS Weight Management showed <a href=\"https:\/\/business.caremark.com\/insights\/2026\/role-clinical-care-management.html\" target=\"_blank\" rel=\"nofollow noopener\">90% weight loss maintenance<\/a> for members up to 10\u201312 months after ending drug therapy.<\/p>\n<p>Provider offerings vary somewhat, but professional support is often a hallmark. &#8220;We want to make sure that if they go off GLP-1s for whatever reason, they maintain the behavior changes,&#8221; said Cody Fair, chief commercial officer of Noom. &#8220;We&#8217;re able to keep that weight off because they&#8217;ve retrained their brain and changed their habits,&#8221; he said.\u00a0<\/p>\n<p>Employee utilization, however, can be a challenge, said Gallagher&#8217;s Friedman. &#8220;It&#8217;s absolutely a commitment, and that&#8217;s probably why you don&#8217;t see a whole lot do it. Especially when they know they can just have their doctor write a script and go directly to Novo or Lilly.&#8221;<\/p>\n<p>FSA, HSA money for medically necessary GLP-1s<\/p>\n<p>While these tax-advantaged accounts are not alone a replacement for a comprehensive health plan, GLP-1 medications are eligible for flexible spending account (FSA) and health savings account (HSA) reimbursement when prescribed by a licensed provider to treat a diagnosed medical condition, such as obesity. The disadvantage of using an HSA to pay for GLP-1s is that the dollars invested don&#8217;t have a chance to grow tax-free for use later on in retirement.<\/p>\n<p>The annual employee contribution limit for an FSA is $3,400 in 2026. For 2026, the maximum annual HSA contribution limits set by the IRS are $4,400 for individuals with self-only coverage and $8,750 for those with family coverage. That will rise in 2027 to $4,500 for individuals and $9,000 for families. Official 2027 IRS contribution limits for FSAs have not yet been announced.\u00a0<\/p>\n<p>&#8220;Benefits are there to cover those out-of-pocket costs,&#8221; said Andrew Stocker, president of employee benefits at Voya Financial. &#8220;Employers need to educate employees about the benefits that do exist.&#8221;<\/p>\n<p><img decoding=\"async\" class=\"InlineVideo-videoThumbnail\" src=\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/108365749-17900106891790010686-48520362188-1080pnbcnews.jpg\" alt=\"Eli Lilly CEO Dave Ricks: One-third of new GLP-1 pill patients are taking Foundayo\"\/><\/p>\n","protected":false},"excerpt":{"rendered":"With open enrollment season in swing, many employees may notice something conspicuously missing from their benefits menu \u2014&hellip;\n","protected":false},"author":2,"featured_media":896798,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[68559,2917,43053,122,5845,16161,155122,97,2601,9041,851,40615,243,16160,375957,1541,2603,13951,28170,369176,366259],"class_list":["post-896797","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-andrew-ross-sorkin","tag-bank-of-america-corp","tag-brian-moynihan","tag-business-news","tag-cvs-health-corp","tag-eli-lilly-and-co","tag-goodrx-holdings-inc","tag-health","tag-health-care-industry","tag-health-insurance","tag-inc","tag-labor-economy","tag-medication","tag-novo-nordisk-a-s","tag-omada-health","tag-personnel","tag-social-issues","tag-suppress-zephr","tag-unitedhealth-group-inc","tag-voya-financial-inc","tag-willis-towers-watson-plc"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/896797","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=896797"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/896797\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/896798"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=896797"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=896797"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=896797"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}