Soaring Healthcare Costs Lead to Higher Enrollment in Alternate Medical Plans According to Alight's Annual Enrollment Analysis
Data from 9.5 million participants finds alternate medical plan enrollments doubled in 2026 from 2025, growing fastest among lower-income employees
Alight, Inc. (NYSE:ALIT), a leading cloud-based human capital and technology-enabled services provider, today released findings from its analysis of 9.5 million users of the Alight Worklife® platform during the 2025 annual enrollment period.
"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."
Alight's analysis of enrollment data reflects a change in employee behavior. This includes the effect of healthcare costs on annual enrollment decisions, the continued increase in employees using AI throughout the enrollment process and the widening gap between salary group and medical enrollment. Key trends and insights from this year's annual enrollment include:
- Higher medical and dental costs: Overall, medical and dental costs are increasing, with employers passing some of the increased medical costs along to employees. For single employees, the medical median cost is rising 9.8% in 2026 after increasing 5% in 2025. The median cost for families jumped even higher, rising to 16.8% in 2026, a nearly 12-percentage point increase from 2025.
- Widening gap between salary group and medical enrollment: Alight's enrollment data demonstrates that lower-income employees also have lower medical enrollment rates. Enrollment for employees who make $20,000-$39,999 per year dropped from 50% in 2025 to 47% in 2026. On the other hand, enrollment for employees who make $80,000+ a year stayed consistent at 86% from 2025 to 2026. According to Alight's findings, age does not play a factor in rates of medical enrollment.
- Alternate medical plan enrollment is on the rise: Across most salary ranges, 2026 alternate medical plan enrollment doubled from 2025, growing fastest among lower-income workers. Alternate plans, which can be based on different plan design features such as copays in lieu of a high deductible, reference-based pricing, primary care-centered approaches and value-based care, often provide employees with more predictability with out-of-pocket costs, even if pricing is around the same or higher than traditional plans.
- More employees are using AI to support their benefits journey: From October-December 2025, there were more than 8.5 million interactions with an AI chatbot across Alight's platform, compared to approximately three million interactions during the same months in the prior year. This data signals a shift in employee attitudes towards the utilization of AI, as Alight's 2025 Employee Mindset Study finds that 43% of workers trust AI to help make good recommendations.
This year's data from Alight also shows enrollment via call remained in low single digits with digital enrollments in the high 90s as a percent of the total mix. A high-tech, human touch approach to benefits provides employees with the digital-first environment they expect with the personalized guidance of a human when needed.
For further information and to stay updated on the full open enrollment results, please visit alight.com.
About Alight Solutions
Alight is a leading cloud-based human capital technology and services provider for thousands of clients and tens of millions of employees and dependents. Through the administration of employee benefits, Alight helps clients gain a benefits advantage while building a healthy and financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, absence management and navigation. Our Alight Worklife® platform empowers employers to gain a deeper understanding of their workforce and engage them throughout life's most important moments with personalized benefits management and data-driven insights, leading to increased employee wellbeing, engagement and productivity. Learn more about the Alight Benefits Advantage™ at alight.com.
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Mariana Fischbach
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