The environment of high-cost claimants, utilization increases, and employment trends will keep health care costs higher overall. On average, 3% of annual claimants represent 1 50% of total health care spend. New treatments are emerging, including high-cost injectable and specialty medications, continuing a structure where a small portion of members represent a large portion of health care spend. In the 2021 Mercer National Survey of Employer- Sponsored Health Plans, employers rated monitoring and managing high-cost claimants as the most important health bene昀椀ts strategy for the next 昀椀ve years. Employers will be best served to continue to 昀椀nd creative reinsurance, population health, and cost optimization strategies to mitigate high-cost claimant risk on employer-sponsored 3 health plans. 50%+ of employers surveyed say they are taking focused action to 9 manage specialty drug costs. 2023 Benefits Trends: The evolving workplace 71