Brandon Collins, AVP and lead consultant at NFP, joins the Benefits Brief to discuss how employers are navigating a hardening healthcare market and rising benefits costs. The conversation covers why more plan options need to be considered, his changing view of GLP-1 coverage for weight loss, the need to plan farther ahead of renewal, and how cost and talent priorities are shaping 2027 benefits decisions.
Brandon Collins' Background
- Works within NFP’s benefits practice, which supports employers ranging from small groups to organizations with several thousand employees.
- Described employers with roughly 50 to a few thousand employees as a particularly strong range for exploring a broader set of benefits strategies and plan options.
- NFP also supports larger enterprise employers through its relationship with Aon and has a specialized offering for nonprofit organizations.
Key Takeaways
- Employers should prepare for continued healthcare cost pressure and be willing to consider options beyond the traditional group health plan.
- Collins has become more open to GLP-1 coverage for weight loss as lower-cost program designs combine the medications with ongoing member engagement and behavior requirements.
- Funding structure and fixed costs are increasingly important areas for employers to evaluate because claims themselves can be difficult to predict or control.
- Benefits planning should begin roughly 12 months before renewal so employers have time to evaluate alternatives instead of reacting late in the cycle.
- Collins did not give one universal ranking for 2027 priorities. Cost containment tends to lead for finance and ownership roles, retention can carry more weight for people leaders, and he placed compliance and risk at the bottom.
Recurring Questions
1. What’s one thing you’re telling every client this year, regardless of their size and situation?
Collins is telling employers to prepare for a hardening market and put more options on the table. With organizations facing greater cost pressure and less control, particularly in fully insured plans, he recommends looking beyond traditional approaches while still protecting benefit quality, competitiveness, and the bottom line.
Everything needs to be on the table
- Cost pressure between healthcare providers and insurance carriers ultimately reaches employers and plan members.
- Fully insured employers can be especially exposed because they are more dependent on what the insurance market presents at renewal.
- Collins described the current message to clients as “brace for impact,” with a need to seriously evaluate the available alternatives.
Look beyond the traditional group plan
- NFP is encouraging clients to consider options outside the traditional group-plan approach rather than automatically renewing the same structure.
- Any alternative still needs to account for the potential disruption to employees and the tradeoffs involved.
- The goal is to maintain a high-quality, competitive benefit while getting costs to a level the organization can support.
- That balance matters because Collins described benefits as typically the second-largest organizational expense behind labor and compensation.
2. What have you changed your mind about since last enrollment season?
Collins has become more open to employer coverage of GLP-1 medications for weight loss. A year ago, he generally considered it too early for employers to add that coverage without stronger evidence of value. Lower-cost approaches that pair the medication with ongoing member engagement have made him more receptive to the strategy.
A year ago, the economics were not convincing
- GLP-1 coverage for diabetes was already common, but Collins remained hesitant about adding coverage specifically for weight loss.
- At the time, he viewed the available return as roughly one-to-one: employers might save about as much in future medical claims as they were spending on the medications.
- That level of return was not enough for him to view GLP-1 coverage for weight loss as a clear recommendation.
Program design changed his view
- More recent approaches can provide the medications at a lower cost while requiring members to remain actively involved in their care.
- Examples Collins gave included:
- Weekly weigh-ins
- Regular meetings with a nurse or clinical coach
- Ongoing behavior changes as a condition of continuing treatment
- Under that type of structure, Collins said NFP believes the longer-term claims impact can reach three to four times the employer’s investment.
- That change in economics has shifted his position, and he is seeing more clients consider these approaches.
Related consideration: funding structure
- In a follow-up discussion, Collins pointed to plan funding as another area where employers should reconsider traditional approaches.
- Options can include individual-coverage HRA strategies, level funding, and self-funding.
- His focus is on the costs employers can influence directly, including premiums and how the plan is protected with reinsurance.
- Claims for conditions such as cancer can be highly unpredictable, making controllable fixed costs an important place to look for efficiency.
3. What do you think most benefit leaders are underestimating right now?
Collins thinks benefits leaders may be underestimating what the next few years could look like if they continue managing benefits the same way they have in the past. Rather than waiting until renewal approaches, he recommends beginning the planning process roughly 12 months in advance.
Start planning well before renewal
- Collins sees waiting for a renewal and making decisions late in the year as increasingly difficult to sustain.
- His team is pushing clients to begin the next planning cycle in January or February.
- Starting earlier gives employers enough time to understand alternative strategies rather than evaluating them under renewal pressure.
Narrow the options before decisions become urgent
- Early planning does not mean every available solution will be right for an employer.
- Collins recommends using the additional time to:
- Identify options that do not fit the workforce and remove them from consideration.
- Narrow the field to two or three viable strategies.
- Meet potential partners and solutions.
- Build a clearer understanding of how each option would work within the plan.
- His larger point is that simply repeating the same annual renewal process is no longer a viable strategy in the current market cycle.
4. For 2027, what’s driving benefits decisions most? Is it cost containment, employee retention, employee trust and experience, or compliance and risk?
Collins did not provide a universal 1–4 ranking. He described the priorities as role-dependent: cost containment tends to lead for owners, founders, and CFOs, while employee retention can be especially important for people and culture leaders. He placed compliance and risk at the bottom and did not separately rank employee trust and experience.
Collins’ prioritization:
Cost containment: Often the leading concern for owners, founders, and CFOs
Employee retention: A major priority for people and culture leaders
Compliance and risk: At the bottom of his list
Employee trust and experience: Not separately ranked
Cost containment
Cost containment can become the dominant factor for organizational leaders responsible for the financial side of the business.
- Collins used the example of an employer facing a 30% increase and needing to find a path back toward a single-digit increase.
- That makes the range of available cost strategies particularly important for owners, founders, and CFOs.
- His broader view is that employers need to reach a cost level that is manageable and feasible without losing the competitiveness of the benefit.
Compliance and risk
Collins placed compliance and risk at the bottom of his list, but not because compliance is optional.
- Any strategy brought to an employer still needs to stay within ERISA and other applicable requirements.
- He views compliance more as a boundary within which employers can explore different approaches rather than the primary force driving the decision itself.
- In the current environment, his focus is on understanding where employers can legitimately become more creative with plan design and strategy.
Employee trust and experience
Collins did not separately rank or explain employee trust and experience in his answer.
- His broader framing was that benefits decisions still need to leave the organization well positioned for its people.
- He did not identify employee trust and experience as a distinct priority relative to cost containment or retention.
Employee retention
Employee retention can become a much larger priority for people and culture leaders.
- Collins pointed to organizations competing for talent against larger employers that can use their size and scale to offer strong benefits.
- Smaller employers that want to compete effectively still need a benefits package capable of helping attract and retain strong talent.
- The decision ultimately becomes a balance between getting costs to a manageable level and remaining competitive against benefits benchmarks in the employer’s market.
Impactful Quotes
“How can we get to the best position that still offers a really high quality benefit that's competitive in the market to attract and retain talent, but protects the bottom line because benefits are usually the number two spend for most organizations behind, you know, their labor and compensation costs.”
“And when an employer does it that way, we believe the ROI is three or four X on claims mitigation further down the road. And so our stance has changed on that a little bit, and we're starting to see more clients take advantage of this.”
“You have to plan now 12 months in advance. And again, a lot of that comes with there are a lot of other things that you can do. So let's start talking about those early.”
“Every decision that is being made right now is a balance, right? Of how do we get to a spot that's manageable and feasible from a cost perspective, but that we know when we stack it up to the benchmark in our industry, we still are positioned really well for our people.”
About the Benefits Brief
The Benefits Brief is an ongoing interview series from Bereave that asks benefits leaders, brokers, and employee benefits experts the same questions about what they are seeing today and what they expect ahead. As more experts participate, their answers create a growing view of changing priorities, areas of agreement and disagreement, and where employee benefits may be heading next.
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