If you run a small business and have offered health benefits in the last two years, you have probably noticed something on your renewal: GLP-1 medications — the class that includes Ozempic, Wegovy, Mounjaro, and Zepbound — are showing up in your claims data, and they are not cheap.
Ozempic and Wegovy are trademarks of Novo Nordisk. Mounjaro and Zepbound are trademarks of Eli Lilly. Trek Insurance Solutions, Horizon Benefit Partners, and Oval Care are not affiliated with or endorsed by either company.
For many small-group employers, this is the first time a single medication category has had a measurable impact on their renewal rates. Understanding why this is happening and what your options are can make the difference between absorbing a cost increase and getting ahead of it.
The GLP-1 Cost Spike
GLP-1 receptor agonists were originally developed for type 2 diabetes. In recent years, they have become one of the most prescribed medication categories for weight management — and the demand has been dramatic.
Here is what the data shows:
- GLP-1 prescriptions have grown significantly year over year, with weight management now representing a substantial share of total GLP-1 volume
- Per-patient costs are high. Branded GLP-1 medications can run $800 to $1,300 per month without insurance coverage, and even with insurance, employer plans often bear a meaningful share of that cost
- Utilization is increasing among working-age adults. Unlike many high-cost medication categories that skew toward older populations, GLP-1 demand is concentrated in the 30-to-55 age bracket — the exact demographic that makes up most small-group plan enrollment
For a small employer with 25 to 100 employees, even a handful of members on GLP-1 therapy can move the needle on total plan costs. If five employees are each generating $1,000 per month in GLP-1 claims, that is $5,000 per month — $60,000 per year — flowing through your plan.
That cost shows up at renewal. And for small groups specifically, where the risk pool is smaller and one or two high-cost claimants can have an outsized effect, the impact is felt more acutely than at larger organizations.
Why Small Groups Are Disproportionately Affected
Large employers with 500 or more lives can absorb GLP-1 cost spikes more easily because their risk pool is bigger. A few high-cost claimants in a 1,000-life group get diluted. In a 30-life group, they do not.
Small-group health plans also tend to have less flexibility in plan design. Unlike large self-funded employers who can carve out specific drug categories or design custom benefit structures, small fully-insured groups are largely at the mercy of whatever the carrier offers at renewal.
The result: small employers are facing double-digit renewal increases driven partly by GLP-1 utilization, with limited tools to manage it.
The Options Employers Are Exploring
Forward-thinking employers are not just absorbing the increase. They are looking at structural solutions.
1. Carve Out GLP-1 from the Medical Plan
Some employers are moving GLP-1 coverage out of their group health plan entirely and providing it through a separate mechanism — such as a Health Reimbursement Arrangement or a wellness membership. This removes the high-cost claims from the group plan’s risk pool, which can stabilize renewals.
2. Offer a Wellness Membership as a Voluntary Benefit
This is where models like Oval Care enter the picture. Rather than including GLP-1 coverage in the group plan — where it inflates premiums for everyone — an employer can offer a telehealth membership as a voluntary benefit. Employees who want GLP-1 access can enroll through the membership, paying through payroll deduction, without those claims running through the group plan.
The math works differently this way:
- Group plan costs stabilize because GLP-1 claims are no longer in the risk pool
- Employees who want the benefit still get access — through a membership, not through the group plan
- No HR administration overhead. Employees enroll directly; there is no plan-change paperwork, no open-enrollment redesign, no carrier negotiation required
- Payroll deduction makes it affordable. Employees pay the membership fee through pre-tax payroll deduction, keeping out-of-pocket costs manageable
3. Pair with an ICHRA for Maximum Flexibility
Some employers are combining a carved-out wellness membership with an Individual Coverage HRA. The ICHRA gives employees a defined allowance to purchase individual coverage, while the wellness membership addresses the specific GLP-1 and wellness need outside the group plan.
This approach gives employees choice and gives employers cost predictability.
How Oval Care Changes the Math
Oval Care is a telehealth and telepharmacy membership — not insurance — that provides access to GLP-1 medications, mental health support, hormone therapy, dermatology, and other health services at potentially reduced out-of-pocket costs.
For employers, the relevant points are:
- PLUS membership includes GLP-1 injectables — if medically approved — provider consultations, and shipping, all included in the membership fee
- ONE membership covers oral medications, mental health, dermatology, hormone therapy, and other categories at up to 80% off, with consultations and shipping included
- No claims run through the group plan. Employees enroll directly; the membership operates independently of the group health plan
- Payroll deduction available. Employees can pay via payroll deduction with zero HR admin burden
- Works alongside any group plan. Oval membership does not replace the group plan — it supplements it, filling gaps that the group plan does not cover
The key insight: an employer does not have to choose between offering GLP-1 access and controlling plan costs. A membership model delivers the benefit without the claims impact.
What to Do at Your Next Renewal
If your renewal is coming up and you are seeing GLP-1 costs driving the increase, here are concrete steps:
- Request your claims data. Ask your broker or carrier for a run-out of GLP-1 claims specifically. You need to know how many members are on these medications and what the total cost impact is.
- Model the carve-out. Ask your broker to model what your renewal would look like if GLP-1 claims were removed from the group plan. The delta is your potential savings.
- Explore membership alternatives. A telehealth membership like Oval Care can provide GLP-1 access to employees who want it, outside the group plan. Ask about group pricing for your employee population.
- Communicate with employees. Employees are often receptive to wellness benefits that come with zero premium increase — especially if they were paying high out-of-pocket costs for GLP-1 medications through the group plan anyway.
The Bottom Line
GLP-1 demand is not slowing down. For small employers, the question is not whether these medications will affect your plan costs — it is how you structure your benefits to manage that impact while still providing the access your employees want.
A telehealth membership model gives you a path to do both: control group plan costs and deliver GLP-1 and wellness benefits through a separate, voluntary channel.
If you are an employer looking to understand how this works for your specific group, it starts with a conversation.
Request a group quote at form.fillout.com/t/mjVCzkcoA9us or contact Trek Insurance Solutions at 888-960-0442 / trekis.net.
Oval Care is a telehealth membership, not insurance. All treatment requires provider approval. Medications ship from licensed, LegitScript-certified partner pharmacies. Group pricing and availability vary by plan and state.