Everything you need to know about navigating high-cost medical claims as an employer.
According to the Centers for Disease Control and Prevention, 60% of Americans have at least one chronic disease. That's 6 in 10 people who have a condition that lasts more than 1 year and requires ongoing medical attention.
Furthermore, the KFF found that the average annual premium for employer-sponsored health insurance was $8,435 for one person and $23,968 for family health coverage.
The Global Medical Trend Rates Report for 2025 highlights the top medical conditions that are expected to drive medical plan costs in 2025. These are as follows:
Cardiovascular diseases
Cancer and tumor growth
High blood pressure/hypertension
The increase in chronic diseases is causing high medical claims for many employers, and they don’t know what to do about it.
FitPros can help you address high medical claims by reducing high-cost behaviors and improving employee health and wellbeing. Talk to us today and take the first step towards reducing high medical claims.
In this article, we cover:
What top companies are doing to address high medical claims
How to use your claims data to create a personalized wellbeing program
Example sessions to include in your wellbeing program
How to Address High Medical Claims
According to the previously mentioned Trends report, top employers are focusing on three main areas in 2025 to mitigate high medical claims costs:
Wellbeing initiatives
Cost containment measures
Flexible benefit plans
We explain each area in more detail below.
Wellbeing initiatives
Wellbeing initiatives are the leading strategy for mitigating high medical claims. But what are wellbeing initiatives? These are typically focused on preventive care, education, and habit-building.
Example wellbeing initiatives include:
Workplace challenges (movement, sleep, hydration, etc.)
Mental health support
Health talks
Nutrition workshops
Financial planning sessions
Health screenings and regular medical exams can also be included in your program. Better yet, incentives, such as free workplace screenings, can be added to give employees the push they need to stay on top of their health and wellbeing.
Moreover, you can include wellbeing initiatives that directly address high-cost medical claims in your company, whether mental health, diabetes, or poor posture, for example.
2. Cost containment measures
Cost containment measures are expected to play an important role in 2025 for employers.
These cost measures are focused on reducing and controlling overuse, such as rapidly rising deductibles, copays, and referrals.
Furthermore, cost containment measures paired with flexible benefit plans—explained in more detail below—will drive incentivized plans that help employees access care in a cost-effective manner.
3. Flexible benefit plans
More employers are switching to flexible benefit plans to cap overall benefit costs. This allows greater cost control and helps deliver packages that can directly help your workforce.
Flexible benefit plans are also used to attract and retain top talent, while providing adaptive benefits to meet the needs of your employees.
Use Your Claims Data to Design a Wellbeing Plan
To take it a step further, you can use employee claims data—accessed via your health carrier or your broker—to create a personalized wellbeing program that targets the exact needs of your employees.
For example, if your claims data has an increase in mental health and stress-related claims, you can host talks on emotional and mental health to provide your employees with the tools and mindset they need to protect their mental health and access the help they need when they need it.
You may also host fitness classes, group workouts, or meditation sessions to get your employees active. Daily exercise can improve mood, reduce stress, and improve self-confidence.
Conversely, if your data shows an increase in type 2 diabetes claims, you can host a workshop on how to manage diabetes. You could also organize nutrition health talks or cooking sessions to provide employees with the tools they need to take control of their nutrition.
These are just a few examples of how the FitPros Client Success team will collaborate with with you to ensure your programming matches your claim data while engaging your employees in live, educational events.
Key takeaways
The top medical conditions that will drive medical plan costs in 2025 are cardiovascular disease, cancer and tumor growth, and high blood pressure/hypertension
Top employers are focusing on wellbeing initiatives, cost-containment measures, and flexible benefit plans to mitigate costs
Use your claims data to personalize your wellbeing program to the highest claims/needs of your employees
High medical claims, when left unattended, can cause serious financial strain on your organization.
But as an employer, you’re in the driver’s seat—you can help your employees by providing tailored sessions and solutions for the problems they’re facing. Talk to us today and take the first step towards reducing your high medical claims.
Looking for more? Contact a Wellbeing Manager to discuss your organizational wellbeing needs.
We provide workplace teams with mindful practices, personal and professional wellbeing growth, fitness instruction, and opportunities for social connection. We aim to inspire the highest potential in people at work, in life, every day, so they can show up healthy and at their best.