By Elizabeth Walker on February 27, 2026 at 9:30 AM
The last few years have been particularly challenging for healthcare professionals, including those in the insurance industry. Even post-pandemic, the ripple effects of the COVID-19 public health emergency continue to shape costs, regulations, and consumer expectations in 2026.
Health insurance professionals must now consider how they will manage evolving business trends, including rising costs, digital transformation, increasing cybersecurity threats, and ongoing regulatory compliance. As you look toward the future of the healthcare industry, staying ahead of these obstacles will give you a competitive advantage in the market.
In this article, we'll look at five common health insurance challenges brokers, agents, and claims specialists face in 2026. We'll also outline how you can overcome them with PeopleKeep and Remodel Health, so you can better serve your clients in the ever-evolving healthcare benefits space.
In this blog post, you’ll learn:
- What’s driving healthcare and premium increases in 2026.
- How evolving customer expectations are reshaping the broker-client relationship.
- How HRAs and modern benefits technology can help you stay competitive.
1. Healthcare costs and premiums continue to outpace wages and inflation
One of the biggest challenges for insurance professionals is the rising cost of healthcare. According to KFF, the average annual premiums for group health insurance in 2025 were $9,325 for self-only plans and $26,993 for family coverage. That’s an increase of 5% for single coverage and 6% for family coverage over the past year1.
However, premium increases are even higher for many groups, with many seeing 30%+ rates. These higher prices make it increasingly difficult for small businesses to find an affordable plan that fits their budget. For many, it's an expensive investment.
The Centers for Medicare & Medicaid Services (CMS) projects national health expenditures to grow approximately 5.8% annually through the early 2030s, which is faster than projected GDP growth of 4.3%2. Yet a recent eHealth survey found that if group health insurance rates increased by 15%, 47% of respondents wouldn’t be able to afford to offer coverage3.
Inflation isn't just impacting organizations looking to offer benefits to their employees. The rising cost of living could have some people stretching their budgets so much that they delay routine or preventive care to make ends meet. According to KFF, one in three people say they've missed or delayed necessary healthcare within the last year due to cost concerns4.
How to overcome this challenge
Traditional group health insurance plans aren't the only options brokers and insurance agents have to offer their clients. Offering a health reimbursement arrangement (HRA), especially to small and medium-sized organizations with limited budgets, can be a far more affordable and flexible alternative.
Through an HRA, employers offer their employees a tax-free monthly allowance of their choosing. Their employees can pick their own individual health insurance and the medical care they receive. Then, they submit those expenses to their employer and receive tax-free reimbursement for their qualifying out-of-pocket costs, such as prescription drugs, medical devices, and diagnostic laboratory services.
There are several types of HRAs available, each offering tax benefits. Here are three popular options:
- Qualified small employer HRA (QSEHRA): The federal government created the QSEHRA for employers with fewer than 50 full-time equivalent employees (FTEs) looking for simple, easy-to-manage health benefits. A QSEHRA allows your clients to reimburse their employees for health insurance premiums and out-of-pocket expenses. Employees can have their own policy or be on a parent’s or spouse’s plan as long as it has minimum essential coverage (MEC).
- Individual coverage HRA (ICHRA): An ICHRA is a way for employers of all sizes to reimburse employees for individual health insurance premiums and qualifying out-of-pocket costs. For organizations with 50 or FTEs, offering an affordable ICHRA allowance can help them satisfy the Affordable Care Act’s employer mandate.
- Group coverage HRA (GCHRA): A GCHRA allows employers to supplement their existing group health insurance, such as a high deductible health plan (HDHP). Your clients can use a GCHRA to offset high out-of-pocket expenses by reimbursing employees for their deductibles, copayments, and coinsurance.
An HRA is an excellent alternative for your clients who see a large rate increase, can't afford group coverage, or don't meet minimum participation requirements. So, how can you help your clients offer an HRA? PeopleKeep by Remodel Health offers innovative HRA solutions for small and mid-sized organizations. By partnering with PeopleKeep, you'll earn commissions for any clients who sign up with us. Plus, your clients will have their $150 sign-up fee waived.
For brokers serving mid-sized and large employers, Remodel Health offers a full-service ICHRA+® administration solution that focuses on implementation support, plan design consulting, and employee education.
2. Customer expectations are higher than ever
We get it; the insurance business is tough. You have sales goals to meet and policies to sell. But if you want to find success in 2026, you need to humanize the insurance customer experience.
Your customers expect a high level of service that's as personal as it is professional. A PwC study on customer experience found that one in three consumers will walk away from a trusted brand after a single bad experience. Data from the survey found that 82% of U.S. consumers want more human interaction as well5.
Healthcare consumers expect their brokers and agents to act as trusted advisors they can count on to help them make informed decisions about their health plans. Your clients want to know that you see them, hear them, and care for them. When you take the time to educate them and listen to their needs, they're more likely to trust your professional opinion.
How to overcome this challenge
A good tactic to overcome the pressure to sell while also building rapport is to work sales and meaningful connections into your business goals. While you undoubtedly already have short-term sales and production goals in place, consider setting long-term goals focused on building your clientele and improving client relationships. You can check in more often and offer important updates whenever possible to enhance customer engagement and satisfaction.
Additionally, suggesting an HRA can help improve customer satisfaction. When employees choose their own coverage, and employers define their contributions, the broker’s role becomes consultative, with a greater focus on education, compliance, and plan design. And with PeopleKeep or Remodel Health, employers of all sizes can provide their staff with personalized health benefits that they’re sure to value, without the added administrative strain.
3. The digital transformation is reshaping the insurance industry
Another challenge for health insurance providers and broker professionals is adjusting to technological advancements. Optimizing operations using digital technologies and artificial intelligence is the name of the game for 2026.
With everything being instant these days, it's become an expectation for your clients. Much of the world digests information in quick bits on the internet, social media, and other digital platforms. Consumers expect digital enrollment tools, secure document sharing, and clear plan comparisons. Younger workforce demographics especially prefer mobile-friendly platforms and on-demand access to benefits information.
Brokers relying on manual spreadsheets, email-based documentation, and paper-heavy processes face operational inefficiencies and increased risk. Plus, mobile apps and other platforms can make your life easier.
How to overcome this challenge
Don't be the last insurance broker to hop on the bandwagon. Reassess your business model and learn how to leverage technology platforms. Several health insurance companies have already adopted cloud computing and artificial intelligence to improve their processes.
In addition to educating your clients in the traditional ways, try giving them a positive digital transformation experience. You can share videos, guides, and infographics to help make the health insurance world less intimidating. Plus, this goes hand in hand with providing exceptional customer service that builds trust and rapport with your clients.
HRA administration platforms address this challenge by centralizing compliance workflows, documentation storage, and reimbursement tracking in secure, automated systems. With PeopleKeep, we streamline SaaS tools for small-group brokers who need scalable efficiency without complexity. Remodel Health pairs technology with dedicated customer service teams for larger organizations that require both a robust digital platform and strategic support.
4. Protecting health information from cybersecurity threats
Another challenge for the insurance industry is protecting clients' personally identifiable information (PII) and protected health information (PHI). The healthcare space has loads of private, confidential data. These days, everything from health records to prescription information to medical histories exists in some electronic format.
According to the HIPAA Journal, roughly 710 data breaches affecting 500 or more individuals were reported to the Department of Health and Human Services (HHS) Office for Civil Rights in 20256. As someone who handles health information, you collect all kinds of potentially sensitive information, making you even more vulnerable to ransomware attacks and data breaches.
How to overcome this challenge
If your clients ever share personal health information with you, it's your responsibility to make sure it's kept safe. Implementing best privacy practices, such as encrypting sensitive files, staying up to date on PHI privacy rules, using antivirus and firewall software, and using a secure password manager to keep everything straight, will help you protect your clients' information.
By partnering with secure administrators, such as PeopleKeep or Remodel Health, brokers reduce their compliance risk and strengthen their data protection protocols, guaranteeing their clients’ information is safe.
5. Ongoing regulatory requirements and market changes
From the rise of telemedicine and telehealth to new federal benefits laws (such as the One Big Beautiful Bill Act), health insurance professionals must continually stay informed about relevant industry news, regulations, and insights as they unfold.
According to CMS data, about 23 million individuals enrolled in a Marketplace plan in 2026. If you’re offering an individual coverage HRA (ICHRA), which works with individual health insurance, you must monitor ACA affordability thresholds (currently 9.96% of household income), reporting requirements, and evolving federal guidance.
How to overcome this challenge
For small employers without HR departments, PeopleKeep simplifies compliance management. If your company grows to a mid-sized or large group size, Remodel Health provides white-glove, ongoing administration so you never have to worry about missing an ACA compliance requirement.
Since there's no stopping the consistent series of transformations, health insurance professionals must keep a close eye on the news and follow trustworthy industry experts to stay in the know. Whether it's signing up for a weekly email newsletter, following official social media accounts, or checking in with blogs and sites from industry experts, such as PeopleKeep and Remodel Health, staying up to date as news breaks is the best way to ensure you're never caught off guard.
Conclusion
From inflation to data breaches, 2026 comes with its share of critical challenges for health insurance professionals. But being aware makes you better prepared. People are looking to you for answers, guidance, and reliable information. When you remember to prioritize customer-centric strategies, you can achieve your business goals while cultivating meaningful relationships.
Ready to help your clients take control of their healthcare costs? Book a call with PeopleKeep by Remodel Health to learn how HRAs can transform your benefits strategy.
This article was originally published on April 16, 2014. It was last updated on February 27, 2026.
References
- KFF’s 2025 Employer Health Benefits Survey
- CMS - NHE Fact Sheet
- Health benefits help SMBs hire and retain workers despite ongoing challenges
- Americans’ Challenges with Health Care Costs
- PwC - The Future of Customer Service
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