For decades, most New England employers relied heavily on traditional fully insured health plans. Annual renewal cycles were more predictable, risk was fully transferred to carriers, and administrative overhead remained manageably low.

Today, many New England employers face a different reality due to fundamental shifts. Less favorable medical loss ratios, increased specialty pharmacy pricing, and overall healthcare inflation have substantially impacted this traditional model. As employers navigate major premium increases that operate independently of their actual workforce claims experience, many benefits leaders across New England are evaluating alternative healthcare financing models.

Workplace well-being isn’t new. However, the ways employees experience it, as well as their expectations around it, have fundamentally changed.

For years, organizations approached well-being through individual programs: physical health initiatives, mental health resources, financial wellness tools, and awareness campaigns. They were well-intentioned, and the needs they addressed were quite real. Yet for many employees in today’s workplace, those efforts often feel fragmented, difficult to navigate, or disconnected from how work and life actually intersect.

Even the most seasoned HR or benefits professional can get lost in the alphabet soup that is the world of spending accounts. Between FSAs, HRAs, and HSAs alone there are countless rules and plan options that can escape those who don’t interact with these accounts for a living. Add to that the recent introduction of the LSA (Lifestyle Spending Accounts) and the confusion only grows.

Below is a concise overview of the five account types we’re asked about most often by employers trying to improve the financial wellbeing of their workforce, followed by a brief update on how the One Big Beautiful Bill Act affected Dependent Care FSAs and HSAs.

As benefits leaders consider 2026 renewals and plan ahead for their 2027 strategies, new opportunities are emerging in how organizations approach musculoskeletal (MSK) care. While traditional Centers of Excellence (COE) have focused on surgical interventions, a new approach, non-operative COEs, prioritize conservative treatment and early intervention over surgical treatment. This shift represents a strategic response to mounting cost pressures driven by inappropriate utilization of surgery, and recognizes that many MSK conditions can be effectively managed without surgery.

The MSK Crisis Demanding Immediate Attention

Recent data surrounding MSK care in the U.S. paints a sobering picture. A 2024 article published in Elsevier’s Lancet Regional Health – Americas journal reports MSK diseases are “the leading cause of years lived with disability” and “an increasing health burden and economic cost of $980 billion annually.” The study found that research involving all types of MSK diseases are underfunded, especially neck pain (0.83% funded), low back pain (13.88% funded), and osteoarthritis (35.08% funded).¹

As we honor National Caregiver Month this November, it’s time to recognize that caregiving is no longer a peripheral issue—it’s a central force shaping workforce dynamics, employee well-being, and organizational resilience. For over 35 years, the Boston College Center for Work & Family (BCCWF) has driven progress on critical work-life issues related to caregiving, emphasizing the importance of flexible work, paid leave for parents and caregivers of all types, and promoting men as equal caregivers. From our recent conversations with work-life practitioners and thought leaders, it is clear that employers are looking for ways to better understand the care demographics of their workforces and the invisible loads they carry, and respond with supports that make a difference.

The Caregiving Reality: Universal, Invisible, and Intensifying

“Working while caregiving” is a nearly universal experience. Whether supporting aging parents, children with disabilities, spouses with chronic illness, or navigating end-of-life care, employees are managing complex responsibilities alongside their professional roles. Yet many do not self-identify as caregivers, and only 56% report that their supervisor is aware of their caregiving status (AARP 2015).

Menopause is a natural transition that affects nearly all women. The more we learn about this life change, the more we understand how much it impacts people’s personal and professional lives. Based on recent research, companies must understand menopause better to improve the health of their employees and the bottom line.

What exactly is menopause?

Menopause is defined as 12 months after a woman's last menstrual cycle. While the starting point is known, the length of this hormonal transition — and the severity of symptoms — varies from person to person.