GLP-1 medications have quickly become one of the biggest conversations in employee health benefits. It’s estimated that about 12% of Americans are taking one of several GLP-1 medications. That’s 30+ million people.
Originally developed to treat Type 2 diabetes, medications in the GLP-1 class are also approved for weight management in certain patients. As their popularity has grown, so has the conversation around whether employer health plans should cover them.
With roughly half of the U.S. population receiving health coverage through an employer, it’s easy to see why GLP-1 coverage has become an increasingly important consideration for businesses. If your employees are asking questions about GLP-1 coverage, you’re not alone. Here are three ways to approach GLP-1 coverage thoughtfully while keeping your overall benefits strategy and budget in mind.
3 Ways Employers Can Manage GLP-1 Coverage and Costs
1. Look at Utilization Management
One way health plans can help manage prescription drug costs is through utilization management. Depending on the plan and medication, this may include requirements such as prior authorization, eligibility criteria or step therapy before a GLP-1 medication is covered.
These approaches are designed to help ensure medications are being prescribed appropriately and that lower-cost treatment options are considered when appropriate. For employers, utilization management can provide a way to balance access to potentially valuable medications with responsible management of prescription drug spending.
2. Understand How Your Formulary Handles GLP-1s
Not all prescription drugs are treated the same way under a health plan’s formulary. Some plans use different tiers to determine how much members pay for specific medications. Depending on the plan, GLP-1 medications may fall into a higher cost-sharing tier.
Understanding where GLP-1 medications fall within your employees’ pharmacy benefit, and what that means for both your organization and your employees, can give you a clearer picture of how your current coverage works. It’s worth reviewing this information with your broker and health plan, particularly as part of your annual renewal conversation.
3. Look Beyond the Medication
GLP-1 medications are just one piece of the larger conversation around managing chronic conditions and supporting employee health. Depending on your health plan and available resources, employees may have access to wellness programs, condition-management resources, nutrition support, and other tools that can complement their overall health care. Encouraging employees to take advantage of these resources can help them become more informed about their health and the care options available to them.
Link to our longer April 2026 blog on this topic, to explore the GLP-1 discussion further.
What Does This Mean for You?
As a CaliforniaChoice group, you already have a range of health plan options available through your program. That means you don’t have to navigate changing health care trends alone. Your employee benefits broker can help you understand how your current health plan and pharmacy benefit address GLP-1 medications, what cost-management approaches may be available, and what to consider as you evaluate your coverage at renewal. If you don’t already have an employee benefits broker, we make it easy to search for one.