CFOs Target Employer Healthcare Plans as a Major Source of Strategic Cost Savings

Employer-sponsored healthcare is emerging as one of the most significant opportunities for companies to improve their financial position. Average per-employee coverage is projected to exceed $18,500 in 2026, while family premiums rose 6% in 2025 to nearly $27,000. At that scale, even modest improvements in plan efficiency can translate into substantial, recurring savings.

Justin Burgess, Vice President and Employee Benefits Practice Leader at Insurance Underwriters of America, leads the agency's employee benefits division with a focus on transparent, cost-effective plan design that challenges traditional renewal models. With over a decade of experience as a health insurance broker, benefits consultant, and podcast host, he brings a practitioner’s lens to the CFO-led benefits conversation now reshaping employer strategy.

"Legacy broker system plus legacy carrier system equals legacy outcomes. When you introduce transparency and accountability into benefits, everything changes," Burgess explains. That perspective is gaining traction at the executive level, with more CFOs working alongside HR to find new ways to manage healthcare costs and apply real strategic thinking to one of the company's largest recurring expenses.

• In the driver's seat: Unlike supply chains or capital investments, where margins for improvement are often thin, healthcare spending frequently contains significant, addressable inefficiencies. CFOs who engage in this space can materially improve forecasting, reduce costs, and strengthen the overall employee value proposition. “Early on in my career, we would never have relationships with CFOs. They would never come to meetings, and now it’s the opposite. They may not understand the math in insurance, but when you convert it into something that resonates specifically with them, then it starts to click."

• Numbers tell the story: Burgess points to the current tariff environment to illustrate the opportunity in front of CFOs. In every other part of the business, the numbers tell a story. Tariffs rise, import costs follow, and leadership adjusts accordingly. "Healthcare has historically offered less of that predictability, but that's what makes it such a compelling frontier for finance leaders," says Burgess. "The CFOs who learn to ask the right questions and demand the right data are the ones finding savings others are leaving on the table."

Burgess emphasizes that smarter, more transparent systems can improve healthcare outcomes for both employers and employees. By addressing structural gaps in benefits management and uncovering hidden pricing opportunities, organizations can make healthcare spending more predictable, efficient, and fair.

• Closing the gap: Burgess highlights what he calls the “broker accountability gap,” an opportunity for employers to get more from their benefits partners. In many traditional relationships, success is measured by negotiating a smaller renewal increase rather than improving how the plan actually performs. “You see a renewal come in at 15%, they negotiate it down to 7%, and everyone celebrates,” Burgess says. “But that doesn’t mean the plan actually got better.” By focusing on measurable outcomes and aligning expectations between brokers, carriers, and employers, companies can close this gap and achieve meaningful, lasting improvements in healthcare spending.

• Spotting hidden costs: Price transparency is one of the most powerful tools available to employers today, and one of the most underutilized. Burgess uses the example of a knee replacement costing $5,000 at one New Orleans hospital and $25,000 at another. "Employees don't see the difference because the way deductibles are structured keeps the true cost invisible to them, but it doesn't have to stay that way. If an employee submitted a $300 steak dinner on an expense report, they'd need to provide a receipt," Burgess says. "Healthcare should work the same way."

• Advocates who deliver: A dedicated advocacy model holds the strategy together. The impact goes beyond finances. When employees have a dedicated advocate who knows their situation and stays with them throughout the process, the entire healthcare experience improves. "When someone is facing a medical crisis, they're already stressed," Burgess says. "What they need is one person who knows their story, picks up the phone, and stays with them start to finish. That kind of support changes outcomes for the employee and for the plan."

Burgess recommends a deliberate, phased approach for employers ready to take action. Starting with targeted, high-impact interventions lets companies generate early wins, build internal confidence, and collect data that makes each subsequent phase smarter.

• Start small: Virtual direct primary care leads the crawl phase, giving members access to a physician on a Friday afternoon rather than defaulting to urgent care, starting at just $10 per employee per month. Pharmacy follows closely behind. "In pharmacy, the goal is to get straightforward about what we're trying to do," Burgess explains. "We should be chasing the lowest net cost, not waiting on rebate money down the line. Once you simplify the objective, you start winning immediately."

• Incentives that work: As employers move into the walk phase, workforce data gathered earlier allows for incentives that resonate. A well-matched incentive drives participation; a poorly matched one gets ignored. "A high-earning employee may not find enough value in driving 30 minutes to save a modest amount, but an employee with a lower salary might," Burgess explains. "When you design for how your people live, the strategy delivers."

• Next-level benefits: In the run phase, employers can introduce more advanced options, such as Individual Coverage Health Reimbursement Arrangements, which provide predictable costs and flexibility as ACA rules evolve. Burgess frames the whole journey as a three- to five-year strategy: "First get access to your data. Then start making changes." The companies that stay patient and stay the course are the ones that see savings compound year over year.

For Burgess, controlling healthcare costs begins with a change in perspective. He argues that leaders get better results when they view health benefits not as a siloed HR function but as a core financial liability. CFOs who manage supply chain risk, liability, and capital allocation already have the skills and instincts to bring the same discipline to healthcare, and the returns can be just as significant. CFOs know every line item in their core business and understand what it takes to run operations efficiently. While they may not know every detail of the healthcare system, they understand managing costs and risk. Framing healthcare as a manageable, accountable line item makes the strategy click. "That’s why I love having CFOs in the room," concludes Burgess.