Which Employers Cover GLP-1s for Weight Loss?

There is no public list of employers that cover Wegovy, Zepbound or other GLP-1s for weight loss, and none of the major benefits surveys names individual companies. What the surveys do show is that coverage varies widely by employer size: nearly one-fifth of firms with more than 200 workers said they cover GLP-1 drugs for weight loss as of October, including 43% of firms with 5,000 or more workers, according to the Peterson-KFF Health System Tracker ^[7]. Among large employers surveyed by the Business Group on Health, 67% cover GLP-1s for weight management ^[3]. Among a broader sample of almost 300 employer plans surveyed by the International Foundation of Employee Benefit Plans, about 36% cover GLP-1s for both diabetes and weight loss ^[4].

The reason no list exists is that most covered workers are not in a standard insurance product at all. Sixty-seven percent of covered workers are in self-funded plans, where the employer, not the insurer, pays claims and decides the drug benefit ^[1][2]. That means two people at different companies can carry insurance cards with the same carrier name and get completely different answers about Wegovy or Zepbound. The only reliable way to know what your employer does is to check your own plan documents and ask HR, which is covered in detail below.

Why is there no list of employers that cover GLP-1s?

Coverage for obesity medicines is inconsistent across employer-sponsored plans, leaving roughly half of commercially insured employees without covered access, according to Lilly, citing data in its launch release for the Lilly Employer Connect platform ^[8]. Because each employer sets its own drug benefit, there is no single registry of who covers what.

The structure of employer coverage makes a list nearly impossible. Sixty-seven percent of covered workers are in self-funded plans, meaning the employer pays for health services directly from its own funds rather than buying insurance ^[1][2]. That share rises to 80% of covered workers at firms with 200 or more workers, and falls to 27% at firms with 10 to 199 workers ^[1][2]. In a self-funded plan, the employer, not the insurer whose name is on the card, decides whether weight-loss drugs are covered.

The surveys that measure coverage also use different groups of employers, so their numbers are not interchangeable:

• KFF’s 2025 Employer Health Benefits Survey covers non-federal public and private firms with 10 or more workers, through 1,862 interviews ^[1].
• The Business Group on Health survey covers 105 large employer members of the organization ^[3].
• The IFEBP pulse survey covers almost 300 U.S. employer health plans ^[4].

What share of employers cover GLP-1s for weight loss?

The honest answer depends on who was surveyed, when, and how large the employers were. Here is what each survey found:

Survey	Who was surveyed	When	Share covering GLP-1s for weight loss
Peterson-KFF Health System Tracker	Firms with more than 200 workers	As of October	Nearly one-fifth; 43% of firms with 5,000+ workers [7]
Business Group on Health	105 large employer members	February–March 2026	67% cover GLP-1s for weight management; most cover GLP-1s for diabetes [3][27]
IFEBP pulse survey	Almost 300 U.S. employer plans	June 2026	About 36% cover GLP-1s for both diabetes and weight loss [4]
Mercer	Employers with 500+ employees	2024	44%; 64% of employers with 20,000+ employees [5]

KFF’s 2025 Employer Health Benefits Survey asked employers specifically about coverage of GLP-1 agonists for weight loss, and the companion article published in the journal Health Affairs reports that larger employers increased coverage of GLP-1 drugs for weight loss ^[1].

Mercer found 44% of employers with 500 or more employees covered weight-loss medications in 2024 ^[5]. In June 2026 reporting, Mercer put the figure at 44% of employers with more than 500 employees covering the drugs for obesity ^[6]. The gap between that number and the Business Group on Health’s 67% reflects how coverage rates vary by employer size and by which employers belong to each survey group ^[6].

The IFEBP survey adds detail on what employers cover besides weight loss: 60% cover GLP-1s for diabetes only, up from 55% in 2025 and 57% in 2024, and roughly 45% cover GLP-1s for other approved conditions such as obstructive sleep apnea and heart disease ^[4].

Is coverage more likely at a very large company?

Yes, in the two surveys that break results out by firm size. The Peterson-KFF tracker found nearly one-fifth of firms with more than 200 workers covering GLP-1s for weight loss, rising to 43% of firms with 5,000 or more workers ^[7]. Mercer found 44% of employers with 500 or more employees covered weight-loss medications in 2024, rising to 64% of those with 20,000 or more employees ^[5].

The Business Group on Health reports a single 67% figure for its members as a whole, and its membership includes the majority of Fortune 100 companies as well as large public-sector employers ^[3]. The IFEBP survey reports about 36% across its sample of almost 300 employer plans ^[4].

Even at large companies, coverage is not guaranteed, and heading into 2027 some employers that do cover the drugs are reconsidering, as the next section explains.

Is GLP-1 coverage expanding or shrinking heading into 2027?

The signals point toward flat or shrinking coverage rather than growth. The IFEBP survey found about 36% of employers covering GLP-1s for both diabetes and weight loss in 2026, the same percentage as 2025 and up only slightly from 34% in 2024 ^[4]. Only about 9% of employers in that survey are considering adopting obesity coverage ^[4].

On the other side of the ledger:

• Of Business Group on Health employers covering GLP-1s for weight management, 72% are likely to continue in 2027 and 10% likely would not; companies that do not cover GLP-1s for weight management today are unlikely to add coverage ^[3].
• Mercer, via Reuters reporting, found 5% of large employers, defined as those with more than 500 employees, actively planning to drop GLP-1 coverage next year ^[6].
• Health insurer Cigna ended GLP-1 weight-loss coverage for its own employees effective July 2026, telling employees they could purchase the medications elsewhere ^[6].

PepsiCo stopped covering weight-loss medications for its employees other than diabetics, telling them in a letter that prescription weight loss medications have become one of the fastest-growing costs in the PepsiCo Plans ^[27]. Marsh found 6% of employers dropped GLP-1 coverage in 2026 and another 5% plan to drop it in 2027 ^[27]. The Business Group on Health found two-thirds of companies currently cover drugs for weight loss, but 10% plan to drop the coverage in 2027 ^[27].

Nearly eight in 10 employers report that GLP-1s are driving an increase in their company’s health care costs ^[3][6], and 87% of Business Group on Health employers expect an oral GLP-1 medication to increase overall demand, while only 9% expect a decrease in price ^[3][6].

Why do two people with the same insurance card get different answers?

Because the card often does not tell you who is actually paying the claims. In a self-funded plan, the employer pays for the health services of enrollees directly from its own funds rather than through the purchase of health insurance ^[1][2]. Sixty-seven percent of covered workers are in self-funded plans, including 80% of covered workers at firms with 200 or more workers ^[1][2].

When an employer self-funds, it decides the drug benefit, including whether weight-loss drugs are excluded, even though a carrier or PBM name appears on the insurance card. Two employees at different companies with the same carrier can therefore have entirely different GLP-1 coverage.

Small-firm workers face an additional wrinkle. Thirty-seven percent of covered workers at firms with 10 to 199 workers are in level-funded plans, which combine a small self-funded component with stop-loss insurance ^[2]. Unlike insured plans, level-funded plans are not required to provide all of the essential health benefits that are mandatory for insured plans ^[2].

What conditions do employers attach when they do cover GLP-1s?

Employers that cover GLP-1s for weight management commonly use strategies to control how the drugs are used. The Business Group on Health survey found these include validating clinical eligibility with objective biometric data, requiring participation in a weight management program to receive coverage, limiting prescribing to specific providers, and excluding certain medications from the formulary ^[3][6]. Marsh found many more employers — 27% — are placing new restrictions on coverage, like minimum body-mass index thresholds or diagnoses of sleep apnea or cardiac conditions ^[27].

On cost-sharing, 83% of Business Group on Health employers apply the same standard cost-share arrangement to GLP-1s as they do for other medications, far more than use a special design or no out-of-pocket costs ^[3][6]. Nearly eight in 10 employers involve their executive leadership in GLP-1 coverage decisions, a sign of how high the financial stakes have become ^[3][6].

Pharmacy benefit managers are also shaping access. PBMs increasingly pair GLP-1 authorizations with lifestyle management vendors, and those programs vary widely, from coaching models to vendor-led prescribing to programs with deprescribing components ^[5]. CVS Caremark announced it would exclude Zepbound from a template formulary starting July 1, 2025, while other major PBMs continue to offer access to both Zepbound and Wegovy ^[5]. Express Scripts offers employers a GLP-1-specific network strategy called Evernorth EnReachRx ^[5].

Most employers exclude compounded GLP-1 products from coverage. The FDA has flagged safety risks of unapproved GLP-1 drugs used for weight loss, and the FDA’s notice period to large-scale compounding facilities ended in May 2025 ^[5].

What is the cost pressure behind these decisions?

GLP-1s approved for weight loss carry list prices over $1,000 per month before rebates, and Zepbound and Mounjaro are both above that threshold ^[5][7]. In the IFEBP survey, respondents said GLP-1s accounted for 11.4% of annual claims in 2026, up from 6.9% in 2023 ^[4]. Weight-loss drugs are the single largest contributor to a record-setting increase in the cost of employer-sponsored health insurance expected next year ^[27], and the CEO of Bank of America said his company is spending $250 million a year to pay for workers’ GLP-1s ^[27].

Mercer found 77% of employers with 500 or more employees call managing their overall GLP-1 costs extremely or very important for 2026 ^[5]. As of Mercer’s July 2025 analysis, generics for the leading GLP-1 products were more than five years away, though a generic for Saxenda (liraglutide) is expected in 2027 ^[5]. Data from Prime Therapeutics shows only 1 in 12 members remain on a GLP-1 for obesity at three years ^[5].

More than half of Business Group on Health employers that cover GLP-1s for weight management expect the medications to yield significant clinical benefits, but few have yet seen evidence, such as reductions in obesity rates or fewer employees needing bariatric surgery, within their aggregated claims ^[3][6].

What are employers doing instead of standard coverage?

Rather than adding GLP-1s to the pharmacy benefit, many employers are pointing workers to other routes. In the IFEBP survey, about 27% of employers encourage employees to obtain GLP-1s through a direct-to-consumer platform, and 21% point workers to their FSA, HSA or integrated HRA dollars for the treatments ^[4].

A new option launched March 5, 2026: Lilly Employer Connect, a platform employers can use to coordinate obesity coverage with independent program administrators ^[7][8]. Through the platform, single-patient-use Zepbound KwikPen is available from Lilly to network pharmacies at $449 across all doses, with no rebates involved ^[7][8]. That $449 is what Lilly charges network pharmacies, not a price any consumer can buy at, and not what an employee necessarily pays. Lilly states that the final cost to the employer varies based on their choice of pharmacy and program administrator, and employee out-of-pocket costs vary based on the cost-share model the employer chooses and the dispensing and service fees agreed to with the program administrators ^[8].

The platform launched with more than fifteen independent program administrators: 9amHealth, Andel, Calibrate Health, Crux Health, eMed, FlyteHealth, Form Health, Goodpath, GoodRx, Ilant Health, Mark Cuban Cost Plus Drug Company, Onsera Health, ReviveHealth, SALTA Direct Primary Care, Sesame, Teladoc Health, Transcarent and Waltz Health ^[7][8]. The dedicated pharmacy network includes dispensing pharmacies HealthDyne and CenterWell ^[8]. The administrators range from organizations offering low-cost benefits administration to more holistic solutions providing comprehensive obesity care with telehealth, nutrition and lifestyle support ^[7][8].

Mercer notes that some employers contribute to lifestyle accounts or incentive HRAs that employees can use to buy GLP-1s directly from the manufacturer, but these options come with compliance considerations that should be carefully evaluated ^[5]. Some employers are also exploring carve-outs that limit prescribing or dispensing to specific vendors ^[5].

One point worth raising with your benefits team: Mercer notes that what employers pay is usually far below list price thanks to negotiated rebates, and employers should ask their PBM how direct-to-consumer options compare, since the net-of-rebate price may be comparable to or even better than the direct-to-consumer price ^[5].

What do employers offer when they do not cover GLP-1s?

Most plans offer weight-related support that stops short of covering the drugs. In the IFEBP survey, 74% of plans offer disease and chronic care management, 61% provide nutritional counseling, and 61% offer bariatric surgery. Employers also said they cover lifestyle modification programs, other non-GLP-1 drugs and medication-free interventions for weight loss ^[4].

Justin Held, director of educational programs at IFEBP, said employers are focusing on how to support the overall health of their workers rather than offering coverage for weight loss ^[4]. What could change employer minds, according to Held, is evidence that covering the drugs reduces costs in other areas, such as fewer knee replacements and bariatric surgeries or higher productivity ^[4]. Some early studies do not show any short-term improvement in people’s health or reduction in their use of other health care ^[27].

How do I find out if my employer covers Wegovy or Zepbound?

Work through these steps:

1. Check the formulary. Search for Wegovy and Zepbound by exact name and device form, and note any prior authorization, step therapy or quantity-limit flags attached to them ^[3][5].
2. Search your plan documents. Look through the Summary of Benefits and Coverage, the evidence of coverage and the summary plan description for the terms “weight loss,” “weight management,” “anti-obesity” and “obesity” ^[2].
3. Ask HR three questions. Is the plan self-funded or fully insured? Are drugs prescribed for weight loss excluded? Is there a separate obesity program outside the pharmacy benefit? ^[1][2][8]
4. Ask the PBM for the coverage criteria. Request the name and number of the applicable coverage criteria document so you can read the exact requirements ^[5].

The third question matters because separate employer programs may not appear on the formulary at all, since they sit outside traditional benefit designs ^[8]. An employer using a platform like Lilly Employer Connect, for example, would not show up in a standard formulary search ^[8].

What can I do if my employer drops GLP-1 coverage?

Manufacturer self-pay channels offer prices well below standard list prices. Novo offers Wegovy pens directly to consumers through the NovoCare pharmacy or via a savings card that can be used at retail pharmacies, with a prescription from any doctor ^[5]. Lilly’s LillyDirect channel supplies Zepbound in vial form, with a reduced price for refills made within 45 days of the prior delivery ^[5].

If your employer joins a direct-purchase program such as Lilly Employer Connect, your out-of-pocket cost is set by the employer’s cost-share design and the administrator’s fees, not by the $449 pharmacy price ^[7][8].

It is also worth knowing that these drugs have approved uses beyond weight loss: Wegovy is approved for cardiovascular risk reduction, Zepbound for moderate-to-severe obstructive sleep apnea in adults with obesity, and Ozempic for slowing chronic kidney disease in people with type 2 diabetes ^[5][8]. Whether a different approved indication changes what your plan covers is a clinical determination for your prescriber ^[5][8].

One limit to keep in mind: your ability to change plans at open enrollment is limited to what your employer offers ^[1]. If your employer’s only plan option excludes weight-loss drugs, switching plans within the same employer will not restore coverage.

Sources

1. KFF. 2025 Employer Health Benefits Survey. October 22, 2025.
2. KFF. Employer Health Benefits Survey 2025 Annual Survey Summary of Findings.
3. Business Group on Health. GLP-1 Costs Loom Large for Employers, Forcing Challenging Coverage Decisions, Business Group on Health Survey Finds.
4. CNBC. Employers aren’t expanding coverage of GLP-1 obesity drugs: survey. July 8, 2026.
5. Mercer. GLP-1 considerations for 2026: Your questions answered.
6. Pharmaceutical Commerce. Why Some Employers Are Scaling Back GLP-1 Coverage in 2027. June 11, 2026.
7. CNBC. Eli Lilly launches program to boost employer coverage of obesity drugs. March 5, 2026.
8. Eli Lilly and Company. Lilly Employer Connect platform launches with over fifteen independent program administrators offering tailored obesity coverage options to expand access to patients. March 5, 2026.
9. Evernorth. EncircleRx.
10. Fierce Healthcare. New Evernorth program to cap out-of-pocket costs for Wegovy, Zepbound at $200. May 21, 2025.
11. U.S. Office of Personnel Management. 2026 FEHB Call Letter. March 31, 2026.
12. Blue Cross and Blue Shield’s Federal Employee Program. FAQ - Pharmacy.
13. Kansas State Employee Health Plan. GLP-1s.
14. Massachusetts Group Insurance Commission. June Update on Vida Health Program and GLP-1 Coverage.
15. Colorado Department of Human Resources. Medical Benefits.
16. WRAL. Expected NC budget won’t restore GLP-1 weight-loss drug coverage for state employees, treasurer says.
17. Blue Cross Blue Shield of Massachusetts. We’ve changed our GLP-1 coverage.
18. Harvard Pilgrim Health Care. What You Need to Know for 2026 Massachusetts Small Group.
19. Becker’s Payer Issues. Cigna defeats class action alleging GLP-1 coverage exclusions are disability discrimination. February 23, 2026.
20. Express Scripts. Frequently Asked Questions: GLP-1 Medications, Diabetes and Weight Management.
21. Bass Berry & Sims HR Law Talk. Emerging Alternatives for GLP-1 Prescription Drug Coverage: What Plan Sponsors Need to Know.
22. STOP Obesity Alliance, Milken Institute School of Public Health, The George Washington University. Federal Health Plans Step Up Coverage of Obesity Treatment. April 29, 2022.
23. Evernorth. Evernorth Launches New Benefit Option That Drives Lower Net Cost for Weight Loss Medicines and Limits Patient Cost to No More Than $200 Per Month. May 21, 2025.
24. Eli Lilly and Company. Lilly Employer Connect platform launches with over fifteen independent program administrators offering tailored obesity coverage options to expand access to patients. March 5, 2026.
25. Reuters. More US employers to drop weight-loss drugs in 2027, as healthcare costs increase. August 25, 2026.
26. STAT. Pharmalittle: We’re reading about a GSK shingles shot, U.S. employers dropping GLP-1 coverage, and more. August 26, 2026.
27. The Washington Post. Why it may become harder to get coverage for GLP-1 weight-loss drugs. September 15, 2026.