Checklist
10 questions to ask before you sign your renewal.
Take these to your current broker or carrier. If the answers come back vague, that's worth knowing too.
- 01
How much of the increase is our own claims, and how much is general cost growth?
The two have different fixes. Cost growth gets negotiated on the assumption; claims get explained and, where they were one-time, pushed back on.
- 02
What cost-growth assumption did the carrier use?
A point or two here moves the whole renewal. Ask for the number and how it compares to the market.
- 03
Were any large one-time claims counted in full?
A claim that won't happen again shouldn't set your rate for the next year, especially if stop-loss already covered most of it.
- 04
What changed in the fixed costs?
Admin fees, stop-loss premium, and network fees should each be shown separately, with last year's number next to this year's.
- 05
If we're level-funded: how does the surplus refund work?
Find out what share of any surplus you get back, when it's paid, and what happens if you leave the carrier.
- 06
How much does our broker earn, on this renewal and on each alternative?
For employer group health plans, federal law requires brokers to disclose compensation of $1,000 or more. You're entitled to see it.
- 07
Was the plan actually taken to market?
Ask which carriers quoted, which declined, and why. "We checked the market" isn't the same as a side-by-side comparison.
- 08
What happens to our employees' doctors if we switch?
Get the percentage of last year's claims that would fall out of network with each option before price decides it.
- 09
Are there plan changes that save money without hurting the people who use the plan most?
Small changes to deductibles, copays, or prescription tiers can offset an increase. Each should be priced against your own claims.
- 10
When do we need to decide?
Work back from open enrollment and employee notice deadlines. Most of the leverage is gone in the last two weeks.
Next
Want a second set of eyes on the answers?
Send me your renewal and I'll go through these with you.