Benefits Broker Evaluation Checklist

Use this checklist to evaluate your current benefits broker or to compare brokers when considering a change. Score each item honestly. If your broker falls short in more than a few areas, it may be time for a conversation — or a second opinion.

Strategic Partnership

• Broker meets with us proactively throughout the year, not just at renewal
• Broker presents a written annual benefits strategy with clear goals and recommendations
• Broker provides regular market updates and industry trends relevant to our company
• Broker understands our business, our workforce demographics, and our budget priorities
• Broker brings us new ideas and strategies without being asked

Renewal Process

• Broker begins the renewal process at least 90 days before our renewal date
• Broker provides a detailed breakdown of what is driving our renewal increase
• Broker markets our group to at least three alternative carriers at every renewal
• Broker presents multiple plan design alternatives with projected cost comparisons
• Broker negotiates with our current carrier using competitive quotes as leverage
• Broker presents a clear side-by-side comparison of all options before we make a decision

Data and Analytics

• Broker provides us with our claims data and loss ratio analysis annually
• Broker identifies our largest cost drivers and recommends specific strategies to address them
• Broker provides benchmarking data comparing our benefits program to similar employers
• Broker tracks our benefits costs year over year and identifies trends
• Broker uses data to support their recommendations rather than relying on opinion

Funding Strategy

• Broker has discussed alternative funding strategies with us (level funded, self-funded, captive)
• Broker has modeled what our costs would look like under different funding arrangements
• Broker understands stop-loss insurance and can advise on deductible levels and contract terms
• Broker evaluates our funding strategy annually and recommends changes when appropriate

Pharmacy Management

• Broker has reviewed our pharmacy spending and identified cost reduction opportunities
• Broker has discussed pharmacy carve-out options with us
• Broker understands PBM pricing models and can explain how our PBM makes money
• Broker has recommended formulary management or specialty drug strategies

Compliance Support

• Broker helps us with ACA reporting and compliance
• Broker advises on ERISA, COBRA, HIPAA, and FMLA requirements
• Broker provides compliance updates when regulations change
• Broker reviews our plan documents and summary plan descriptions
• Broker helps us prepare for any compliance audits

Employee Support

• Broker supports our open enrollment process with materials and employee communications
• Broker is available to answer employee questions during open enrollment
• Broker helps resolve claims issues and escalations for our employees
• Broker provides employee education on how to use their benefits effectively

Compensation Transparency

• Broker has disclosed exactly how they are compensated on our account
• We know whether our broker earns commissions, fees, or both
• Broker has disclosed any bonuses, overrides, or incentive payments they receive from carriers
• We understand how our broker's compensation model might affect their recommendations

Technology and Administration

• Broker provides or recommends a benefits administration platform
• Broker helps with carrier billing reconciliation
• Broker assists with enrollment data management and carrier feeds
• Broker provides a client portal or dashboard for accessing plan documents and data

Scoring

Count the boxes you checked. This gives you a rough sense of where your broker stands.

25 or more checked: Your broker is delivering strong value. Continue to hold them accountable and raise the bar each year.

18 to 24 checked: Your broker is doing a decent job but has gaps. Have a direct conversation about the areas where they are falling short and set clear expectations.

12 to 17 checked: Your broker has significant gaps. Consider getting a second opinion from an independent advisor to see what you might be missing.

Fewer than 12 checked: Your broker is likely underserving your account. It is time to seriously evaluate alternatives.

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Want help evaluating your broker or getting a second opinion? Schedule a free benefits strategy review and we will give you an honest, independent assessment.