Renewal Increase Checklist

When your carrier sends a renewal increase, you have more options than you might think — but acting on them requires a structured approach. Use this checklist to make sure you are covering all the bases.

1. Understand What Is Driving the Increase

• Request a written explanation from your carrier for the renewal increase
• Ask for a breakdown of medical trend vs. claims experience factors
• Request your group's loss ratio for the past 2–3 years
• Ask your broker to explain what "trend" is being applied and why
• Determine whether the increase is primarily driven by claims, trend, or carrier margin changes

2. Get Your Claims Data

• Request an aggregate claims report from your carrier (most carriers will provide this for groups of 50+ on request)
• Review the report for: top diagnostic categories, high-cost claimants (redacted), pharmacy spend, and utilization trends
• Identify whether pharmacy is a material driver (commonly 20–35% of total cost)
• Ask your broker to help you interpret the data

3. Benchmark Your Plan

• Ask your broker for benchmark data: How do your plan costs compare to similar employers by size, industry, and geography?
• Review your current plan design against benchmarks: Is your employee contribution strategy competitive? Are your deductible and out-of-pocket levels in range?
• Ask: Are you offering more benefits than you need to attract and retain talent?

4. Evaluate Alternatives to Your Current Structure

• Ask your broker to obtain competing quotes from at least 2–3 carriers
• If you have 50+ employees, ask about level-funded options
• If you have 100+ employees, ask your broker to model a self-funded comparison
• Evaluate whether a captive or consortium arrangement is relevant for your industry or group
• Ask about reference-based pricing as a cost containment strategy (appropriate for some groups)

5. Review Your Plan Design

• Is your deductible level appropriate given your workforce demographics?
• Are you offering too many plan options, creating adverse selection in the rich tier?
• Could you add a high-deductible/HSA option to give employees a lower-cost choice?
• Review your employee contribution strategy: Is it based on a flat dollar or a percentage of premium?
• Evaluate voluntary benefits that could supplement a higher-deductible plan

6. Address Pharmacy Costs

• Request a pharmacy spend report from your carrier or PBM
• Identify whether any high-cost specialty drugs are on your formulary
• Ask about manufacturer copay assistance programs for specialty drugs
• Evaluate whether your PBM contract is competitive (rebates, network discounts, formulary management)
• Ask whether a pharmacy carve-out strategy is worth exploring

7. Evaluate Your Broker Relationship

• Is your broker presenting you with options and data, or just a renewal and a recommendation?
• Do you know how your broker is compensated? (Ask for full disclosure)
• Is your broker proactively bringing cost management strategies, or waiting for you to ask?
• Have you gotten a second opinion from another broker in the last 3 years?

8. Plan the Decision Timeline

• Note your plan effective date and work backwards: When do you need a carrier decision?
• Build in 30–45 days for employee open enrollment before the effective date
• Allow 2–3 weeks for underwriting and quote evaluation
• Set an internal decision deadline at least 60 days before your plan effective date

9. Communicate With Employees

• Draft a communication plan: What will you tell employees, and when?
• Prepare answers to common employee questions (network, prescriptions, cost changes)
• If plan design is changing, prepare comparison materials showing old vs. new
• Plan a Q&A session or benefits fair to support enrollment

10. Document and Track

• Document all quotes received and the basis for your decision
• Save all carrier proposals for future comparison
• Set a calendar reminder to begin the renewal evaluation process 90–120 days before next renewal
• Set a reminder to request claims data quarterly (not just at renewal time)

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Want help working through this checklist? Benefits Collective provides employers with a no-cost benefits strategy review. Schedule a consultation to get a second opinion on your renewal.