Navigating the benefits renewal process can be complex, but asking the right questions can make a significant difference in the outcome. Whether you’re a business owner, CFO, HR professional, or decision-maker, understanding the nuances of your group benefits plan is crucial to securing the best terms for your team. 

The Six

1. What has been calculated as the demographic pricing adjustment for Life and Long-Term Disability? 

Why? This helps ensure your rates reflect actual workforce changes, avoiding unnecessary cost increases.

2. If the insurance company is asking for more than the demographic change, what is the rationale? 

Why? It’s important to understand if rate hikes are based on real risk changes or other factors such as insurer manual rate changes. 

3. What is the paid loss ratio for health and dental, and how does it compare to the insurer’s target loss ratio (TLR)? 

Why? Knowing this provides insight into whether your plan’s claim usage is fair compared to the targets set by insurers. 

4. What are the trend/inflation and fee guide factors being used to calculate the Health and Dental rates? 

Why? Understanding these factors allows you to understand how much the insurer is expecting your claims to change for the upcoming year, both due to inflation and increased utilization. 

5. How much have you negotiated from the insurance company’s original proposed renewal rate adjustments? 

Why? This question reveals the effectiveness of your consultant’s negotiation strategy, ensuring they’re providing you with the fairest renewal possible. 

6. What is the pooling threshold, and what are the pooling charges included in our Health rates? 

Why? This question helps to identify if any changes are being made to the catastrophic claim protection program on your plan. This is also a great time to revisit this program to ensure it maintains the best balance between claim risk and pooling program cost for your organization. Check out our blog on pooling charges to see why this is so important! 

By asking these questions, you’ll be better equipped to navigate the renewal process, ensuring your plan continues to meet your organization’s needs. 

Need help with your renewal? Download our one-pager [here] to have these questions handy for your next meeting. For more personalized guidance, our team is here to make the renewal process smooth and convenient—reach out to navigate your options with confidence. 

Understanding your benefits plan doesn’t have to be overwhelming. With the right questions, you can take control and make informed decisions that benefit both your organization and your employees.