Author: Ted Stevenot

Sometimes there isn’t a better quote.

That’s an uncomfortable place to begin a discussion about a health insurance renewal, but it is where we recently found ourselves with a client facing an unusually difficult renewal increase.

This wasn’t a case where we opened the renewal, saw a large increase and immediately started moving deductibles around.

We pulled it apart.

We looked at the group’s claims experience. We looked at the people and conditions that appeared to be driving the experience. We considered whether some of those claims might be behind us or whether they represented continuing risk. We looked at other carriers. We looked across the renewing carrier’s entire array of available plans. We considered different deductibles, copays and network structures. We considered HMO and EPO options. We considered whether an ICHRA might make sense. We even considered whether there was a reasonable way to separate classes of employees and use different approaches for different parts of the workforce.

The deeper we went, the clearer the problem became.

There wasn’t an easy way out.

The problem wasn’t a lack of health insurance renewal options. It was that none of the realistic options were good.

When a renewal gets everyone’s attention

This increase was large enough that people became involved in the discussion who normally don’t spend their time thinking about health insurance.

That’s understandable.

When employee benefits suddenly create a major financial problem for a business, owners and senior leadership naturally start asking questions.

• Did we shop other carriers?
• Did we really look at everything?
• Where did these particular plan options come from?
• Why did we choose these plans out of all the alternatives?
• Could we look at another carrier someone had heard about?
• Could we wait a few months and try again?

Those are good questions.

In fact, I think an employer facing an increase of this magnitude should ask them.

But answering them requires more than saying, “We shopped the market.”

It requires being able to explain what you did and why.

We tested the market. The market gave us an answer.

We approached the realistic carrier alternatives for this group.

Most were unwilling to quote the case competitively. The alternatives we received did not materially improve the renewal.

That wasn’t a solution.

It also meant we had very little negotiating leverage with the incumbent carrier. Had another credible carrier produced an attractive proposal, we might have been able to use it to push for some relief. Without a competitive alternative, there wasn’t much leverage to bring to that conversation.

One question that came up involved another carrier we hadn’t pursued.

There’s an important distinction here between being able to say you requested a quote from every carrier whose name appears on a list and actually conducting a responsible market review.

Not every carrier has meaningful penetration in every market. Network strength matters. Provider relationships matter. Contracted discounts matter. A carrier with very little local market presence may technically be an option without being an option we would be comfortable recommending.

We could have requested another quote simply so we could say we had done it.

But if we wouldn’t advise the client to take that option, what would that accomplish?

Shopping a health insurance case isn’t a box-checking exercise. The objective isn’t to produce the largest stack of proposals. It is to identify credible alternatives that we would actually be willing to put in front of the employer and its employees.

In this case, the credible market alternatives weren’t better.

A few better claims months don’t necessarily change the underlying problem

Another natural question was whether we should simply wait a few months and shop the case again.

We can certainly revisit a case.

But there is a problem with assuming that waiting a few months will automatically produce a different result.

In this case, we didn’t have the kind of detailed claims information a very large employer may have available. You can see enough to know that claims have been substantial. You may see that claims were particularly high during one period and then improved during another.

That can create an understandable sense that perhaps the group is getting better.

But paid claims looking better for several months doesn’t necessarily mean the underlying risk has disappeared.

There are really two views occurring at the same time.

• There is the backward look: What claims has the plan already paid?
• And there is the forward look: Based on the health conditions present in the group, medical trend and other underwriting factors, what might this population cost going forward?

Those aren’t necessarily the same thing.

A condition that generated significant claims last year may still exist even if it hasn’t generated a major claim during the last few months. From an underwriting perspective, the potential for future claims may remain.

That was an important part of this particular case.

We weren’t looking at a group where everything that had happened could simply be placed in the rearview mirror.

So “let’s try again in a few months” sounded more promising than it actually was.

Eventually you have to manage the trade-offs

Once we had worked through the alternatives, we were left with the renewing carrier and a difficult increase.

Now the question changed.

Instead of asking, How do we make the increase disappear?

We had to ask, How do we make the best of a bad situation?

The employer had been offering multiple medical plan choices.

We went back through the renewing carrier’s larger portfolio of available plans and pulled out the options we thought were most relevant. That selection wasn’t arbitrary. We were trying to find the best intersection of premium, deductible, out-of-pocket exposure, network access and the benefits employees actually use.

We ultimately recommended simplifying the plan structure and consolidating the existing choices into a single option.

You could think of it as meeting in the middle.

For some employees, the change meant greater out-of-pocket exposure. For others, it actually meant somewhat lower cost sharing. Because of how enrollment was distributed across the existing options, the change produced meaningful premium savings for the group.

Was it painless?

No.

More employees were moving toward greater cost sharing than were moving in the other direction. There is no point pretending otherwise.

But we also didn’t take the plan all the way to the bone.

We didn’t move everyone into the highest deductible available. We didn’t force the group into the narrowest network structure. We didn’t move to an HMO simply because it could reduce premium. And we didn’t create the disruption of abandoning the group plan entirely for an ICHRA.

Those possibilities were considered. We just didn’t think the situation required pushing that far.

There are times when benefit management is less about finding a perfect answer and more about knowing how far to turn each dial.

In the middle of reducing benefits, we found a place to add value

There was another part of this renewal that I think is worth mentioning.

The employer already offered some voluntary coverage, meaning employees who wanted those benefits could purchase them through the group without the employer having to absorb the premium.

During the process, we also found an opportunity to expand those voluntary benefits.

At first glance, “voluntary benefit” can sound like something that isn’t much of an employer benefit at all.

After all, the employer isn’t paying the premium.

But I don’t think that’s the right way to look at it.

An employer can create value simply by providing access.

Through a group arrangement, employees can have access to disability coverage, dental and vision plans, and benefit structures that may be difficult or impossible for them to duplicate efficiently in the individual market. Dental and vision plans can also provide access to established provider networks. In the case of dental coverage, for example, group plans can include meaningful annual benefits, strong networks and orthodontia options that an employee may have difficulty reproducing independently at a comparable cost.

The employer is already administering benefits and paying a bill to the carrier. Where good voluntary products are available, opening those options to employees can make sense even if the employer doesn’t contribute toward the premium.

In this case, I especially liked adding voluntary benefits because of everything else that was happening.

We were asking employees to absorb a more difficult medical benefit structure. At the same time, we found another place where we could improve the overall benefits package without adding meaningful employer cost.

That doesn’t erase a difficult medical renewal.

But when you’re managing a difficult situation, you look for every place where you can create value.

Sometimes the answer is simply the best answer available today

This case pressed us.

We care about what happens to the company and its employees. We didn’t want them to receive this renewal, and we certainly didn’t want to walk into the room and tell them there was nothing we could do.

So we kept asking ourselves the same question:

What else could we do?

• We asked it while we were working on the case.
• We asked it when management questioned our approach.
• We asked it among ourselves afterward.
• What did we miss?
• What other carrier should we have approached?
• What other funding arrangement should we have considered?
• What other plan structure could have produced a better balance?

There is an important discipline in doing that. Experience shouldn’t make you defensive about your work. It should make you willing to challenge it.

If somebody has a better idea, I want to hear it.

But after going back through this case, I wouldn’t manufacture an alternative simply to make the process look more exhaustive. I wouldn’t recommend a carrier I didn’t believe was a responsible choice. I wouldn’t disrupt the entire benefits program just to demonstrate that we had done something dramatic.

Sometimes professional judgment means being able to say: We looked. This is where the facts led us.

And we’re not done

There is one more thing I want this employer to understand.

This recommendation isn’t a declaration that these should be their benefits forever.

It is our recommendation for what they should do now.

We will revisit it.

If the group’s circumstances improve, we will look for opportunities to improve benefits. We will look at the market again. We will reconsider carriers. We will reconsider plan structures. We will reconsider funding arrangements. If circumstances eventually make an ICHRA or another approach appropriate, we’ll look seriously at that too.

And if the next renewal is difficult again, we still have additional levers available that we deliberately chose not to pull this time.

That matters.

When an employer is facing a difficult renewal, I don’t think the objective should simply be to survive the meeting, place the coverage and move on.

The objective is to make the best decision available today while remaining vigilant for the next opportunity to make things better.

There are renewals where a broker finds a substantially better carrier and everybody walks away happy.

There are renewals where negotiation produces meaningful savings.

And then there are renewals like this one.

The market has spoken. The claims are real. The alternatives aren’t better. There is no rabbit to pull out of the hat.

That’s when the work becomes less visible but perhaps more important.

You pull the renewal apart. You test your assumptions. You challenge your own recommendations. You explain the trade-offs. You protect the things worth protecting. You make concessions where they produce the most value. You look elsewhere in the benefit package for opportunities to improve something. And you preserve options for the future.

A broker’s value isn’t demonstrated only by finding a cheaper quote.

Sometimes there isn’t one.

Sometimes the value is knowing what to do next.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses and their owners evaluate health insurance and employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping small businesses navigate health insurance.

Talk With McCarthy Stevenot Agency

If your Ohio business is facing a difficult health insurance renewal, we can help you review the renewal, evaluate realistic alternatives and understand the trade-offs before you make a decision.

Contact McCarthy Stevenot Agency to discuss your situation, or call 513-891-9888.

Related resources

• Why Small Businesses Should Build a Health Insurance Renewal System
  
• What to Do When Small Business Health Insurance Rates Go Up in Ohio
  
• How to Get a Second Opinion on Your Small Business Health Insurance in Ohio
  
• What Happens Before We Ever Call About Your Renewal
  
• HMO, EPO, PPO, HDHP, HSA and Copay Plans Explained
  

Disclaimer

Broker’s Desk is a series of observations from more than three decades of helping Ohio small businesses and their owners navigate health insurance. Some articles explain a process. Others tell the stories behind the work. All are intended to help readers understand how experienced brokers think through real-world situations, not to suggest there is one right answer for every business or individual.

Health insurance when starting a business is one of the first major obstacles many aspiring business owners encounter.

A gentleman approached me recently with a concern I’ve heard, in one form or another, for most of my career.

“I’m thinking about leaving my employer and starting my own business. What should my wife and I do about health insurance?”

Leaving employer-sponsored health insurance is often one of the biggest considerations for people deciding whether to strike out on their own.

The right solution depends on details such as whether the business has employees, where it is located, whether it qualifies for group coverage, and whether individual health insurance may be the more practical starting point.

Health Insurance When Starting a Business Depends on the Facts

His business would be located in Kentucky.

His wife wasn’t part of the business. She wasn’t an employee and wasn’t looking to become one.

The business would consist of one owner.

Those few facts dramatically changed the conversation because health insurance for business owners often depends on details that aren’t immediately obvious.

When geography changes the answer

Our agency is licensed in Ohio, but we’re not currently licensed in Kentucky.

That meant I couldn’t recommend or enroll him in a Kentucky plan.

Instead, I did what I hope any professional would do.

I researched the issue, then called a trusted colleague in Kentucky to make sure I wasn’t missing anything.

A second opinion

I reached out to Jim Beatrice at Business Benefits Insurance Solutions in Northern Kentucky. Jim and I have known each other professionally for many years, and I wanted to make sure I wasn’t overlooking an option unique to Kentucky.

Jim’s practical experience confirmed what my research suggested.

For owner-only businesses, and for some other very small businesses depending on their circumstances, the Kentucky individual marketplace through kynect is frequently the place to begin evaluating coverage.

Every situation deserves its own review, but there usually isn’t a simple small-group health insurance solution waiting for an owner-only business.

Why this surprises people

Many entrepreneurs assume that once they form a business, they automatically have access to small-group health insurance.

Sometimes that’s true.

Sometimes it isn’t.

Ownership structure, employees, state rules, carrier guidelines, and association eligibility can all affect the available options.

For an owner-only business, individual health insurance may ultimately prove to be the most practical starting point. That is a different question from whether a company with employees should offer group health insurance.

That’s why asking the right questions matters before making assumptions.

The next conversation

Once the likely path became clearer, our discussion shifted from “What coverage is available?” to “Given those choices, how do we make the most of them?”

It’s a different conversation.

Sometimes it involves deciding between competing plans.

Sometimes it’s about budgeting for healthcare expenses.

Sometimes it’s about building flexibility into the future rather than simply solving today’s problem.

Those conversations are highly individual, which is why they almost always begin with questions rather than recommendations.

One question. Bigger implications.

This conversation reminded me that health insurance influences far more than medical care.

It affects career decisions.

Business formation.

Retirement timing.

Financial planning.

For many people, finding the right health insurance after leaving an employer becomes one of the deciding factors in whether they’re willing to build something of their own.

That’s a lot of weight for one decision.

Final thoughts

One thing I’ve learned after many years in this business is that the simplest questions are often the ones with the most moving parts.

Sometimes the answer is a group plan.

Sometimes it’s an individual plan.

Sometimes it’s simply knowing why one path makes more sense than another.

That’s why these conversations matter before applications are submitted and decisions are made.

In this instance, we didn’t write an insurance policy.

But we were able to help someone better understand the road ahead.

Sometimes that’s one of the most valuable services we can provide.

If that’s what happens, it’s been time well spent.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses and their owners evaluate health insurance and employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping small businesses navigate health insurance.

Talk With McCarthy Stevenot Agency

If you are starting an Ohio business or trying to understand whether individual or small-group health insurance may apply to your situation, the first step is identifying the facts that affect eligibility and available options.

Contact McCarthy Stevenot Agency to discuss your situation, or call 513-891-9888.

Related resources

• Small Business Health Insurance Options in Ohio
• Health Insurance for Ohio Businesses With Five or Fewer Employees
• Should Your Small Business Even Offer Group Health Insurance?
• Ohio Small Business Health Insurance FAQ

Disclaimer

Broker’s Desk is a series of observations from more than three decades of helping Ohio small businesses and their owners navigate health insurance. Some articles explain a process. Others tell the stories behind the work. All are intended to help readers understand how experienced brokers think through real-world situations, not to suggest there is one right answer for every business or individual.

Insurance and inflation are closely connected whenever an insurer makes a promise that may not have to be fulfilled for years or even decades.

I’m excited to contribute as a speaker at the inaugural Midwest Bitcoin Summit, taking place September 23–24, 2026, at the Greater Columbus Convention Center in Columbus, Ohio.

The detailed schedule and session format are still being finalized. Whether I speak individually or as part of a panel, I hope to bring an insurance perspective to a conversation that frequently centers on technology, finance, mining, energy and monetary policy.

My perspective comes from more than three decades working in insurance and employee benefits as a partner at McCarthy Stevenot Agency, Inc.

The central question I hope to explore is straightforward:

Could Bitcoin eventually play a carefully limited role in helping insurance companies meet certain long-term obligations?

That question begins not with Bitcoin, but with the basic promise made by every insurance company.

Insurance Is a Promise About the Future

Insurance companies accept premiums today in exchange for a promise to pay covered claims in the future.

Sometimes that future is tomorrow. In other cases, the obligation may not become payable for years or even decades.

Life insurance, annuities and long-term care coverage can involve long-duration obligations. Workers’ compensation and certain liability claims can develop and remain open for extended periods. Property losses may happen suddenly, but the ultimate cost of rebuilding can be affected by labor shortages, material costs and concentrated demand following a catastrophe.

These risks are different, but they share an important characteristic: the insurer must maintain the financial capacity to deliver on a promise whose ultimate cost may not yet be known.

Why Insurance and Inflation Must Be Considered Together

Insurers use actuarial analysis to estimate the frequency and severity of future claims.

But the number of claims is only one variable.

The eventual cost of fulfilling those claims can also change. Healthcare services, long-term care, construction materials, skilled labor, litigation and catastrophe recovery may each experience different inflationary pressures.

A broad measure of inflation may not accurately reflect the change in cost affecting a particular insurance obligation.

For example, an insurer covering the replacement cost of a building must consider more than the structure’s cost today. The company must also consider what comparable materials and labor may cost when a future loss occurs.

After a widespread catastrophe, that calculation becomes more difficult. Many policyholders may require repairs or reconstruction at the same time, increasing demand for contractors, materials, temporary housing and other services.

The financial obligation can therefore be affected by the event itself, the number of claims and the inflation occurring within the specific part of the economy needed to fulfill the promise.

The Assets and Liabilities Must Work Together

Insurance companies do not merely collect premiums and wait for claims. They invest assets while maintaining reserves and capital intended to support their obligations.

Bonds remain the largest asset class in the United States insurance industry. At year-end 2025, they accounted for slightly less than 60% of insurer cash and invested assets.

That reliance on fixed-income assets is understandable. Bonds can provide contractual cash flows, defined maturities and an established framework for evaluating credit quality.

Life insurers also use asset-liability management to align expected asset cash flows with anticipated liability payments. The purpose is to reduce the risk that assets and obligations respond differently to interest rates, liquidity needs or changing market conditions.

Regulators reinforce this discipline through statutory accounting, reserve requirements and risk-based capital standards. Risk-based capital requirements establish a minimum level of capital based on an insurer’s size and the inherent riskiness of its assets and operations, helping regulators identify companies that may be weakly capitalized.

The system is intentionally conservative because policyholders depend on insurers to fulfill their promises.

Where the Bitcoin Question Begins

The argument is not that insurers should abandon bonds or replace their traditional portfolios with Bitcoin.

The more focused question is whether a relatively small allocation, matched with an appropriately long time horizon, could someday complement traditional assets when supporting certain long-duration risks.

Bitcoin introduces obvious concerns.

Its price can decline sharply. It does not produce contractual cash flows. Custody must be addressed. An insurer could face a liquidity problem if it had to sell during a severe drawdown. The asset would also require appropriate accounting, regulatory and risk-based capital treatment.

Those objections are real.

But another risk also deserves attention: the possibility that the assets supporting a future obligation do not preserve enough purchasing power to meet the actual cost of the promise.

That risk may become more important when the obligation is remote, the future cost is especially sensitive to inflation or the claim involves an event with low frequency but unusually high severity.

The potential role of Bitcoin would therefore depend on several questions:

• How long is the expected liability horizon?
• How much liquidity must remain immediately available?
• How small would the allocation need to be?
• How would severe and prolonged price declines be handled?
• How would the asset be secured and reported?
• What capital charge would properly reflect its risk?
• Would the proposed allocation improve or weaken policyholder protection?

These are not questions that should be answered by enthusiasm alone.

Regulatory Treatment Would Have to Change

Current statutory accounting presents a substantial obstacle.

NAIC statutory accounting guidance classifies directly held crypto assets as nonadmitted assets. In practical terms, directly held crypto assets are excluded from admitted assets and therefore do not support an insurer’s reported statutory surplus in the same manner as admitted assets.

A responsible path would not begin by pretending Bitcoin has no risk. Nor would it require regulators to grant it the same treatment as a high-quality bond.

It could begin with tightly limited exposure, conservative capital treatment, strict custody requirements and careful matching between the asset and the duration of the obligation it is intended to support.

Policyholder protection would remain the first priority.

A Question Worth Exploring

Insurance is ultimately about making promises deliverable.

Bitcoin raises questions about scarcity, monetary inflation and the preservation of value across time. Insurance raises questions about uncertainty, future obligations and the financial resources required to meet them.

The intersection of the two is not primarily about seeking higher investment returns.

It is about asking whether a new type of asset could someday help support an old and essential objective: maintaining the capacity to fulfill a promise long after it was made.

I look forward to contributing to that discussion at the Midwest Bitcoin Summit and hearing the perspectives of others working in insurance, technology, finance, policy and Bitcoin.

Midwest Bitcoin Summit 2026

September 23–24, 2026
Greater Columbus Convention Center
Columbus, Ohio

Learn more at midwestbtc.com.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses evaluate employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping Ohio employers navigate health insurance renewals and employee benefits.

Disclaimer: This article is provided for general educational and discussion purposes. It is not investment, legal, actuarial or regulatory advice. McCarthy Stevenot Agency does not provide investment-management services. The suitability and permitted treatment of any insurer investment depend on applicable law, regulatory guidance, company circumstances and professional analysis.

When an employer hears there may be a problem with a health insurance claim, it’s natural to assume the insurance company has denied coverage.

Sometimes that’s true.

Sometimes the problem isn’t the claim at all.

Recently, a client contacted us after their healthcare provider indicated there could be a problem obtaining authorization for a scheduled surgery. The explanation centered on the group’s health plan showing an August 31 coverage end date.

That immediately raised more questions than it answered.

Questions about claim authorization can sometimes stem from coverage issues, eligibility information, renewal timing, or simple administrative confusion. The first step is figuring out which one you’re actually dealing with.

Small business health plans renew throughout the year. An upcoming renewal date, by itself, shouldn’t explain why a scheduled procedure suddenly appears to have a problem.

Rather than jumping to conclusions, we started asking a different question:

What are we missing?

At a Glance

• Not every authorization issue is a coverage issue.
• Administrative problems can create confusing signals.
• Experience helps identify where the real problem lies.
• Resolving the underlying issue often allows the claim process to move forward.

When the Pieces Don’t Fit Together

As we looked deeper, the pieces didn’t seem to fit together.

The renewal hadn’t arrived through the normal process. When renewal information finally became available, it didn’t resemble a typical renewal. Instead of clearly showing the current plan renewing into the next plan year, the documents looked more like alternate proposals. At the same time, different people were receiving different information about the group’s eligibility and renewal status.

None of those things, by themselves, meant the surgery wouldn’t be covered.

Together, though, they suggested the claim itself wasn’t the real issue. Something in the administrative process wasn’t lining up, and we needed to untangle that first.

Experience Means Knowing Where to Look

Experience isn’t just knowing the rules. It’s recognizing when the facts don’t fit the explanation.

After decades of working with small group health plans, you develop a sense for what looks normal and what doesn’t. Sometimes the most valuable thing a broker brings isn’t an immediate answer. It’s knowing where to look next.

In this case, that meant making additional calls, confirming the group’s renewal status, and working through the questions until the situation became clear.

Once the renewal information was confirmed, the concern that had been delaying the authorization process was resolved, and everything could continue through the normal channels.

From the client’s perspective, it looked like a surgery might not happen because of an insurance problem.

From our perspective, it looked like several administrative pieces weren’t lining up yet.

Those are two very different things.

What Clients Never See

Most employers never see that part of the process. They don’t see the questions being asked behind the scenes, the unusual renewal paperwork, or the phone calls needed to separate an administrative issue from an actual coverage issue.

They simply hear back that the situation has been sorted out.

In this case, resolving the administrative issue removed the obstacle preventing the authorization process from moving forward.

That’s exactly the outcome we hope for.

Because sometimes the most important work happens before a claim is ever denied.

Sometimes the problem isn’t the claim in the first place.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses evaluate employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping Ohio employers navigate health insurance renewals and employee benefits.

Protecting Client Privacy

Client names, identifying details, and certain facts have been modified or omitted to protect client confidentiality. The situations described reflect real-world experience, but no post is intended to identify a specific employer.

Looking for a deeper explanation of the renewal process? These guides provide additional context.

Related Resources

• Why Small Businesses Should Build a Health Insurance Renewal System
• Health Insurance Prescreen for Ohio Small Businesses
• You Don’t Know Your Broker Until Something Goes Wrong
• Ohio Small Business Health Insurance Guide

Disclaimer

Broker’s Desk is a series of observations from more than three decades of helping Ohio employers navigate health insurance. Some articles explain a process. Others tell the stories behind the work. All are intended to help employers understand how experienced brokers think through real-world situations—not to suggest there is one right answer for every employer.

One of our recent small business health insurance renewals really stood out.

Every client has an expected renewal timeline. As those dates approach, we’re watching for renewal information so we have time to review it before decisions are made.

Based on our renewal calendar, this one should have arrived.

It hadn’t.

That simple observation started everything that followed.

So we contacted the carrier and learned this renewal had fallen outside the normal process and required additional handling. After a little persistence, it finally arrived.

I thought we were ready to begin the review.

We weren’t.

First, We Had to Figure Out What We Were Reviewing

The renewal packet contained several proposal pages, but it never clearly identified which plan the group was actually being renewed into.

It also didn’t include the Summary of Benefits and Coverage (SBC) for that plan.

Before I could compare premiums or benefits, I first had to know exactly what I was comparing.

We contacted the carrier again, confirmed the renewal plan, and requested the SBC.

Only then could the review really begin.

Evaluating the Small Business Health Insurance Renewal

Because the employee census had changed, the first step was recalculating last year’s premium using the current enrollment. That gave us an apples-to-apples comparison.

The result was an true increase of approximately 5.2%.

From there, we compared the benefits.

Almost everything remained the same. The primary change was that emergency room services moved from 100% after the deductible to a $300 emergency room copay plus the deductible, followed by 100% coverage.

For a renewal in that range, it was a relatively modest change.

Could We Do Better?

We still looked at the alternatives.

One thing employers don’t always see is that plan options aren’t always available in small, predictable steps.

The next comparable non-HSA copay plan wasn’t just a slightly higher deductible. It jumped from a $5,000 deductible with 100% coverage after the deductible to a $6,000 deductible with 80% coverage after the deductible.

Yes, it lowered the premium.

It also represented a much bigger change in benefits.

One thing I’ve learned over the years is that you work with the hand you’re dealt. I can’t invent plan options that don’t exist. My job is to understand the options that are available and recommend the least disruptive path for the client.

In this case, staying with the current plan made the most sense.

Broker’s Desk

Looking back, what stands out isn’t the 5.2% increase.

It’s everything that had to happen before we could confidently recommend accepting it.

Had the client opened that renewal packet on their own, I think they would have had more questions than answers. The renewal plan wasn’t clearly identified, the actual increase wasn’t obvious because the employee census had changed, and the benefit documents weren’t included.

That’s why even a good renewal deserves a careful review.

Sometimes the value isn’t finding a different plan.

Sometimes it’s simply bringing clarity to a process that would otherwise leave more questions than answers.

At a Glance

• A scheduled renewal didn’t arrive when expected, prompting us to follow up with the carrier.
• The renewal packet didn’t clearly identify the renewal plan or include the Summary of Benefits and Coverage (SBC).
• We confirmed the correct renewal plan before comparing premiums and benefits.
• After adjusting for changes in the employee census, the actual increase was approximately 5.2%.
• The primary benefit change was a $300 emergency room copay plus the deductible.
• We reviewed alternative plans, but the next comparable option required a much larger change in benefits.
• The recommendation was to remain with the current plan because it represented the least disruptive path.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses evaluate employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping Ohio employers navigate health insurance renewals and employee benefits.

Protecting Client Privacy

Client names, identifying details, and certain facts have been modified or omitted to protect client confidentiality. The situations described reflect real-world experience, but no post is intended to identify a specific employer.

If you’d like to learn more about health insurance renewals and employee benefits, these guides provide additional context.

Related Resources

• Why Small Businesses Should Build a Health Insurance Renewal System
• The Renewal System You Didn’t Know You Had
• Health Insurance Prescreen for Ohio Small Businesses
• Case Study: Reducing a 22% Renewal
• Ohio Small Business Health Insurance Guide
• Broker’s Desk: Real-World Stories from Ohio Small Business Health Insurance

Disclaimer

Broker’s Desk is a series of observations from more than three decades of helping Ohio employers navigate health insurance. Some articles explain a process. Others tell the stories behind the work. All are intended to help employers understand how experienced brokers think through real-world situations—not to suggest there is one right answer for every employer.

Every health insurance broker says they provide great service.

The problem is, there’s no way to prove it in advance.

You can read Google reviews. You can ask for references. You can look at awards and credentials.

But you really don’t know.

Not until something goes wrong.

When a Health Insurance Broker Is Really Tested

One afternoon an employer called our office.

“Mike, I’ve got an employee here with me. We need to talk.”

The employee had just been diagnosed with cancer. Her doctor had recommended a treatment, but the insurance company had denied it.

She was scared.

She was frustrated.

She didn’t know what to do next.

Mike listened.

He told her we’d figure out exactly why it had been denied. If the insurance company was correct, we’d explain it. If there was an opportunity to appeal or ask for an exception, we’d pursue it.

Then he hung up the phone and went to work.

I’ve watched Mike do this for years.

He knows who to call. He knows how to explain the situation. He knows when to push, when to ask, and when not to accept the first answer.

Sometimes the decision changes.

Sometimes it doesn’t.

One thing always stays the same.

The client knows someone is standing beside them.

Years ago there was another case involving an infant who was ready to leave the hospital but needed approval for equipment to safely go home. The equipment cost very little compared to the hospital stay that continued while everyone waited for an answer.

Mike wouldn’t let it go.

He kept working the phones until someone finally looked at the situation as a whole instead of simply processing another request.

People ask us from time to time what makes our agency different.

Honestly, I don’t think it’s something you can explain with a list of services.

It’s this.

It’s what happens on the day a client calls with bad news.

I’ve often thought that’s the hardest part about talking about service.

Before someone becomes a client, it’s just a promise.

After thirty-five years, I know what happens when those difficult calls come in.

I’ve seen Mike answer them.

I’ve seen him advocate for people who needed someone in their corner.

And I’ve learned that real service isn’t measured by how smoothly things go when life is easy.

It’s measured by who stands beside you when life isn’t.

At a Glance

• You often learn the value of your insurance broker when something unexpected happens.
• Helping clients navigate difficult claim situations is part of the work behind employee benefits.
• Advocacy can include understanding denials, asking questions, and pursuing available appeal options.
• Some situations have positive outcomes, while others do not, but clients deserve clear guidance throughout the process.
• Real service is measured by how people are supported when challenges arise.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses evaluate employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping Ohio employers navigate health insurance renewals and employee benefits.

Protecting Client Privacy

Client names, identifying details, and certain facts have been modified or omitted to protect client confidentiality. The situations described reflect real-world experience, but no post is intended to identify a specific employer.

If you’d like to learn more about health insurance renewals and employee benefits, these guides provide additional context.

Related Resources

• Why Small Businesses Should Build a Health Insurance Renewal System
• Health Insurance Prescreen for Ohio Small Businesses
• Case Study: Reducing a 22% Renewal
• Ohio Small Business Health Insurance Guide
• Broker’s Desk: Real-World Stories from Ohio Small Business Health Insurance

Disclaimer

Broker’s Desk is a series of observations from more than three decades of helping Ohio employers navigate health insurance. Some articles explain a process. Others tell the stories behind the work. All are intended to help employers understand how experienced brokers think through real-world situations—not to suggest there is one right answer for every employer.

Most employers never see the first part of their health insurance renewal.

They get an email from me with the renewal attached, a summary spreadsheet, and maybe a recommendation. What they don’t see is everything that happened before I clicked Send.

Here’s the thing.

By the time you see that email, I’ve probably been thinking about your renewal for days.

Every insurance company has its own way of delivering renewals. Some send an email. Some post them to a broker portal. Some are right on time. Some are late. Some years they’re early, and the next year they’re not. After all these years, I’ve learned not to expect too much consistency.

Around the turn of every month, I’m watching for them.

What I Look for First

When they start coming in, the very first thing I look at isn’t the premium.

It’s the percentage increase.

If I see a low single-digit renewal, I almost relax. That’s probably not going to be a difficult conversation.

When I see 18%, 27%, or 43%…

I still don’t like it.

That hasn’t changed in thirty-five years.

Mike McCarthy has a saying I’ve always liked.

“We hit the ceiling before the client does.”

It’s true.

Before we ever call the employer, we’ve already had our own reaction. We’ve already been frustrated. We’ve already started asking ourselves the same questions the client is going to ask.

• Can we do better than this?
• Can we reduce the increase?
• Can we preserve the benefits employees are already comfortable using?

That’s where the real work begins.

The renewal goes into our system. I organize the files. I start building the summary spreadsheet. I begin looking through the carrier’s plan offerings for alternatives that make sense.

Not the cheapest plans.

The plans that are the least disruptive while still accomplishing something meaningful.

There’s a difference.

Eventually all of that becomes one simple email.

Your renewal.

A summary spreadsheet.

And a note that says if you’d like to review additional options, we’ll get started.

The email is only a few paragraphs long.

The work behind it has been going on long before it arrived in your inbox.

That’s the part most people never see.

At a Glance

• Much of the work behind a health insurance renewal happens before the employer receives the renewal.
• The first thing I evaluate is the percentage increase, not just the premium.
• Every renewal is reviewed for opportunities to reduce costs while minimizing disruption.
• The summary employers receive represents days of preparation and analysis.
• The goal is to make a complicated renewal easier to understand and evaluate.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses evaluate employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping Ohio employers navigate health insurance renewals and employee benefits.

Protecting Client Privacy

Client names, identifying details, and certain facts have been modified or omitted to protect client confidentiality. The situations described reflect real-world experience, but no post is intended to identify a specific employer.

If you’d like to explore the renewal process in more detail, these guides provide additional context.

Related Resources

• Why Small Businesses Should Build a Health Insurance Renewal System
• Health Insurance Prescreen for Ohio Small Businesses
• How Much Does Small Business Health Insurance Cost in Ohio?
• Ohio Small Business Health Insurance Guide

Disclaimer

Broker’s Desk is a series of observations from more than three decades of helping Ohio employers navigate health insurance. Some articles explain a process. Others tell the stories behind the work. All are intended to help employers understand how experienced brokers think through real-world situations—not to suggest there is one right answer for every employer.

One of the things people never see is the amount of noise inside a health insurance renewal.

Every carrier has its own proposal.

Every carrier has its own plans.

Every year those plans change.

Some carriers have dozens of options.

Honestly, most people have no chance.

That’s not because they aren’t smart. It’s because these proposals weren’t written for employers. These proposals weren’t written for employers. They were written by actuaries, product managers, and insurance companies trying to offer every possible variation of coverage.

Our job is to make sense of it.

Reducing Complexity in a Health Insurance Renewal

When a renewal comes in, I don’t just forward the proposal to the client.

I start pulling it apart.

I have a spreadsheet I’ve built over many years. Every time I come across a plan that’s actually relevant, I save it. Over time it’s become a library of plans that lets me compare things much more quickly.

I’m not trying to summarize everything.

I’m trying to surface the things employers actually care about.

• The deductible.
• The out-of-pocket maximum.
• Office visit copays.
• Prescription drug copays.
• Coinsurance.

The proposal may be fifty pages.

My spreadsheet fits on one page.

That’s intentional.

I’m trying to pull the signal out of the noise.

The other thing I’m thinking about is disruption.

A lot of people assume the goal is to find the cheapest plan.

It isn’t.

If employees have spent years learning how to use a particular type of plan, I don’t want to throw that away just to save a little more money.

I’m looking for the point where the savings become meaningful without unnecessarily changing how people receive care.

Sometimes we find that point with the current carrier.

Sometimes we don’t.

That’s when we begin looking outside the renewal.

But the first step is always the same.

Reduce the complexity.

Then make the decision.

That’s a much better way to compare health insurance than trying to digest fifty pages of insurance language on your own.

At a Glance

• Most health insurance renewals contain far more information than employers need to make a decision.
• My first step is reducing dozens of pages into a simple comparison.
• I focus on the plan details that affect employees most often.
• The goal isn’t simply finding the lowest premium. It’s balancing savings with unnecessary disruption.
• Simplifying the renewal makes better decisions possible.

About the Author

For more than three decades, Ted Stevenot has helped Ohio small businesses evaluate employee benefits as a partner at McCarthy Stevenot Agency, Inc.

He writes the Broker’s Desk series to document the real-world decisions, conversations, and observations that come from helping Ohio employers navigate health insurance renewals and employee benefits.

Protecting Client Privacy

Client names, identifying details, and certain facts have been modified or omitted to protect client confidentiality. The situations described reflect real-world experience, but no post is intended to identify a specific employer.

If you’d like to explore the renewal process in more detail, these guides provide additional context.

Related Resources

• Why Small Businesses Should Build a Health Insurance Renewal System
• Health Insurance Prescreen for Ohio Small Businesses
• How Much Does Small Business Health Insurance Cost in Ohio?
• Ohio Small Business Health Insurance Guide

Disclaimer

Broker’s Desk is a series of observations from more than three decades of helping Ohio employers navigate health insurance. Some articles explain a process. Others tell the stories behind the work. All are intended to help employers understand how experienced brokers think through real-world situations—not to suggest there is one right answer for every employer.