Every year, an employer opens a small business health insurance renewal and sees a number they weren’t expecting.

Sometimes it’s manageable.

Sometimes it’s 25%.

Sometimes it’s much more.

The first reaction is often:

“We need to start getting quotes.”

Interestingly, that’s usually not my first step.

After more than 30 years helping Ohio small businesses evaluate health insurance renewals, I’ve found it’s better to understand the renewal before deciding whether it’s time to replace it.

The goal of Broker’s Desk is to explain how experienced brokers evaluate real-world situations—not to suggest there is one right answer for every employer.

Here’s what the first hour usually looks like. While every renewal is different, the process of evaluating one is surprisingly consistent.

1. Break the Health Insurance Renewal Apart

The first thing I do is pull the renewal apart and compare the benefits side by side.

I’m looking beyond the premium to understand what changed and whether those changes justify the increase.

Insert comparison table image here

Caption: An anonymized comparison showing how we evaluate renewal options before making any recommendation.

2. Look for the Least Disruptive Solution

I’m not trying to find the cheapest plan.

I’m trying to preserve as much of what employees already know and value as possible while bringing the renewal back under control.

Before considering another carrier, I’ll often evaluate whether modest adjustments to the current plan are enough to improve the renewal, such as:

A modest change in coinsurance.
A slightly higher deductible.
A different out-of-pocket maximum.
Another plan from the same carrier with similar benefits.

Sometimes a relatively small adjustment is enough to bring a renewal back into a range the employer is more comfortable accepting.

3. Ask the Bigger Question

Only after we’ve explored those possibilities do we ask:

Is it time to look beyond the current plan?

Sometimes the answer is yes.

Sometimes it isn’t.

That’s the point where we decide whether a broader market review or health insurance prescreen is worthwhile.

Every Renewal Starts a Conversation

No two employers are exactly alike.

The right answer depends on the business, the employees, and the goals of the employer.

That’s why I think of a renewal as the beginning of a conversation rather than the end of one.

Over the coming weeks, I’ll share a few anonymized renewal examples that show how this process works in practice.

At a Glance

Renewals deserve analysis before shopping.
We look for the least disruptive way to control costs.
Premium is only one part of the decision.
Structural changes can matter as much as plan changes.
Every employer’s situation is unique.

Frequently Asked Questions

Should I get quotes immediately after receiving a health insurance renewal?

Not necessarily. Before requesting quotes, it’s often helpful to understand exactly what changed and whether modest adjustments to the current plan could improve the renewal.

Does every renewal require changing insurance carriers?

No. In many cases, employers choose to remain with their current carrier after evaluating plan options that better balance premiums, benefits, and disruption.

When should a small business consider a health insurance prescreen?

A prescreen is often worthwhile when reasonable plan adjustments don’t produce an acceptable outcome or when an employer wants to evaluate broader market options before making a renewal decision.

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 share practical observations from real health insurance renewals and employee benefits decisions.

Protecting Our Client’s 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

Disclaimer

Broker’s Desk articles are educational and based on real-world situations encountered in our practice. Client names and identifying details have been changed or omitted to protect confidentiality. Because every employer’s circumstances are unique, these articles should not be considered legal, tax, or insurance advice for any specific situation.

Every health insurance renewal tells a story.

Sometimes the answer is changing carriers. Sometimes it’s exploring a level-funded plan or a MEWA. And sometimes the best solution is making a few thoughtful adjustments to an existing plan while keeping disruption to a minimum.

Here’s an anonymized example from a recent renewal. Some details have been simplified to protect the employer’s privacy, but the numbers and decision-making process reflect an actual case.

The Health Insurance Renewal Situation

The employer had maintained a legacy (pre-ACA) health insurance plan for many years. Like many employers with older plans, they valued the familiarity of the benefits and preferred to avoid unnecessary disruption if possible.

When their renewal arrived, the premium increase was 22.69%.

That immediately raised an important question:

“Is there a better way to manage this renewal?”

Looking Beyond the Initial Renewal

A premium increase doesn’t automatically mean an employer needs to change carriers.

Our first step is usually to determine whether a different plan design with the same carrier can better balance premium, benefits, and long-term costs.

In this case, we identified an alternate plan that kept many of the features employees were already accustomed to.

The individual deductible remained at $2,500, with a $5,000 family deductible.

Primary care, specialist, and urgent care office visit copays stayed essentially the same.

The largest changes were:

The plan paid 80% after the deductible instead of 100%.
The maximum out-of-pocket increased modestly.
The emergency room benefit changed to a different cost-sharing structure.

While those are meaningful changes, the overall feel of the plan remained very similar.

More importantly, the premium increase dropped from 22.69% to 9.7%.

Here’s a simplified comparison of the most meaningful changes.

Benefit	Current Renewal	Alternate Legacy Plan
Premium Increase	22.69%	9.7%
Individual Deductible	$2,500	$2,500
Family Deductible	$5,000	$5,000
Coinsurance After Deductible	100%	80%
Maximum Out-of-Pocket	$2,500 Individual $5,000 Family	$3,500 Individual $7,000 Family
Primary Care Visit	$30 Copay	$30 Copay
Specialist Visit	$60 Copay	$60 Copay
Urgent Care	$75 Copay	$75 Copay
Emergency Room	$300 Copay	$250 Copay + 20% Coinsurance

We Also Looked at the ACA Alternative

For comparison, we also reviewed what moving to an ACA-compliant version of comparable coverage would look like.

That illustration offered a slightly lower deductible but also included:

A substantially higher maximum out-of-pocket.
A less favorable emergency room benefit.
Higher prescription drug copays across multiple tiers.

One of the most surprising findings was the premium.

The ACA alternative produced an increase of approximately 141% for this particular employer.

For this employer, the comparison looked like this.

Benefit	Alternate Legacy Plan	ACA Alternative
Premium Increase	9.7%	141%
Individual Deductible	$2,500	$2,400
Family Deductible	$5,000	$4,800
Coinsurance After Deductible	80%	100%
Maximum Out-of-Pocket	$3,500 Individual $7,000 Family	$5,750 Individual $11,500 Family
Primary Care Visit	$30 Copay	$30 Copay
Specialist Visit	$60 Copay	$60 Copay
Urgent Care	$75 Copay	$75 Copay
Emergency Room	$250 Copay + 20% Coinsurance	Deductible + $450 Copay
Prescription Drugs	$10 / $25 / $40 Tier 4: 25% (Max $200)	$15 / $60 / $120 Tier 4: $400 Copay

That result doesn’t mean ACA plans are always more expensive or that they are the wrong choice for every business. Every employer’s situation is different.

It simply illustrates why we evaluate each renewal individually instead of assuming one approach will fit every group.

The Employer’s Decision

After reviewing the available options, the employer chose the alternate legacy plan.

Reducing the renewal increase from 22.69% to 9.7% while keeping the deductible the same and minimizing changes to employee benefits met their primary goal.

Because preserving their existing legacy coverage was important to them, they also decided not to complete a broader health insurance prescreen this year.

Could additional options have been available?

Possibly.

But every renewal involves balancing premium, benefits, disruption, and administrative effort. In this case, the employer felt the revised renewal struck the right balance.

What Other Employers Can Learn

One renewal doesn’t predict another, but this case illustrates several principles we see regularly.

A large renewal increase doesn’t automatically mean you need to change carriers.

Sometimes relatively modest benefit adjustments can significantly reduce a renewal increase while keeping the overall employee experience largely intact.

Sometimes the best decision is to explore the broader market through a health insurance prescreen.

And sometimes the best decision is to stay exactly where you are.

Our role isn’t to push employers toward one particular type of plan. It’s to evaluate the available options, explain the tradeoffs, and help each employer choose the approach that best fits their goals.

Case Study Note: This article is based on an actual employer renewal. Certain plan details have been simplified or omitted, and identifying information has been changed to protect client confidentiality. Every employer’s situation is different, and renewal options vary based on plan design, carrier, underwriting, and other factors.

About the Author: Ted Stevenot is a Partner at McCarthy Stevenot Agency and has helped Ohio employers evaluate employee benefits since 1991. His work focuses on helping small businesses compare traditional group health insurance, level-funded plans, MEWAs, and ICHRAs while balancing cost, employee benefits, and long-term sustainability.

The case studies in this series are based on real employer situations, with identifying details modified to protect client confidentiality.

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Author: Ted Stevenot

What Happens During the First Hour After a Health Insurance Renewal Arrives?