A health insurance renewal crossed my desk this week with a 42% increase.
When employers see a number like that, the natural reaction is to start getting quotes.
That wasn’t my first step.
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.
The first thing I did was pull the renewal apart and compare the options that were already available from the current carrier.
Before looking anywhere else, I wanted to see whether there was a reasonable way to bring the increase down without changing carriers or making major changes to the plan.
As I reviewed the renewal, I noticed something else.
This was a very small group, and one employee had stayed on the employer’s health plan after turning 65 because a younger spouse was still covered under the group plan.
Now the spouse had also reached Medicare eligibility.
Before I spent much time comparing deductibles and coinsurance, I wanted to answer a different question.
Looking Beyond the Premium
Should these two individuals remain on the group health plan at all?
If they moved to Medicare, the structure of the group would change immediately.
I wanted to answer that question before deciding whether comparing more health plans even made sense.
Only after looking at that bigger question did I go back to comparing plan options.
Comparing the Available Options
Here’s an example of the type of comparison I put together.
| Benefit | Renewal Plan | Option A | Option B |
|---|---|---|---|
| Individual Deductible | $2,500 | $3,000 | $5,000 |
| Family Deductible | $5,000 | $6,000 | $10,000 |
| Coinsurance | 100% | 80% | 100% |
| Individual Out-of-Pocket Maximum | $7,000 | $8,000 | $8,000 |
| Family Out-of-Pocket Maximum | $14,000 | $16,000 | $16,000 |
| Office Visit Primary/Specialist | $30/$60 | $30/$60 | $30/$60 |
| Prescription Drugs | Rx Level 1 | Rx Level 1 | Level 1 Rx |
| Estimated Monthly Medical Premium | $4,191.59 (+42%) | $3,642.59 (+23.4%) | $3,686.08 (+24.87%) |
An anonymized comparison showing how we evaluated renewal options before making any recommendation.
What Happens Next?
I wasn’t looking for the cheapest option.
It was about seeing whether modest adjustments to the current plan could reduce the increase while preserving as much of the existing coverage as possible.
In this case, changing the deductible and coinsurance reduced the projected increase substantially while keeping the same carrier.
That may or may not be the direction this employer ultimately chooses.
They may decide to stay with the renewal.
They may adjust the current plan.
They may decide it’s time to complete a health insurance prescreen and look more broadly.
The important part is that those decisions come after understanding the renewal, not before.
Sometimes the premium is the story.
Sometimes it isn’t.
Sometimes opening the renewal tells you something about the people covered by the plan that is even more important than the premium itself.
We’ll see where this one ultimately lands.
At a Glance
Every renewal is different. Broker’s Desk shares real situations to explain the evaluation process, not to suggest there is one right answer for every employer.
- A large renewal doesn’t automatically mean it’s time to change carriers.
- The first step is understanding the renewal before shopping.
- Changes in the makeup of a small group can be just as important as premium.
- Modest plan adjustments sometimes reduce increases while preserving coverage.
- Every renewal deserves a thoughtful review before broader market shopping begins.
Frequently Asked Questions
Can Medicare eligibility affect a small business health insurance renewal?
Yes. When employees or covered spouses become eligible for Medicare, it can change the structure of a small employer’s health plan and create options that didn’t previously exist.
Should every large renewal lead to shopping the market?
Not necessarily. Sometimes the better first step is understanding the renewal and evaluating whether reasonable plan adjustments or structural changes make sense before requesting quotes.
Can staying with the same insurance carrier reduce a renewal increase?
Sometimes. Different plan options from the same carrier may reduce the increase while preserving much of the coverage employees already know.
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 Clients’ 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
- How Much Does Small Business Health Insurance Cost in Ohio?
- Ohio Small Business Health Insurance Guide
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.