A second opinion on your health insurance renewal.
Your renewal arrived with a number and a recommendation. Before you sign, have someone with no stake in the answer check the math, the market and the plan. We review renewals for Michigan employers at no cost and put what we find in writing.
Six things a second opinion looks at before anything else.
Most of what goes wrong in a renewal is visible in the documents you already have. We start there, not with a sales pitch.
The Arithmetic
Rates times enrolled counts, tier by tier, should equal the premium the carrier states. When they do not tie, a rate was mistyped or a count is wrong, and it gets fixed before anyone negotiates anything.
Whether the Increase Fits Your Size
Under 50 employees, small-group rates are community-rated and filed with the state, so the question is whether another plan or carrier filed lower, not whether the rate can be talked down. Above 50, your own claims start to count. Our page on double-digit renewals explains how to take the number apart.
What the Market Was Actually Asked
Which carriers were approached, on what census, and which declined or never quoted. “We shopped it” is not an answer; a list of carriers and their responses is.
Plan Design and Contributions
Whether the same money buys a better-fitting plan, and whether the employee share still passes the ACA affordability test. The affordability calculator does that check in a minute.
What Is Missing
Claims experience, a large-claimant report, the carrier’s rate exhibit, and the written disclosure of what your broker is paid. Our page on how benefits brokers are paid covers that last one.
How Much Time Is Left
How many days remain before the decision is due, and what can still change in that window. Some levers need weeks; others, like correcting a rate error, need a phone call.
Four steps, and nothing changes unless you decide it should.
A second opinion is a read, not a switch. Your plan, your carrier and your broker stay exactly where they are while we look.
Send What You Already Have
The renewal letter, your current plan summary, the contribution split by tier and enrolled counts by tier. At 50 or more employees, add the census and claims experience.
We Read It
About seven days for groups of 2–50, fourteen for 51–250 and up to twenty-one above that, assuming a complete file.
You Get It in Writing
What the renewal actually says, what we would question, and what we would do next, in plain language you can take to your leadership.
You Decide
Keep the renewal as offered, go back to your broker with our questions, or work with us. Any of the three is a good outcome if it is an informed one.
A second opinion earns its keep in these situations.
Any renewal can be reviewed, but these are the ones where a fresh read most often changes the outcome. If you are weighing a renewal line by line yourself, start with the first two.
A Double-Digit Increase
Especially when the only explanation offered is “trend” or “your claims were high.” If pharmacy is the driver, our GLP-1 coverage guide shows where that spend comes from.
A Recommendation to Accept as Offered
Sometimes that is the right call. It should come with the evidence that the market was tested.
Plan Changes You Did Not Ask For
Carriers retire plans and map groups to new ones. The replacement can carry a higher deductible or a narrower network at the same price.
You Crossed 50 Employees
Pricing, reporting and the ACA employer mandate all change at once. Our crossing fifty guide covers what moves.
The First Renewal After a Large Claim
How the carrier weighs one bad year depends on your size and credibility, and it is worth checking the math.
No Market Check in Three Years
Rates, carriers and networks move. A plan that was right three years ago may not be the best fit now.
What employers ask before they send it.
These sit alongside the questions on our send us your renewal page, which covers cost, confidentiality and broker of record letters.
Will our current broker find out?
Not from us. We do not contact your broker. If we need information from the carrier, you sign a one-page authorization that lets the carrier release your group’s own data to us. It does not change who represents you.
Our rates are filed with the state. Can a second opinion still lower them?
The filed rate for a given small-group plan is the filed rate. What changes the cost is the choice of plan, carrier, network and contribution split, and whether the renewal was calculated correctly in the first place. Our Michigan benefits compliance page explains what the state regulates.
The renewal quietly changed our plan. How would we know?
Compare the renewal plan’s deductible, out-of-pocket maximum, copays, network and pharmacy tier structure against your current summary of benefits and coverage, line by line. We do that comparison as part of every review.
Our broker says the market was tested. How do we check?
Ask for the list of carriers approached, the census they were sent, and each carrier’s written quote or declination. A real market check leaves a paper trail. For more like this, see the questions to ask a benefits broker.
Is it worth a second opinion if the increase is small?
Often, yes. A low increase can come from a plan downgrade, a benefit change or a network swap. The price is only half of what renewed.
We are level-funded or self-funded. Does this still apply?
Yes, and there is more to check: the stop-loss deductible and any lasers on individual members, the aggregate corridor, the fixed administration costs and how any surplus is returned.
Can you review dental, vision, life and disability too?
Yes. Those lines are usually priced from rate cards by group size, so shopping them is often quicker and the savings easier to confirm than on medical.
What if the renewal is fine?
Then you hear that in writing, with the reasons, and you keep it. Knowing your renewal is sound is a useful answer, and one you can show your leadership.
Do we have to change carriers to save money?
No. Many of the savings we find stay with the same carrier: a better-fitting plan, a different contribution split, a corrected rate or census, or a network that matches where your employees live. Our health and cost strategy work builds on the same levers.
Who at CFH actually does the review?
A plan analyst works the numbers and an account executive walks you through what they found. For proper coverage of an account we work in teams of five, so the people who review it are the people who would run it.
Ready? Send us your renewal, or talk it through with someone first. No cost, no obligation.
General information about renewal reviews, not legal advice. Plan-specific questions belong with ERISA counsel, and we will bring them in.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
Switch to CFH. Unhappy with your broker? Your employees won’t notice. You will. →
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