Large claim renewal impact calculator: how much will one claim move the renewal?
Enter your premium, the large claim, the pooling level and the credibility the carrier gives your experience to estimate the renewal effect. Built for HR and finance teams preparing for a renewal.
Estimate how one large claim affects renewal.
Ask your carrier for the pooling level and the credibility. The result updates as you type.
Claims above this level are pooled and not charged to your group. Ask the carrier for the figure.
The weight the carrier gives your own claims. Ask the carrier for it.
Your estimate
A simplified model. Real renewals blend many factors, including trend, plan changes and the pricing rules of each carrier.
How does one large claim affect a renewal?
In an experience-rated renewal, the carrier looks at what your group claims cost and gives that experience a weight, called credibility. Smaller groups get less weight. Many carriers also cap each claim at a pooling level, so only part of a very large claim counts. The calculator above shows the effect of both rules.
What should an employer ask the carrier?
Ask for the claim detail behind the renewal, the pooling level, the credibility factor, the trend and any margin. Ask whether the claim is expected to continue, since a one-time event should not drive a permanent increase. Our renewal increase checker can help you test the answer.
Common questions
Why does a small group get less credibility?
Fewer people mean less reliable experience. Carriers lean on the wider book of business for small groups and on the experience of the group for larger ones.
Is a pooling level the same as stop-loss?
They work alike but are different products. Pooling is a pricing rule in an insured renewal. Stop-loss is separate coverage bought by a self-funded employer.
Can we challenge the increase?
Yes. Ask for the detail, compare other carriers and review the plan design. We can help with each step.
What if the claimant has left the plan?
Ask the carrier whether the claim will continue to be counted and whether it should be adjusted.
Talk to us about your renewal
Book a 30-minute call and we will look at your claims, the renewal and the options that fit. Visit us at 41000 Woodward Avenue, Suite 350 East, Bloomfield Hills, MI 48304, or call 248.370.8853.
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