In the smallest groups the medical rate is set before you ever see it.
With only a few dozen enrolled contracts, your medical rate is filed and approved before your year begins. Nobody negotiates it, so the work is elsewhere.
The rate is a filed number, not an offer.
Knowing that changes where effort belongs.
A Filed and Approved Rate
The rate for your book comes from a filing made before your renewal date. There is no one to call about it and nothing to discuss.
Why This Matters to You
A broker who says they negotiated a filed rate is describing something that did not happen. We will not tell you that, and you should ask anyone who does.
What Sets Your Number
Age and area mix, the plan you choose and the rating factors the carrier is allowed to use. At this size your own claims are not what the rate is built from.
Three things you can still move.
None of them is the filed rate. All of them change what you pay.
Which Book You Are In
Different carriers and plan families price the same group differently. The comparison across books is where the real difference sits.
The Ancillary Cards
Dental, vision, life and disability are shopped rather than negotiated, and the saving there is real.
Participation
Contribution strategy and enrollment shape who is in the pool and what you pay for it. A group with low participation can look different to a carrier than its headcount suggests.
A plain read of a number you cannot negotiate.
The value is in the interpretation.
Whether the Increase Is Market-Wide
A filed increase is the carrier’s statement about its whole book. We show how it compares, so you know whether you are an outlier or one of many.
Whether a Move Is Worth It
Moving books has costs, including new networks and cards. We give you the difference and the disruption together.
What to Look at Next Year
At each renewal the question is the same: is this still the right book? We put the answer in writing.
Questions that come up.
Short answers to the questions we hear most. Each links to the full page.
Can a broker negotiate the medical rate for a very small group?
No. In the smallest groups the medical rate is a filed and approved number set before renewal, so there is nothing to negotiate on the rate itself. We will not claim otherwise, and the work shifts to the parts that can still move.
What can still be changed if the medical rate is already filed?
Three things can still move: which carrier book and plan family you are in, the ancillary cards for dental, vision, life, and disability, and participation through contribution strategy and enrollment. None of these is the filed rate, but all affect what you pay.
What do you tell a small group about an increase it cannot negotiate?
We show whether the increase is market-wide or an outlier, present the price difference of switching books alongside the disruption, such as new networks and cards, and put in writing what to look at next year.
Ready? Send us your renewal, or talk it through with someone first. No cost, no obligation.
General information, not legal or tax advice. Plan-specific questions belong with the plan documents, the carrier and counsel.
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.
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