Going to market every year is not automatically in your interest.
Marketing a plan is easy to sell because it looks like work. Sometimes it is the right move. Sometimes it invites a fresh underwriting review, disrupts people mid-treatment and lands you where you started. Telling you which year is which — before the requests go out — is the part of the job you are actually paying for. In the years you do not go to market, a health and cost strategy works on the part of the rate that is yours.
The signs that say test the market.
A market test earns its disruption when the renewal is out of line with anything your own file can explain.
The Increase Outruns the Build-Up
When the renewal sits well above the number built from trend, credibility and census, the gap is the carrier’s pricing decision — and pricing decisions are what competition moves. A gap between the renewal and its build-up is the strongest reason to take a health plan to market.
Your Experience Beats the Book
A group whose claims run better than the carrier’s manual rate can be taxed for being small. That is a case to put to other carriers, with the numbers attached. Strong claims experience is a reason to market the plan.
Service Has Already Failed
Repeated billing errors, eligibility mistakes or claims that should have paid are reasons to move that no rate concession fixes. Service failures justify going to market regardless of rate, because a lower premium does not fix a broken administration. Service is part of value.
The signs that say renegotiate instead.
Not marketing is sometimes the most valuable recommendation in the file, and it is the one a broker paid on activity has least reason to make.
A Large Claim Is Still Open
A new carrier underwrites the same claims your incumbent has already absorbed. Marketing in a year with a live high-cost claimant can invite a worse number, not a better one. An open large claim can make marketing premature. Wait for the claim to resolve.
The Carrier Is Pricing You Fairly
A plan with credible experience and a renewal close to its build-up is often better renegotiated than moved. The saving from a switch has to beat the cost of the switch. Fair renewals are often better renegotiated than moved. Switching has a cost.
Disruption Has a Price
Network changes, prior authorizations restarting, new ID cards and a new service team all land on your employees. None of it appears on a rate sheet. Disruption cost belongs in every go-to-market decision. None of it appears on a rate sheet, but employees feel all of it.
A recommendation, with the reasons written down.
Whichever way it goes, you get the reasoning in writing before anything is sent to a carrier.
The Case for Going Out
What the renewal should have been, how far it missed, and which part of the miss competition can plausibly move. A written case for going to market keeps the decision clear, and it sets the target any new carrier has to beat.
The Case for Staying
What a switch would cost in disruption and underwriting risk, and what the incumbent is likely to concede without one. A written case for staying weighs disruption honestly against what the incumbent is likely to give up without a switch.
The Ancillary Lines Separately
Dental, vision, life and disability are often priced on brackets and cards rather than your experience. They can be shopped in a year the medical plan should stay put. Ancillary lines can be marketed on their own schedule, even in a year when the medical plan is renegotiated with the incumbent.
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.
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