A disciplined approach to your health benefits renewal
A benefits renewal is a decision, not a date on an invoice. For a company with 2 to 50 employees, the useful work happens 90 to 120 days before the plan year ends: while there is still time to compare a fully insured renewal with a level-funded plan, SHOP coverage, an ICHRA, or a QSEHRA, and while there is still time to issue employee notices if you change structures.
If you wait until the renewal letter arrives with a short deadline, you are choosing among whatever can still be issued in a hurry. That is a process problem, not a reason to accept the first number you see.
We will not use a typical rate-increase percentage on this page. Renewal results vary by census, plan, and year, and a made-up average would not help you.
A working timeline
120 to 90 days before the plan-year end
Confirm the census, the states where people work, the current contribution, and whether headcount is approaching the applicable large employer line. See Do employers under 50 have to offer health insurance?. If a QSEHRA is in place and you may cross that line, the transition has to be planned here, not after the year turns.
90 to 60 days
Compare the structures that fit. If you will stay on a group plan, review the renewal and any alternative quotes, including stop-loss terms on a level-funded arrangement. If you will move to or from an HRA, draft the employee notices — ICHRA and QSEHRA notices are generally due at least 90 days before the new plan year for current employees, so this window is already tight if you have not started.
60 to 30 days
Lock the design, the contribution, and Section 125 elections. Prepare enrollment materials. If SHOP participation is a concern, remember that the November 15-December 15 window is when the minimum participation rate does not have to be met, which can matter for a January 1 effective date.
30 days through the effective date
Enroll employees, confirm substantiation for an HRA, and make sure payroll deductions match the elections.
This is a working calendar, not a statutory timetable, except where a specific notice or SHOP rule is cited. Your insurer, HRA administrator, or state SHOP may need earlier lead time.
What we review every year
- Whether the current structure is still the right one, not only whether the renewal is acceptable
- Contribution strategy, including affordability if you use an ICHRA
- Ancillary lines — dental, vision, life, and disability — so they renew on the same decision cycle
- Multi-state changes: new work locations, remote hires, or a state where a product can no longer be issued
- Compliance items that come with the design you keep or the design you adopt, including cafeteria-plan elections and, if federal COBRA could apply, a check of employer-size rules
Federal COBRA continuation generally applies to group health plans of employers with 20 or more employees, measured under the Department of Labor's rules. Companies under that line may still have state continuation rules. We will identify which regime appears to apply; counsel should confirm it.
How we help
Send us the current plan, the census, and the renewal date. We will put a recommendation on the calendar with enough time to change course if the renewal is not the right answer. If you would rather run a formal benefits RFP, we will use that process instead.
Frequently asked questions
Our renewal arrived 30 days before the effective date. Is it too late to change?
It may be too late for some alternatives, and it may not be too late for others. We will tell you what can still be done on the time you have, including whether a later effective date is the cleaner move.
If we change from a group plan to an ICHRA, when do employees have to be notified?
Current employees should receive the ICHRA notice at least 90 days before the plan year starts. That is why a late renewal is a poor time to change structures. Newly eligible employees have a shorter timeline, described on the ICHRA page.
Does accepting a renewal lock us in for reasons other than the contract term?
The contract and any stop-loss or rate-guarantee terms control. We will read those before you sign. There is no separate federal rule we would cite as a general "lock-in" beyond the documents.