Three things driving the increase
Carrier loss ratios are running hot for the third year in a row, GLP-1 utilization has changed the specialty-drug math, and behavioral health utilization is up sharply post-pandemic. Each of those alone would push renewals up; together they have produced the double-digit increases that are now the norm rather than the exception.
What you actually control
You do not control carrier loss ratios. You do not control GLP-1 list prices. You do control three things: plan design, the volume of routine care that runs through your plan, and the experience score your carrier will use to price your renewal.
Lever 1: Plan-design adjustments
Deductible increases, copay re-rating, and tier reshuffling are the standard broker plays. They lower the premium by shifting cost to employees. This works mathematically but predictably hits employee satisfaction and retention. Use sparingly.
Lever 2: Move routine claim volume off the plan
Routine primary care, urgent care, and prescription claims are the single largest claim-count drivers on most group plans. A supplemental preventative care plan (specifically a SIMERP-structured one) absorbs that volume separately, which directly reduces the claim-experience score your renewal is built on.
Lever 3: Tax savings that fund the curve
The same SIMERP that absorbs claim volume also generates employer FICA savings of roughly $53 per employee per month. Those savings can be used to offset the portion of the renewal increase you can't avoid - turning a 18% increase into something closer to 10% net, with better employee benefits on top.
- Pull this year's renewal letter and identify which line items are experience-rated vs trend-rated.
- Ask your broker for a claim-mix summary by service category - primary care vs urgent care vs specialty.
- Estimate the volume of claims that could move to a SIMERP-side network and what that does to next year's experience score.
The honest framing
There is no magic answer to a hot renewal market. The combination that has worked best for the employers we see is a small plan-design adjustment plus a SIMERP layer plus a clear conversation with employees about what's changing. The math is durable. The framing matters.