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For benefits consultants, this renewal season is leaving no room for autopilot mode. Benefit renewal costs are rising while employers are asking harder questions about affordability, vendor performance, and what their advisor will do differently this year.
The latest research shows that employers expect healthcare costs to rise 11.1% in 2027, potentially the steepest increase in more than two decades.¹ This number makes a strong renewal negotiation necessary. It also shows why negotiation alone isn’t enough.
The advisors who create the most value will connect three jobs that are too often handled separately: understanding what drove claims costs, changing the plan or vendor strategy where data supports it, and helping employees act on that strategy every day.
Ultimately, employers need solutions that change how they use healthcare and turn them into smarter consumers. Here are a few strategic ways you can approach benefit costs this season.
Before debating deductibles or contribution tiers, build a clear account of what happened in the plan and which drivers are likely to continue.
For self-funded clients, analyze at least 12 months of mature claims data and use a longer lookback when it improves context. Keep high-cost claimants separate from recurring population trends so one unusual year doesn’t distort the entire strategy.
Take a look at:
Don’t hand your client a stack of charts. Take three to four ideas from your analysis that you can test. A useful hypothesis names the driver, the affected population or service category, the likely cause, the proposed change, and the metric that’ll show whether the change worked.
For example: Outpatient imaging spend increased because members used higher-priced hospitals for services available elsewhere. The next step would be to validate price and quality differences, estimate the addressable volume, and determine whether network design, communications, or navigation support could redirect employees to more affordable options.
This is where AI-powered claims analytics can help both advisors and employers move from static reports to focused questions. Healthee’s claims analytics can surface cost drivers, utilization patterns, plan performance, and modeled opportunities.
As an advisor, you still own the recommendations and strategy. We make the data easier to handle and give you some insights to get started.
Some renewal plans struggle because they treat cost increases like utilization issues. Higher usage does matter, but unit price, provider contracting, site of care, and pharmacy economics can be just as important. Different causes require different adjustments.
Price is the main issue when employees are not necessarily using more care, but the plan is paying more for each service. Compare allowed amounts (aka negotiated rates and eligible expenses) for common services across providers and care settings, while also considering quality and access.
Focus on what the plan and employee actually pay, not the advertised network discount. These findings can support more focused contract negotiations, network changes, site-of-care programs, or employee cost-comparison tools.
Look for repeated patterns you can address without creating barriers to necessary care. The response might include better primary-care access, clearer virtual-care options, targeted support for a chronic condition, improved pharmacy management, or more effective promotion of an existing program.
Keep the distinction clear for the client: price strategy changes what the plan pays for an appropriate service, while utilization strategy changes which services are used, where they’re used, or how early members receive support.
Raising deductibles and contributions can lower your client’s immediate expense, but it can also transfer the problem to their workforce. That may be necessary in some cases, but it shouldn’t be the default before you evaluate more targeted options.
For each option, show the estimated impact to employers and employees, implementation effort, timing, confidence level, and measurement plan.
Depending on the client’s funding and claims profile, the list may include:
The right renewal strategy should consider the employer’s budget and the employee’s ability to use the benefit. If a lower-premium plan creates financial friction that delays appropriate care, the short-term savings may come with longer-term consequences.
Model payroll contributions, expected total annual costs, deductible exposure, account funding, and common care scenarios together.
Give leaders a range instead of an exact savings amount. Claims are volatile, contract terms change, and employee behavior can’t be forecast perfectly. Label assumptions, distinguish guaranteed savings from modeled opportunity, and get actuarial, legal, or clinical review where the recommendation requires it.
A plan can be well designed on paper and still underperform because the employee experience still feels confusing or overwhelming. As an advisor, part of the renewal work is explaining how this new strategy will reach employees at enrollment and when they’re looking for care.
A side-by-side list of premiums and deductibles isn’t enough for many households. Decision support should help employees consider premiums, expected use, out-of-pocket exposure, provider preferences, prescriptions, and family needs together.
Healthee’s decision support tool gives employees personalized plan recommendations and estimated total-cost comparisons based on their employer’s specific benefits package.
By giving employees a simple way to understand their health plans and feel confident about their choices during open enrollment, you’re setting them up to make smarter decisions all year long.
Open enrollment comes and goes quickly, but employees make cost-sensitive decisions every time they search for a provider, schedule an MRI, fill a prescription, or choose where to get nonemergency care.
The challenge is knowing which option makes sense in the moment. Employees need an easy way to compare in-network providers, understand expected costs, check coverage, and identify lower-cost care settings without sacrificing quality or delaying necessary care.
Give employees ongoing access to plan-specific guidance instead of expecting them to remember everything they heard during open enrollment. Tools such as Zoe can provide that extra layer of support by answering benefits questions and helping employees understand their options throughout the year.
Claims analytics should help shape your client’s engagement calendar. If the analysis shows avoidable out-of-network use, low virtual-care use, confusion about a high-value program, or consistent use of expensive services, create a campaign to address that issue in plain language.
The goal is to remove friction, explain available choices, and connect people with support. You can help employers translate each priority into a simple campaign brief:
Audience: Who needs the information, based on our aggregated insights?
Decision: What choice or action should become easier?
Message: What does the employee need to know now?
Support: Where can the employee ask questions and get a personalized answer?
Measure: Which engagement and claims indicators will show progress?
A client shouldn’t have to wait until the next renewal to learn whether this year’s changes worked. Establish a quarterly rhythm where you connect engagement, utilization, and financial results.
Track data that show whether employees can use and understand their benefits well, such as decision-support activity, provider searches, cost-comparison activity, Zoe engagement, and program activation. These results don’t prove savings, but they can show whether the intended experience is making an impact.
Review the claims and plan outcomes that matter to the original hypothesis: per-member cost, service-category trend, site-of-care mix, network use, pharmacy trends, avoidable costs, program performance, and plan enrollment. Adjust for seasonality, completion factors, population change, and major outliers before drawing conclusions.
Quarterly reviews also strengthen the next renewal. Instead of rebuilding the story from scratch, you and your clients can enter the season with documented decisions, observed results, unresolved questions, and more targeted priorities.
120 to 90 days before renewal: Secure complete data, reconcile enrollment and claims periods, identify material contract limitations, and establish the baseline.
90 to 60 days before renewal: Develop the claims story, test cost hypotheses, evaluate vendors and network options, and model targeted scenarios.
60 to 30 days before renewal: Present tradeoffs, confirm the final plan strategy, define employee impacts, and build the communication and decision-support plan.
During open enrollment: Give employees personalized plan comparisons, simple explanations, and a clear place to ask specific benefits questions.
After enrollment: Review plan migration and employee questions, launch the year-round engagement calendar, and confirm quarterly check-ins.
Each quarter: Compare results with the original hypotheses, refine campaigns, document decisions, and update the strategy.
Benefits consultants don’t need another disconnected dashboard.
Healthee helps you differentiate your offering by combining claims intelligence, personalized decision support, and year-round benefits navigation in one client experience. You can bring employers clearer cost insights while giving employees practical, plan-specific support that extends beyond renewal and open enrollment.
If you want to learn more about how we could work together to support your clients, reach out to our team!
1. The Wall Street Journal. “U.S. Workers Are Paying More for Healthcare, and Next Year Will Be Worse.” 2026. https://www.wsj.com/health/healthcare/u-s-workers-are-paying-more-for-healthcare-and-next-year-will-be-worse-0924d0dd
