The Fair and Reasonable Renewal Rate: the Art of Carrier Negotiations

Carrier Negotiations for a Fair & Reasonable Renewal Rate | Matthew Strain & Luciano Franco | Corporate Synergies
Annual health insurance carrier negotiations doesn’t have to be a contact sport. A fair and reasonable renewal rate is possible–if everyone is allowed to win.
As Seen in Workforce
As Seen In

During carrier negotiations, employers naturally seek the lowest rate increase, while carriers typically propose a high increase. The fair and reasonable renewal rate increase lies somewhere in between.

Understanding what fair and reasonable is and achieving that rate on an ongoing basis can help you protect and maintain your organization’s financial health over the years, while continuing to offer your employees a consistent benefits plan.

What is a fair and reasonable renewal rate?

Each employer’s rate increase is unique to the utilization, plan design, claims history, current experience and other specific factors. There is no one fair and reasonable renewal rate. Rather, it’s a rate that allows you to continue to offer the same or equivalent benefits to your employees without experiencing a bigger-than-normal increase from year to year.

There’s a problem with negotiating too low.

Faced with a steep rate increase, it’s tempting to work with your broker and underwriter to negotiate aggressively to achieve a very low increase—or no increase at all—for your next plan year. But that could backfire when you’re offered a higher-than-normal increase the following year. What looks like a positive move turns out to be temporary because your plan is underpriced, forcing the insurance carrier to make up for the shortfall.

Even worse, if the plan is underpriced, the future year’s carrier negotiations could stall, creating a situation where the best and final offer is not as low as past years. This will force you to look at other carriers for benefits, with no guarantee they will be competitive. If a move to another carrier is needed, it creates work for your HR team and could disrupt your employees’ care if the network changes drastically.

On the other hand, a long-term carrier relationship yields benefits for you and your employees. One benefit to building a good carrier relationship is a better understanding of what’s normal and what’s not when it comes to claims utilization.

Carrier negotiations for a fair and reasonable renewal rate means the stakeholders get what they need.

A carrier that can view data over a number of years and confirm how your plan usually performs is more likely to be forgiving when you have a year with high claims. And no matter how healthy and educated your employees are or how well your plan typically runs, every employer will suffer catastrophic claims from time to time.

To get to a fair and reasonable renewal rate, start early.

Start several months before the end of your plan year. Roughly six months before your plan renews, work with your employee benefits broker and their internal underwriters to develop a pre-renewal analysis. Claims data can be used to predict the upcoming plan year costs.

This analysis will give you a chance to discuss benefits plan design adjustments to meet your budget goals and ensure your program meets the needs of your employees.

It can also help you in offering a data-backed counter rate increase, which is fair and reasonable for you, aiding in carrier negotiations.

Matt Strain | Corporate Synergies
Matt Strain is responsible for the design and coordination of the client’s health and welfare benefits program. In this critical role, he identifies the employer’s goals, objectives and service requirements and then unites the appropriate Corporate Synergies resources to execute the program. He works closely with the Director of Account Management to meet all client needs and to ensure that deliverables are attained as promised. He has a continuing presence on the client’s account as a relationship manager.

Share

Related Content

Latest Content

Want More?

On Demand Webinars​

View any of our past recorded webinars. Note that the recorded webinars are not eligible for CE credits.

Current Events Calendar ​

Learn from respected experts while you earn CE credits for select continuing education events, free of charge.​

Further Learning​

Never miss another event! Receive email alerts for upcoming events and service offerings.​

LIKE WHAT YOU'RE READING?

Get Notified!

We will send important benefits-industry information directly to your inbox as it becomes available, including accredited CE events.

Nicole Crowley

Coming Soon

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.

Matt McCuen

National Executive at Imagine360

Matt McCuen is an industry veteran, with over 30 years of experience in the self-funded space.  

As the National Marketing Executive for Imagine360, Matt works with self-funded employers across the nation to improve the benefits they offer to their employees and families. 

Imagine360 is the leading provider of employer-sponsored health plan solutions that deliver deep cost savings and concierge member support. Leveraging 50+ years of expertise, Imagine360’s solutions combine the financial benefits of reference-based pricing, best-in-class member support, and health plan administration.  

Greg Santulli

CEO of Rx Valet

Greg Santulli is the CEO and Co-Founder of Rx Valet, an industry leading Pharmacy Cost Savings company. Greg has over 30 years of experience in healthcare and pharmacy. His leadership has positioned Rx Valet as the one of the leading providers of Pharmacy Cost Containment, low-cost access to medications and a successful pharmacy benefit manager. His company’s approach is to engage all parties involved to provide unprecedented results. 

Mitch Lamoriello

VP Wealth Advisor at Advus Partners

Mitchell has innovation in his bones. He understands the unique challenges and circumstances clients face in their financial lives, and is passionate about discovering new ways his family firm can help serve a changing investor and investment marketplace.

As an investment specialist, Mitchell sits on the Advus’ investment committee. He also is responsible for assisting in the firm’s qualitative and quantitative due diligence process and contributing to the research on capital markets and global economic conditions. His knowledge base in investments provides him with a strong foundation to help answer client questions and navigate issues with their portfolio. As he spends more time with clients, Mitchell understands the importance of achieving goals and has expanded his knowledge, skills and approach beyond investments to encompass holistic financial planning.

andy rhea

Andy Rhea

President of Align Risk Solutions

Andy is the President of Align Risk Solutions. Prior to the formation of Align, Andy served as General Counsel to the Captive Insurance Division for the Tennessee Department of Commerce and Insurance. He began his legal career with the Mississippi Insurance Department and in private practice. He is a licensed attorney (in both Tennessee and Mississippi) and holds the Associate in Captive Insurance designation. Andy is very active in various captive insurance associations, currently serving as the President of the Tennessee Captive Insurance Association. Andy is a graduate of Mississippi State University where he received a BBA and MBA, and he earned his law degree from the University of Mississippi. During the feasibility and formation phases of Align’s process, Andy is involved in all regulatory, business plan and application functions. Ongoing, Andy is responsible for corporate governance, regulatory matters, and client relationships. 

Andrew Zito

President/CEO – Advus Fincancial Partners

Andrew has always been fascinated by complex things. The more complicated something is, the more he wants to understand it and fix it. From applying technology to solve business problems to working with plan sponsors to untangle complicated situations, he thrives on finding efficient and effective solutions.

Andrew oversees the operations of Advus, translating the firm’s vision and objectives into actionable processes. His responsibilities encompass technology solutions, business processes, service standards and human resources. He also is directly responsible for the retirement plan division and settingits strategic direction.

Andrew specializes in the qualified retirement plan aspect of the Advus business. Throughout his career, he has worked with retirement plans in a variety of different capacities. He began his career as an intern at Advus (formerly LAMCO Advisory Services, Inc.) assisting with compliance testing. He then spent several years working on platform conversions for retirement plans before moving into his present consulting role. Within the retirement plan space, he specializes in complex plan situations including plan mergers, spinoffs, complex regulatory audits, M&A activity and error corrections.