Renewing Small Group Health Insurance

Mike Carlson

Craford Benefit Consultants

Let’s be honest, renewing small group health insurance is dramatically different than large-group.  With small group, removed are the utilization/demographic patterns, IBNR, trends, administration expenses and much of the contribution modeling (to name a few).  So, if small group renewals are easier, then why are they time-consuming?  And what is the reason for the fire-drills?

The primary reason for health-insurances, vortex of time-gobbling, is the interplay between the broker and the consumer.  And before I alienate either group, please allow me to qualify.

Generally speaking, management of the health-plan is not the Office-Managers primary role.  And generally, the insurance broker has other clients, who renew at the same time.  These two elements, coupled with the insurance carrier’s requirement of “i’s dotted” and “t’s crossed“, often produce fire-drills.

So what happens when the office-manager is unfamiliar with the health-insurance landscape, terminology and systematic receipt/delivery of documentation?  The administration of the employer’s Medical-plan, becomes a burden.  And how does the insurance broker ease the pain?  They perform by providing a systematic gameplan.

And because this is a blog, I’d like to say, there are several areas of my life where I am, “a stranger in a strange land.”  Each time I attend my daughters softball games, with an apple, seat-cushion and sunglasses, I am reminded of my ignorance, as I see other families with their wagon of essentials (sunscreen, cooler, chairs, shade-tents, etc.).  So, to the office-managers, responsible for health-care administration, I am not judging.  You aren’t required to be experts.

At renewal, a “good” insurance-broker will assist the client by:

·         Request an ACA Census including medical and ancillary enrollment, including the Employer name, zip code, county and RAF (when applicable)    

·         Determine the “likes” and “dislikes” of the current program, total group size/FTE’s, Union, PEO involvement.

·         Establish specific plan designs and provider networks to quote.

·         Complete provider and Rx searches.

·         Present Renewal Options and obtain client decisions.

·         Request hardcopy, softcopy or online enrollment materials.

·         Conduct enrollment meetings - don't forget COBRA or Cal Cobra employees.

·         Remind employee's to get Rx filled prior to 1/1 (if applicable).

·         Schedule Training with HR contact.

·         Schedule employee-meetings if necessary.

·         Cancel prior coverage once new approval is given.


Let us help you to navigate this process. You have more pressing business issues to tackle and we are here to streamline and simplify your small group health insurance renewal. The experienced staff at Craford Benefit Consultants is waiting to hear from you and we look forward to developing a relationship with you and your team.