1. Cost: Are You Receiving Good Value?

Understand What Is Driving Pricing Adjustments

Rate increases are not uncommon. Inflation, claims utilization trends, changing demographics and carrier assumptions can all affect health and dental pricing. As we’ve written about, there are many reasons that benefit plan pricing increases. The proposed adjustment should still be reviewed in context. Your advisor should make the renewal understandable, clearly explain what is driving the adjustment and address any pricing concerns with the carrier. Employers should be able to answer:

• What is driving the proposed adjustment?
• Do the claims experience and assumptions support it?
• Have trend, pooling, expenses and advisor compensation been clearly explained and are they reasonable?

The cost lens asks: Do we understand the renewal adjustment, and does it reasonably reflect the plan’s experience and pricing factors?

2. Support: Are You Getting the Service You Need?

Look Beyond the Renewal Meeting

Your advisor should be a key partner throughout the year, not simply the person who delivers the annual renewal report. They should be the go-to resource for your internal team, providing knowledgeable advice, clear direction and ongoing oversight. That means helping you understand your options, anticipate the implications of decisions and take the right action as questions, changes or issues arise. By the time you reach the renewal meeting, you should already understand any major developments affecting the plan. The meeting should move the conversation forward, not be spent catching up on the past year or presenting a series of surprises.

• Provide informed advice and oversight when you are considering a plan change, responding to new employee needs or weighing cost against coverage.
• Support day-to-day administration and answer questions across areas such as enrolments, terminations, eligibility, billing and plan changes.
• Help employees understand and use the plan through clear communication, education and help navigating coverage questions.
• Step in when an issue becomes complex or time-sensitive, such as a late applicant, a dependent eligibility question, a difficult claim or a disability situation.

At Immix Group, our team provides ongoing support, informed advice and oversight. We coordinate directly with carriers and providers, both proactively and when an issue needs additional attention. This gives employers a knowledgeable team that understands the plan, provides clear direction and helps move issues forward. If important concerns, unresolved questions or recommendations appear for the first time at renewal, that may point to gaps in the support provided throughout the year. The Support lens asks: Does your renewal build on an ongoing conversation, or does it feel like your advisor is catching up?

3. Plan Design: Would You Build the Same Plan Today?

Businesses and workforces change over time. The plan may have been designed when the organization was smaller, employee demographics were different or fewer options were available in the benefits marketplace. Even when the plan is renewed every year, outdated limits, older cost-control mechanisms or other restrictions may remain in place without being reconsidered. The underlying design should receive the same scrutiny as the rates.

Plan design should be tested against current needs, not carried forward by default. Consider:

• Does the coverage, including benefit limits, reflect current employee needs and how the plan is being used?
• Are older cost-control mechanisms still necessary and effective, or are they creating avoidable gaps or friction?
• Do the funding structure and level of flexibility still fit the organization?

Listen Before You Redesign

Employee feedback should inform plan design, not become a tick-box exercise. Ask focused questions, give employees enough context to weigh priorities and trade-offs, protect confidentiality and be clear about how the findings may influence decisions. A credible feedback process should:

• Listen broadly. Combine survey results with employee questions, comments and plan-use patterns.
• Be prepared to respond. Explain what was heard, what will change and what will remain the same.

Employee preferences are one input, alongside claims data, cost, contractual requirements and business objectives. Used properly, feedback can identify where a focused change would have the greatest value.

Define What Matters Most

The right design begins with clarity about what matters most. HR and organizational leaders should identify what the plan is meant to achieve, which values it should reflect and which priorities or protections are non-negotiable. For one employer, that may mean supporting recruitment and retention; for another, offering flexibility across a varied workforce or maintaining straightforward administration, dependable protection and cost predictability. Employee feedback should help test and refine these priorities, but the organization’s objectives and values provide the framework for weighing trade-offs and choosing among competing options. The goal is not to adopt every new feature or respond to every preference. It is to make deliberate choices that keep the plan relevant, understandable and sustainable.

The Plan Design lens asks: Would we build the same coverage, structure and level of flexibility for today’s workforce, based on what the organization values and needs to accomplish? A good advisor helps HR and leadership define those priorities, then brings together employee feedback, plan data and business objectives so choices are consistent, trade-offs are clear and any change is purposeful.