If your 2027 health insurance renewal comes with a large increase, start by confirming what changed, what the new plan actually costs, and which alternatives your business can realistically support. A useful renewal review should connect the price to a written explanation, a comparable set of options, and an implementation plan.
For Ohio business owners, finance leaders, and human resources teams, the bigger problem is often the compressed decision window. A higher premium creates a budget problem. Learning about it when employee communications are nearly due creates an operating problem, too.
I do not expect a broker to predict every claim or the exact renewal rate. I do expect the renewal conversation to begin before the proposal arrives, with clear assumptions and an honest account of what remains unknown.
What the 2027 renewal survey actually says
In eHealth's September 2026 survey of owners and managers at businesses with 500 or fewer employees, 54% of respondents offering group health coverage reported double-digit premium increases for 2027. Among group-coverage respondents facing any increase, 80% were surprised by its size. These are survey findings, not an Ohio rate forecast. Source: eHealth's 2026 employer survey.
The planning lesson is straightforward: an employer should have a way to make decisions under uncertainty. That means assigning someone to collect the information, identifying the choices worth evaluating, and agreeing on a decision date.
First, understand how your current plan is priced
Your renewal is not necessarily a report card on your employees' claims.
For non-grandfathered, Affordable Care Act compliant small-group coverage, insurers cannot use a particular group's health status or claims history to set its premium. Federal rating rules permit specified factors, including age, geography, family size, and tobacco use, with applicable restrictions. Large-group coverage generally follows different rating rules. Source: Centers for Medicare & Medicaid Services.
Ask your broker to identify your plan's market and funding arrangement before explaining the increase. “Your claims went up” is not an adequate explanation without showing whether and how those claims affect your contract.
Employee headcount and covered lives are also different figures. Covered lives include enrolled dependents. Keep both numbers visible in your renewal materials so the discussion starts from the right population.
Start your 2027 health insurance renewal with five facts
1. Establish a reliable current-cost baseline
Gather the current plan summaries, rates, most recent invoice, enrollment by coverage tier, and employer contribution schedule. Reconcile them before comparing proposals.
Separate the cost of covering each employee from the effect of adding or losing employees. Otherwise, a change in enrollment can look like a pricing change, or hide one.
Put the employer's annual cost and employees' payroll deductions on the same page. A lower employer contribution can make the company budget look better while leaving the plan's underlying cost unchanged.
2. Get the renewal explanation in writing
Request the proposed rates, effective date, benefit changes, and the carrier's explanation of the increase. Ask which parts of that explanation can be supported by available information.
Record unanswered questions with an owner and a follow-up date. “We are waiting on the carrier” needs a next step, especially when leadership must approve a budget.
3. Request the information your arrangement makes available
Ask what medical and prescription spending reports can be provided, what period they cover, and whether the reporting is complete. Where appropriate, have the authorized benefits team assess large-claim patterns and recurring costs using privacy-protective information.
If group-specific reporting is unavailable, document that limitation. Build scenarios around the information you do have instead of presenting a precise claims forecast that the evidence cannot support.
4. Test the employee experience
Compare more than deductibles. Check important hospitals and doctors, prescription coverage, referral requirements, and the process for ongoing treatment.
A formulary is the plan's covered-drug list. Check it alongside any approval requirements and employee cost sharing. A familiar carrier name does not establish that the proposed plan offers the same experience.
For a Columbus-area business with employees elsewhere in Ohio, review access where people live and receive care. The headquarters ZIP code is not the whole employee population.
5. Set decision criteria before reviewing the quotes
Agree on the employer budget, acceptable employee disruption, cash available for unexpected costs, and internal administrative capacity.
Then identify what would make an option unsuitable. This keeps a low opening price from becoming the default recommendation before anyone has read the terms.
Compare fully insured, level-funded, and self-funded costs
In a fully insured plan, the employer purchases coverage from an insurer that assumes the covered claims risk. In a self-funded plan, the employer takes responsibility for funding covered claims, typically with an outside company helping administer the plan. Source: National Association of Insurance Commissioners.
Level funding is a form of self-funding. It packages expected claims funding, administration, and stop-loss insurance into a set payment. Stop-loss insurance helps protect the employer or plan against eligible claims above specified thresholds; its terms matter. Source: Milliman, July 2026.
For each realistic option, have your advisor prepare this comparison:
| Decision item | What leadership needs to see |
|---|---|
| Annual employer cost | A comparable estimate using the same enrollment and contribution assumptions |
| Employee impact | Payroll deductions, cost sharing, provider access, and prescription differences |
| Financial exposure | Expected spending, contractual obligations, exclusions, and cash timing |
| Contract exit | Notice requirements, remaining claim obligations, and any conditions on a surplus return |
| Ongoing work | Who handles reporting, employee questions, administration, and required plan responsibilities |
A self-funded projection should include claims and the other costs of operating and protecting the plan. Treat a possible surplus as conditional. Have the advisor reconcile quoted limits with the actual contracts, including obligations outside those limits.
Changing the funding label is not a savings strategy by itself. The question is whether the complete arrangement fits your business and your employees.
Build a renewal calendar that leaves room to decide
I recommend a planning meeting roughly four months before renewal when feasible. This is a working target, not a legal deadline.
Use that meeting to confirm the renewal date, decision makers, information requests, and employee communication schedule. Establish a provisional budget range and label it as an estimate.
As proposals arrive, compare them using the same assumptions. Give finance enough time to evaluate cash requirements and give the human resources team enough time to verify the employee changes.
If you are already close to renewal, start with the decisions still available. Assign dates for missing information, final approval, enrollment setup, and employee notices. Confirm contractual and legal requirements with the people responsible for them.
Keep a short decision record: what you chose, why you chose it, and which assumptions need to be revisited during the year.
Frequently asked questions
Can a broker predict our exact renewal increase?
No. Ask for a planning range, the information behind it, and scheduled updates. A useful forecast makes uncertainty visible and gives leadership time to consider responses.
Does a double-digit renewal mean we should change carriers?
It is a reason to review the options. Before moving, compare total cost, employee access, coverage terms, and implementation demands. Staying can be a reasonable decision when the alternatives offer a poor tradeoff.
Is level-funded health insurance less expensive?
It can be for some groups, but a proposal needs a complete financial and contract review. Compare the estimated cost with the obligations your business would accept. The lowest illustrated figure should not decide the outcome on its own.
What should we bring to a renewal review?
Start with your renewal date, current plan summaries, rates, enrollment, and employer contribution schedule. Add the renewal proposal and available reporting. List the budget and employee concerns leadership wants the review to address.
Make the next decision with a clearer picture
R2I's employee benefits practice for Ohio employers combines local advisor access with technology that helps organize costs, assumptions, and funding comparisons. My standard for a useful renewal review is simple: leadership should be able to explain the decision and the tradeoffs behind it.
If your 2027 renewal is approaching, request a transparent review. Bring the plan you have, the proposal you received, and the questions you still need answered.