A January 1 renewal is easier to manage when the decisions happen in a clear order. For an employer with 25–100 employees, that means gathering reliable information, comparing realistic options, setting employee contributions and leaving enough time for enrollment.
This guide was originally published in July and updated in September 2026. If your planning is just beginning, focus on the work still ahead. Confirm your actual carrier, administrator and payroll deadlines before adopting any target date below.
September: build one reliable starting point
Begin with a current census, existing rate sheets, plan summaries, contribution schedule and renewal history. Reconcile employee counts and coverage tiers before requesting quotes. A quote based on an old census can create confusion when the final rates arrive.
Ask your current carrier or administrator what claims and utilization information is available, what period it covers and when it can be delivered. Your reporting options and rating method depend on the market, product, group and funding arrangement. Headcount alone does not explain how your renewal will be calculated.
- Name one person who owns the renewal calendar.
- Identify the leadership decision-maker and the maximum contribution change you want to evaluate.
- Record employees’ recurring concerns about providers, prescriptions, claims and payroll deductions.
- Agree on which alternatives deserve quotes and what information underwriters need.
The goal is a shared brief that your broker, finance team and HR team can use. It should explain what you want to improve and what disruption you are willing to consider.
October: compare complete options
When the renewal arrives, ask for a written explanation of the factors behind it and compare it with alternatives using the same census and effective date. Review employer cost, employee deductions, deductibles, networks, prescriptions and implementation requirements together.
If level funding or another self-funded arrangement is under consideration, request a comparison of expected cost and contractual maximum exposure. Include administration, stop-loss premiums, claims funding, potential settlement obligations and the terms governing any surplus. A lower monthly quote is only one part of that comparison.
The NAIC’s discussion of self-funding and stop-loss explains why attachment points, underwriting and contract terms matter. Ask the adviser presenting the option to identify the risks the employer would retain.
November: decide and test contributions
Choose a decision target that leaves time for employee communication, enrollment and carrier processing. Mid-November may be a useful planning target, but it is not a universal carrier deadline.
Build a contribution worksheet for each coverage tier and payroll frequency. Show leadership both the employer’s annual commitment and the employee’s per-paycheck cost. Check that payroll rounding and deduction schedules match the enrollment materials.
For plan years beginning in 2027, the IRS has set the required contribution percentage used in the ACA affordability rules at 10.22%. Where the employer shared responsibility rules apply, confirm the appropriate test and safe harbor. The IRS describes Form W-2, rate-of-pay and federal-poverty-line safe harbors; a household-income calculation should not simply be substituted for the employer’s selected method.
Keep a short decision record: options reviewed, important tradeoffs, selected plan and why leadership chose it. That record will help explain the decision to employees and provide context at the next renewal.
December: make implementation visible
Use an enrollment checklist with an owner and completion evidence for every step. Confirm elections, dependent information, employer contributions, payroll deductions and carrier submission requirements. Assign someone to resolve missing or inconsistent entries.
Employee communication should answer practical questions: what changes January 1, what each option costs, how to check a provider or medication, when elections are due and where to get help. Ask the carrier about transition assistance when a plan change may affect ongoing care.
Track applicable notices and documents separately from enrollment submissions. Confirm responsibilities with the administrator or other assigned adviser instead of assuming every vendor handles every requirement.
January: verify the result
After coverage begins, reconcile the first invoice, enrollment roster and payroll deductions. Investigate discrepancies promptly, and confirm how employees can obtain identification information and help with access issues.
A useful renewal process continues after the effective date. Schedule a follow-up to review implementation problems and record the information you wish you had earlier. Those observations become the starting point for the next planning cycle.