Renewal gives employers a regular opportunity to inspect the plan, but a calendar date alone should not dictate a change of insurer. The useful trigger is a specific question: Is the current arrangement still doing what the organization needs it to do?
Reasons to take a closer look
- The renewal increase is hard to explain from the available claims results and plan changes.
- Employees repeatedly run into coverage limits or exclusions.
- The workforce has changed in size, location or composition.
- Billing, enrolment or claims problems keep drawing the employer in.
- The employer wants to revisit cost sharing or offer a different form of support.
First find out what is causing the concern. Employees may need a clearer explanation, or the plan itself may need adjustment; neither automatically calls for a new insurer. If, for example, a dental claim pays less than expected, check the plan maximum, applicable fee guide, reimbursement percentage and what employees were told before deciding what to change.
Decide whether to adjust, compare or move
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| What the review shows | What to ask next |
|---|---|
| A cost increase | What is driving the increase, and could a focused plan adjustment help? |
| A gap in coverage | Can the current insurer close the gap, and at what cost? |
| Recurring service problems | Which issues are documented, and what will the insurer do to resolve them? |
| A promising alternative quote | How do its coverage, renewal terms and service compare with the current plan? |
If the concerns warrant seeking other quotes, give insurers the same group and coverage information. Ask them to identify any important difference from the current plan, then weigh the full proposal rather than its initial premium alone.
How to carry out the review
- Define what needs attention. List cost, coverage and service concerns separately, then identify which ones the review must resolve.
- Explore what the current insurer can improve. Ask for an explanation of the renewal and specific options to change coverage or service.
- Compare alternatives if key concerns remain. Ask other insurers to address the unresolved issues, then examine what each proposal would change.
- Check what a switch would involve. Confirm notice requirements, implementation responsibilities and how employees with active claims or absences would be handled.
- Record the decision and its reasons. Explain why the plan will stay as it is, be adjusted or moved to another insurer, and note which costs, coverage or service issues to check at the next renewal.
There is no set schedule for seeking quotes from other insurers. When coverage and service still fit, a review of the current plan may be enough. A significant problem may call for a wider comparison sooner.
Before changing insurers
Before committing to a switch, check the current contract’s notice and termination terms. Confirm the new start date, enrolment steps and employee communications. Ask both insurers how employees away from work and those with active or potential disability claims would be treated; get the answers confirmed for the actual plans. CLHIA Guideline G3 addresses insurer changes and continuation of certain coverage for disabled members.
Illustrative example: Suppose claims and pooling charges—the cost of protection against high-cost claims—raise the rates at renewal. A second insurer offers a lower first-year rate, but its disability wording and drug rules differ. If the current insurer can make a focused change that meets the cost and coverage goals, staying may be preferable. If it cannot, assess whether the lower first-year rate justifies the coverage differences and the work of moving. The actual terms decide.
To begin: Gather the latest renewal, current plan documents and available claims reports, and describe the concern that prompted the review.
Talk through your options
We can help you assess what can be improved within your current plan and whether another insurer merits consideration.