I’ve spent the better part of 12 years looking at spreadsheets. My current one has 14 columns dedicated to year-over-year (YOY) premium increases for teams ranging from 8 to 60 employees. I’ve sat on more "strategy calls" with brokers than I care to admit, and I have a very low tolerance for fluff. When you see a 14% hike on your renewal packet, your broker will likely start talking about "market volatility" or "industry-leading trends." My response is always the same: What does that mean in dollars, and why is that my problem?
If you are staring down a double-digit renewal, you aren’t alone. Small group premium increases are accelerating as we head toward 2026, and the disconnect between healthcare costs, stagnant wage growth, and inflation is reaching a breaking point. It’s time to stop nodding along during broker calls and start asking the questions that actually move the needle.
The Reality Check: Why Your Renewal is Hurting
Before we get to the questions, let’s look at the data. According to the Kaiser Family Foundation (KFF.org), the average annual premiums for employer-sponsored health insurance have consistently outpaced both inflation and wage growth over the last decade. For small businesses, this is particularly lethal because we lack the negotiating power of a Fortune 500 company.
We are "price takers." When you have 20 employees, you don't get to demand lower rates from the carrier. You get the rate the algorithm spits out based on your zip code, your demographics, and, if you’re unlucky, the "claims experience" of your small pool of employees. As coverage rates continue to decline among small businesses, the pool gets smaller, and the risk per person theoretically rises. It’s a vicious cycle.
If you spend any time on a Reddit discussion thread about small business health insurance, you’ll see the same sentiment echoed over and over: small business owners feel like they are being squeezed out of the benefits game entirely. It’s not just you; it’s the structural failure of the small group market.
The Broker Evaluation Framework
Most brokers view you as a "book of business." If you aren't pushing back, you’re an easy renewal. When you get that double-digit renewal notice, your first move is a plan options review. Do not just look at the premium; look at the plan design. Here is exactly what you need to ask.
1. "What are the specific assumptions driving this increase?"
Brokers love "hand-wavy" claims like "overall medical inflation." Ask them to pull the report. Is the increase due to a specific high-claimant event (a catastrophic illness in your group), or is it a general trend adjustment? If it’s the latter, they are using you to pad their margins. If it’s the former, you need to discuss alternative funding models.
2. "Break down the 'industry-leading' value proposition in dollars."
If they say they have "competitive rates," ask them: Compared to whom? Ask for a side-by-side comparison. If you’re paying 12% more, show me the claims data that justifies the carrier’s stance, or show me the alternative carriers you’ve shopped this against in the last 30 days.
3. "What are our alternatives to a fully-insured plan?"
If you have a healthy team, stop subsidizing the risk pools of massive, unhealthy groups through a traditional fully-insured plan. Ask your broker about:
- Level-Funded Plans: These often allow for a "refund" if your claims are lower than expected. Individual Coverage HRA (IC-HRA): A Health Reimbursement Arrangement that lets you give employees tax-free cash to buy their own plans on the exchange. Self-Funded/Captives: For groups of 30+, this might be a path to taking control of your own claims data.
Comparison Table: The Cost of Complacency
This table represents the impact of a double-digit renewal over a three-year period. Assuming a starting annual premium spend of $200,000 for a small business.
Scenario Year 1 (Premium) Year 2 (12% Hike) Year 3 (12% Hike) Status Quo $200,000 $224,000 $250,880 Aggressive Review (5% Limit) $200,000 $210,000 $220,500The difference over just two years? Over $30,000. That’s a salary for a junior hire or a massive investment in your operations. Stop accepting the "standard" renewal.
Questions to Keep in Your Pocket
When you sit down for that renewal call, keep these questions printed out. If the broker stammers or gives you buzzwords, you know it’s time to find a new partner.
"Can you provide a market analysis of at least three carriers for our specific SIC (Standard Industrial Classification) code?" "How much of this premium is going toward administrative fees versus actual expected claims payout?" "If we increase the deductible or shift to a High Deductible Health Plan (HDHP), what is the exact dollar-for-dollar reduction in the premium?" "What is your commission structure on this policy, and does it change if you move us to a different carrier?" (Yes, ask this. You have a right to know if their advice is biased by their payout).Final Thoughts: You Are the Employer, Not the Charity
It is easy to get caught up in the emotional side of benefits. We want to provide for our teams; we want to keep them happy and healthy. But a business that goes bankrupt trying to provide gold-plated insurance benefits is a business that provides zero jobs.
If your renewal is in the double digits, it’s a symptom of a systemic issue. Do not accept it as a cost of doing business. Make your broker work for their commission. Demand data, demand alternatives, and if they can't provide a clear, numbers-based strategy to mitigate the 2026 hike, find someone who can. Your spreadsheet—and your bottom line—will thank you.
A note on terminology: Throughout this post, I've used terms like fully-insured (where the carrier takes the risk) and level-funded (a hybrid model where you share the risk). If your broker isn't explaining these to you dropping group insurance for ICHRA in plain English, that’s your first sign to switch.