Somewhere along the way, someone told you your company is too small to run your health plan any differently. Too small, claims too high, market’s the market, nothing we can do. You accepted it, because the person saying it sounded like they knew.
They were wrong. And this renewal season is proving it in my own book.
I have two kinds of midsize clients right now. One kind is fully insured, the standard setup most brokers sell, and they are getting hammered, some north of 20% this year. The other kind is self-funded and unbundled, meaning we chose each piece of the plan separately and can see inside all of it. Same size. Same headcount. Same lousy market. Their renewals are calm.
Size was never the problem. Structure is.
Now the honest caveat. Sometimes fully insured is the right answer. For a smaller group, or one with very high claims, it can be the smart, safe call. That should be a conclusion you reached by looking at the math, not a default someone handed you because looking was inconvenient for them.
Most owners never hear this part. A company your size can self-fund and cap its risk with stop loss insurance, a policy that catches the catastrophic claims so one bad year does not blow up your budget. You keep the savings in the good years. You see every dollar of claims and every vendor’s cut, the whole engine. The big carriers rarely mention this, because their model runs on you not knowing. Telling you “you’re too small” is easier than proving what your options actually are.
The reaction I watch land on people is not relief about the money, though the savings are real. It is closer to anger. “Why did nobody show me this existed?” They are right to be angry.
What to do this fall: before you sign another renewal, ask one question. “What would this plan look like if I could see inside it?” Ask what self-funding and stop loss would mean for a company your size. An advisor who says you’re too small just handed you your answer, and it is not about your size.
You built a company big enough to have this problem. You are big enough to fix it.
Want to see what your plan looks like with the lid off? Let’s talk.
