If your group health insurance renewal feels like a yearly jump-scare – “Congrats! Your rates went up again” – you’re not alone. For many small business owners, health insurance renewal season has become something to endure rather than an opportunity to improve their benefits strategy.
Here’s what we see all the time when new clients come to us at Quantum Employee Benefits: their broker auto-renewed their group health plan – accepted the increase – and called it a day. No comparison of alternative plans. No discussion of different networks or funding options. No explanation of what actually changed or why. Just a PDF attached to an email and a casual, “See you next year!”
That’s not a renewal strategy. That’s a subscription you forgot to cancel.
The issue isn’t that health insurance costs increase – unfortunately, that’s part of the system. The real problem is when employers are never shown options. Without comparing multiple small business health insurance plans, you lose leverage. You’re left guessing whether your renewal is reasonable, inflated, or missing better-fit alternatives that could save money or improve coverage.
As broker consultants, we never auto-renew a client. Ever. We quote plans at every renewal because it’s the only way to confirm you’re still getting the right combination of:
- Competitive Health Insurance Rates
- Thoughtful Plan Design
- Appropriate Provider Networks
- A Positive Employee Experience
- And Sustainable Long-Term Cost Control
A successful health insurance renewal should be intentional and strategic – not passive or rushed.
In this blog, we’re breaking down the 7 plans your broker should quote (and the plan categories behind them) so you can approach your next group health insurance renewal with clarity, confidence, and real negotiating power. You may not choose every option – but understanding what should be quoted is how you take control of the process.
Once again, here’s Jud, our founder, covering the salient points of the Plans Your Broker Should Quote in his latest video: https://youtube.com/shorts/yeoHTY8_e_g?si=c-o7wAaQwDL-kx7o
Why Quoting Multiple Health Insurance Plans at Renewal Matters
Health insurance renewal is one of the only times during the year when employers have meaningful leverage – but only if that leverage is used.
When a broker presents a single renewal option, the insurance carrier has very little incentive to sharpen pricing or improve terms. From the carrier’s perspective, silence usually means acceptance. Over time, this is how businesses drift into overpaying for benefits without realizing it.
Quoting multiple group health insurance plans at renewal changes that dynamic entirely. These Plans Your Broker Should Quote are critical.
When your broker quotes different plan types, networks, and funding options, several important things happen. First, pricing becomes competitive. Insurance carriers know their plans are being compared side by side, which often leads to more aggressive rates or improved renewals.
Second, you gain visibility. You’re able to see whether your current plan is still the best fit – or whether a different structure could better support your budget and your employees. Many employers are surprised to learn that alternatives exist that they were never shown before.
Third, quoting plans forces a conversation about strategy, not just price. Renewal becomes a chance to ask smarter questions, like:
- Are we paying for access our employees don’t actually use?
- Is our network broader than it needs to be?
- Could a different plan design reduce costs without sacrificing care?
- Are there funding options that give us more control long term?
This process doesn’t mean change for the sake of change. In many cases, employers ultimately stay on their existing plan – but now they do so by choice, not by default. And that distinction matters.
A broker who quotes multiple plans is showing diligence, transparency, and advocacy. They’re demonstrating that your renewal isn’t on autopilot – and that your business deserves better than a one-option decision.
Now that we’ve covered why quoting matters, let’s look at what types of plans your broker should quote – starting with the core plan structures available to most small businesses.
Understanding the Main Types of Group Health Insurance Plans
Before diving into the specific plans your broker should quote, it’s important to understand the core types of group health insurance plans available to most small and mid-sized businesses in the U.S.
Many renewal conversations fall apart simply because employers are handed acronyms – PPO, HMO, EPO, HDHP – without a clear explanation of what they actually mean or how they affect real people using real healthcare.
This section isn’t meant to overwhelm you. Think of it as a foundation. Once you understand how each plan type functions, comparing renewal options becomes far less confusing –- and far more empowering. After this, you should feel confident when asking for Plans Your Broker Should Quote.
PPO Plans (Preferred Provider Organization)
A PPO plan, or Preferred Provider Organization plan, is often considered the most flexible option in group health insurance. In general, these are the most popular plans and most will want them included in Plans Your Broker Should Quote.
PPOs allow members to see doctors and specialists without referrals, and they typically provide both in-network and out-of-network coverage. This flexibility is the main reason PPO plans usually come with higher premiums.
That said, PPO plans only work well when people understand how networks actually function.
While PPOs technically allow out-of-network care, benefits are significantly stronger when care is received in-network. Deductibles, coinsurance, and out-of-pocket costs are all lower when providers and facilities are contracted with the insurance carrier. Out-of-network benefits exist, but they are often misunderstood and can become expensive quickly.
PPO plans generally include:
- An annual deductible (sometimes as low as $0)
- Coinsurance after the deductible
- A maximum out-of-pocket limit per calendar year
- Separate in-network and out-of-network cost structures
That last point is critical. Many PPO plans have two separate out-of-pocket maximums – one for in-network care and one for out-of-network care. Spending toward one does not count toward the other, which is why understanding provider networks matters so much.
PPO plans tend to work best for:
- Employees who value provider choice
- Teams attached to specific doctors or hospitals
- Businesses willing to pay more for flexibility
Even if a PPO isn’t the final choice, it should almost always be quoted. It sets a benchmark for access, network breadth, and pricing during your group health insurance renewal.
HMO Plans (Health Maintenance Organization)
HMO plans operate very differently from PPOs and are often misunderstood as “worse” plans, when in reality they’re simply more structured.
With an HMO, members choose a medical group and a Primary Care Physician (PCP). That PCP becomes the central coordinator of care and typically provides referrals to specialists within the medical group.
This structure is designed to promote continuity, preventive care, and oversight. For many employees, especially those who like having a consistent provider managing their health, this can be a positive experience.
However, HMOs are far more restrictive:
- There is no out-of-network coverage, except for true emergencies
- All non-emergency care must stay within the selected medical group
- Referrals are usually required for specialist visits
Emergency care is the exception. Members can go to any emergency room for a true emergency, but if the visit is later deemed non-emergent, the financial responsibility may shift back to the member.
HMO plans often come with lower premiums and predictable costs, which makes them appealing for cost-conscious employers. In some states, HMOs are the dominant or default option due to how healthcare systems are structured locally.
A knowledgeable broker should quote at least one HMO option when available, particularly if premium control is a priority during renewal.
EPO Plans (Exclusive Provider Organization)
EPO plans sit somewhere between PPOs and HMOs, and for many groups, they strike an ideal balance.
Like HMOs, EPOs require members to stay in-network for coverage. Out-of-network care is generally not covered, except in emergency situations. However, unlike HMOs, EPOs usually do not require referrals or a designated Primary Care Physician.
This means employees can see in-network specialists directly without additional administrative steps.
EPO plans are often appealing because:
- Premiums are typically lower than PPOs
- There are fewer restrictions than HMOs
- Care feels more flexible while still controlling costs
In many markets, EPOs are one of the most cost-effective group health insurance plan designs available – yet they’re frequently overlooked simply because they aren’t explained well.
If your broker isn’t quoting EPO options during renewal, it’s worth asking why.
HDHP Plans (High Deductible Health Plans) Paired with HSAs
High Deductible Health Plans, or HDHPs, are among the most misunderstood plan options in small business health insurance – and also among the most powerful when implemented correctly.
An HDHP comes with a higher deductible, often several thousand dollars, which can make it sound intimidating at first. But the true value of an HDHP lies in what it’s paired with: a Health Savings Account (HSA).
An HSA is a tax-advantaged account that can be used to pay for qualified medical expenses. Contributions are generally tax-deductible, funds grow tax-free, and withdrawals for eligible healthcare costs are not taxed.
HDHPs typically include:
- lower monthly premiums
- higher deductibles
- standard out-of-pocket maximums
- full protection for major illness or injury
When employers contribute to HSAs – even modestly – HDHPs can become one of the most employee-friendly and cost-efficient options available. Employees gain control, transparency, and the ability to save healthcare dollars year over year.
These plans work especially well for:
- healthier populations
- employees who like budgeting and control
- businesses looking to reduce premiums without sacrificing catastrophic coverage
Even if an HDHP isn’t ultimately chosen, it absolutely belongs in the renewal quote. Without it, you may be overlooking a smart long-term strategy.
Full Networks vs. Limited Networks
Plan design is only half the equation. Networks are just as important – and often more impactful in day-to-day use.
A network is the list of doctors, hospitals, medical groups, and facilities that have contracts with an insurance carrier. Using in-network providers is what keeps healthcare costs predictable and manageable.
Most carriers offer:
- Full networks, which include all contracted providers
- Limited or narrow networks, which include a smaller subset
Limited networks often exclude major, high-demand hospital systems or specialty providers, which is why they usually cost less. In large metro areas, well-known hospitals are frequently excluded from lower-cost networks.
That said, limited networks can be a great option when:
- Employees aren’t tied to specific providers
- The remaining network is still strong locally
- Budget constraints are real
In some regions, limited networks are nearly identical to full networks – making them an easy savings opportunity. A good broker verifies this instead of assuming.
Network options should always be quoted and explained clearly at renewal.
Health Insurance Funding Options Your Broker Should Quote
Plan design and networks determine how coverage works, but funding options determine how the insurance itself is paid for and where financial risk lives. This is one of the most overlooked – and most important – parts of a successful group health insurance renewal. Make sure to include these in the Plans Your Broker Should Quote.
Many employers assume they only have one option, when in reality there are multiple funding models available. A knowledgeable broker should explain these options clearly, outline the risks and benefits of each, and help determine whether an alternative structure could offer better long-term control.
Traditional Fully Insured Health Insurance Plans
Fully insured plans are the most common and most familiar form of group health insurance – these will be included in Plans Your Broker Should Quote automatically – if they quote at all. With this model, the employer pays a fixed monthly premium to the insurance carrier, and the carrier assumes all claims risk.
These plans are predictable and easy to administer. Employers know exactly what they’ll pay each month, regardless of how much care employees use. That simplicity is why many businesses default to fully insured plans year after year.
However, fully insured plans also come with limitations. Employers typically receive little to no insight into claims data, which makes it difficult to understand what’s driving costs or how to improve outcomes long term. There is also limited flexibility in plan design, and renewals are largely controlled by the carrier.
Fully insured plans should absolutely be part of the renewal quote – but they shouldn’t be the only option considered.
Level-Funded Health Plans
Level-funded health plans are often best described as a bridge between fully insured and self-insured models, designed specifically for small and mid-sized businesses. While these should be included in Plans Your Broker Should Quote, they’re not for every group.
With a level-funded plan, the insurance carrier estimates expected claims based on group size, location, demographics, and history. The employer then pays a fixed monthly amount that covers:
- Administrative Costs
- Stop-Loss Insurance
- A Claims Fund
Stop-loss insurance is critical here. It protects the employer from high-cost individual claims and from aggregate claims exceeding expectations. In other words, it caps risk and provides predictability.
One of the biggest advantages of level-funded plans is transparency. Employers receive regular reporting that shows how claims are tracking throughout the year. This data allows for smarter decisions, better renewal planning, and, in many cases, meaningful cost savings over time.
Some level-funded plans may also return unused claims dollars at the end of the year, depending on plan structure.
Level-funded plans are not appropriate for every group, but when they fit, they can offer greater control, better insight, and a more strategic approach to healthcare spending.
QSEHRA (Qualified Small Employer Health Reimbursement Arrangement)
For employers with fewer than 50 full-time employees, a QSEHRA can be a powerful alternative to traditional group health insurance. If you fall in this range, be sure to add it to Plans Your Broker Should Quote.
Instead of sponsoring a group plan, the employer sets a monthly reimbursement allowance. Employees then purchase individual health insurance that works best for their personal situation and are reimbursed – tax-free – for premiums and eligible medical expenses, within IRS limits.
QSEHRAs offer several advantages:
- Predictable, Capped Costs for Employers
- Flexibility and Choice for Employees
- Suitability for Remote or Multi-State Workforces
- Reduced Administrative Complexity
While QSEHRAs are not the right solution for every business, they can be an excellent fit for smaller teams that are priced out of traditional group plans or want to move away from a one-size-fits-all approach.
If a broker isn’t at least evaluating whether a QSEHRA makes sense, an important option may be missing from the conversation.
Ancillary Benefits Your Broker Should Quote
Ancillary benefits are often treated as an afterthought during renewal, but they play a major role in how employees perceive the overall value of their benefits package. These absolutely must be included in Plans Your Broker Should Quote.
Dental, vision, life, and disability coverage are now widely expected, even in small organizations. Fortunately, these benefits are typically very affordable and offer a strong return in terms of employee satisfaction and retention.
At a minimum, renewal quotes should include:
- Dental insurance for preventive and major care
- Vision insurance for exams, glasses, and contacts
- Employer-paid life insurance
- Short-term and long-term disability coverage
Ancillary benefits can be fully employer-paid, employee-paid, or structured as a combination of both. This flexibility allows employers to design a benefits package that feels complete without straining the budget.
Voluntary Benefits
Voluntary benefits are employee-paid policies that complement core coverage and help fill financial gaps – all without increasing employer cost. These can be included alongside employer-paid ancillary benefits and should be in the Plans Your Broker Should Quote.
These benefits are especially valuable because they allow employees to personalize their protection based on individual needs, family situations, and risk tolerance. For many employees, voluntary benefits provide peace of mind when unexpected expenses arise.
Common voluntary benefits include:
- Accident insurance
- Critical illness coverage
- Hospital indemnity plans
- Supplemental life insurance
- Legal services
- Pet insurance
When implemented thoughtfully, voluntary benefits enhance the overall benefits experience and demonstrate that the employer cares about employee well-being beyond basic coverage.
A Quick Note on PEOs (Professional Employer Organizations)
While not technically a health insurance plan, PEOs should still be part of the renewal discussion in certain situations. We always at least include it in the conversation at renewal, but we do recommend asking for it to be included in Plans Your Broker Should Quote.
A PEO enters into a co-employment arrangement with a business and takes on responsibilities such as payroll, HR administration, compliance, and benefits. By pooling many small employers together, PEOs can sometimes access different health insurance pricing or plan options.
However, PEOs also come with:
- Additional fees
- Changes to HR structure
- Long-term contractual considerations
Because of these trade-offs, PEOs require careful analysis. They can be a great solution for some businesses and a poor fit for others. A thoughtful broker should explain when a PEO might make sense – and when it likely doesn’t.
Final Thoughts on a Successful Health Insurance Renewal
A successful group health insurance renewal is never about picking a single plan and hoping for the best. It’s about understanding the full landscape – plan types, provider networks, funding options, and supplemental benefits – and then making decisions intentionally, with clarity and confidence. That’s why these Plans Your Broker Should Quote are so vital.
When renewals are rushed or handled on autopilot, employers lose leverage and employees lose choice. But when the process is thoughtful and well-explained, renewal becomes an opportunity: to regain control of costs, improve the benefits experience, and build something that actually works for your team.
If your current renewal process doesn’t include real comparisons, clear explanations, and strategic guidance, it may be time for a different conversation.
And if you’re looking for a partner who treats renewal as an opportunity – not a formality – the team at Quantum Employee Benefits is always happy to help. Whether you want a second opinion, a clearer explanation of your options, or a more proactive renewal strategy, you don’t have to navigate it alone.
Reach out anytime. We’re always happy to walk through the details, answer questions, and help you build a benefits strategy that truly supports your business and your people.
