August 23, 2026
Louis C. Bernardi, “The Benefits Whisperer”
The Healthcare Heist Newsletter – by Lou Bernardi, The Benefits Whisperer, Certified Healthcare Fiduciary Coach, Certified Health Value Advisor.
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5 Things Every Plan Sponsor Should Do Now
Every fourth quarter, the same ritual begins.
Renewals arrive. Premiums jump. Brokers scramble. Carriers sharpen their pencils. HR teams build spreadsheets. CFOs ask why costs are going up again.
Then everyone starts looking for ways to make the increase hurt a little less.
Raise the deductible.
Change the copays.
Increase employee contributions.
Move to another carrier.
Sound familiar?
That’s not healthcare strategy. That’s renewal management.
And there’s a big difference.
If you’re heading into a Q4 renewal, particularly if your plan is experience-rated or self-funded, this is your opportunity to stop asking only:
“How do we get a better renewal?”
And start asking:
“What are we doing to lower the actual cost of healthcare?”
Here are five recommendations I would give every CEO, CFO, HR leader and plan sponsor heading into renewal season.
1. START EARLY: Before Your Renewal Arrives
One of the biggest mistakes employers make is waiting for the renewal.
By then, the clock is working against you.
Decisions become rushed. Alternatives become harder to evaluate. And maintaining the status quo starts looking increasingly attractive simply because you’re running out of time.
Don’t wait for your carrier to tell you what next year will cost.
Start the conversation now.
Ask your team to begin analyzing claims, pharmacy spending, large claimants, utilization patterns, network performance and other available data.
The question isn’t simply “What increase should we expect?”
It’s “What’s driving our costs, and what can we do about it?”
2. DO YOUR RESEARCH: Understand What’s Behind the Number
Your renewal is the result.
Your claims are the story.
Especially for experience-rated and self-funded plans, understanding what happened inside the plan can be far more valuable than staring at the renewal percentage.
Where did the money go?
Hospital claims?
Specialty drugs?
GLP-1s?
Infusions?
Musculoskeletal procedures?
Cancer treatment?
Dialysis?
Emergency room utilization?
Out-of-network care?
High-cost claimants?
And then ask the more important question:
Could any of those claims have cost less without sacrificing, and potentially while improving, the quality of care?
That’s where the conversation gets interesting.
The goal shouldn’t simply be to finance next year’s healthcare differently.
The goal should be to buy healthcare better.
3. BRING IN COMPETITION: Even If You Like Your Current Partners
Competition creates accountability.
That doesn’t mean you have to fire your broker, carrier, TPA or PBM.
It means they shouldn’t assume the business is theirs simply because they’ve had it for years.
Ask what else is available.
Benchmark your current arrangement.
Evaluate other carriers, networks, funding structures and partners.
And don’t limit competition to the insurance companies everyone already knows.
There is an entire ecosystem of independent TPAs, transparent PBMs, high-performance networks, Centers of Excellence, direct contracting arrangements, navigation solutions, specialty pharmacy programs and alternative funding strategies that many employers never see.
You can’t evaluate an option nobody bothered to show you.
4. ASK BETTER QUESTIONS: Especially One
During your renewal strategy meeting, ask your benefit advisor:
“What are we doing to lower our actual claim costs?”
Then listen carefully.
If the answer immediately turns to deductibles, copays, employee contributions or changing carriers, ask again.
Those strategies may change who pays the claim.
They don’t necessarily change what the claim costs.
Ask:
“What strategies are you bringing us that actually reduce the price we pay for healthcare and prescription drugs?”
That is a very different conversation.
For experience-rated and self-funded employers in particular, reducing claims can ultimately be far more powerful than endlessly negotiating premium.
5. TELL YOUR BENEFIT PARTNERS YOU WANT FRESH IDEAS
Sometimes advisors don’t bring new ideas because their clients haven’t asked for them.
So, ask.
Better yet, challenge them.
Tell your broker or consultant:
“This year, I don’t just want different benefit options to offset the premium increase. Show me strategies we haven’t considered before.”
Ask:
What else is out there?
What haven’t you shown us?
What are innovative employers doing differently?
How can we attack pharmacy costs?
How can we better manage large claims?
How can we help members identify higher-quality, lower-cost providers?
Could alternative funding make sense?
Could independent vendors perform certain functions better?
And my favorite:
“If this were your money, what would you do differently?”
You might be surprised by the answer.
Don’t Waste Another Renewal
Healthcare costs aren’t slowing down.
The traditional response has been to absorb some of the increase, shift some to employees, modify the plan and repeat the process again next year.
There is another option.
Stop treating the renewal as the strategy.
Use renewal season as the catalyst to investigate why you’re spending what you’re spending—and whether there is a better way.
Because every unnecessary dollar leaving your health plan is a dollar that can’t go toward wages, hiring, technology, expansion, benefits or profitability.
That’s the Healthcare Dividend hiding inside your health plan.
And when you reclaim those dollars and put them back to work inside the business?
That’s your Growth Fund.
So before the Q4 renewal frenzy begins, start asking better questions.
You might discover that the biggest opportunity isn’t getting a better renewal.
It’s needing less insurance in the first place.
One Question to Bring to Your Next Benefits Meeting
“Forget the renewal for a minute. If our objective were to reduce our total healthcare spend by 20% without reducing benefits or shifting costs to employees, what would you recommend we do differently?”
If your current team can’t answer that question, it may be time to bring another voice into the conversation.
Contact the author at lcbernardi@britepathbenefits.com
Schedule a call at calendly.com/lcbernardi
Visit our website at www.britepathbenefits.com