Your group health insurance renewal can rise because the insurer changed its rates, more employees or dependents enrolled, or the plan itself changed. Compare the old and new rates using the same enrollment first. Then calculate what the renewal means for your business and each employee coverage tier.
When your renewal arrives, the headline percentage tells you how much a quoted cost changed. It takes a closer look to see which part of that increase came from higher rates and which part came from enrollment or plan changes. Ask your broker or insurer for a comparison that shows those changes separately.
What can cause group health premiums to rise?
- Insurer rates. The insurer may expect to pay more for hospital care, physician services, or prescriptions across the market it covers. It can also project that members will use more of those services. Ask for the reason given for your plan’s rate change.
- Enrollment. More covered employees or a shift from employee-only to family coverage can increase the total bill. Where applicable rating rules allow it, factors such as the ages of covered members or their rating area can affect the quote.
- Plan design. If your current option changed or the renewal proposes a replacement, compare the network, deductible, and covered services. The new price may reflect different benefits.
- Funding arrangement. Rules differ by market and plan type. Insurers generally cannot use your group’s claims history to set premiums for ACA-compliant fully insured small-group coverage. In a level-funded arrangement, the claims funding and stop-loss costs can change at renewal. Ask for an itemized breakdown of those costs.
Compare both years using the same enrollment
Suppose your current bill is $10,000 a month and the renewal shows $11,600. Ask for the new rates applied to the same employees and dependents as the current bill. If that figure is $10,800, the new rates add $800 a month in this example. The remaining $800 reflects the enrollment change, assuming the plan and all other inputs are the same.
Ask for the same comparison by coverage tier. If the carrier uses rates based on each covered person, ask your broker to show separately how changes to the census and the rates affected the total.
Calculate what the increase means for each paycheck
Start with the monthly premium for each tier. Subtract the employer contribution, then convert the remaining employee share using the number of paychecks that will carry a deduction.
For example, if employee-only coverage rises from $500 to $550 a month and the company continues paying $400, the employee share goes from $100 to $150. That is a 10% premium increase and a 50% increase in the employee’s share. Run this comparison for dependent tiers before announcing the new costs.
What to bring when you ask for another quote
Gather your current rate sheet, the renewal proposal, a current employee census, and the employer contribution for each tier. Use the same census and effective date when comparing alternatives. Check the provider network, prescription coverage, and employee out-of-pocket costs alongside the premium.
Did your group health premiums go up? Request a Benefits Review to discuss your renewal and ask for a group health insurance quote.
Sources & publication notes
Sources checked November 13, 2026. Figures identified as examples are original illustrations, not quotes or client results.
- CMS market rating reforms
Permitted rating factors and state variations in the small-group market.
- CMS health insurance market reforms
Restrictions on the use of claims history and other factors in small-group premium rating.
- CMS rate filing instructions
How insurers explain changes in projected medical service costs and use of care.
This educational guide is not a plan document or individualized tax, legal, or insurance advice; confirm requirements for your employer and coverage before acting.