A 20% Health Plan Renewal? Build a Side-by-Side Cost Comparison Before You Switch

Information current as of October 20, 2026.

A 20% medical renewal deserves more than a quick search for a lower premium. It deserves a comparison that shows where the money goes, what employees would pay and which responsibilities would move to your business. If your Washington company has received that kind of increase, start with one consistent set of numbers before choosing a different carrier, network or funding arrangement.

Key takeaways

• Use the same census, effective date and contribution assumptions for every quote.
• Separate employer savings from costs shifted to employees.
• Compare contract obligations and access to care before changing funding arrangements.

First, make sure the increase describes your plan

A 20% increase can describe your particular renewal without describing most Washington employers. The Office of the Insurance Commissioner (OIC) reported a 12.8% approved average increase for the 2026 small-group market. That historical figure is not a prediction of your 2027 renewal. Individual-market headlines describe a separate market. Source: Washington OIC.

Also distinguish the carrier’s rate change from a change in the total bill. Added dependents, employee ages and enrollment changes can affect the invoice. Washington’s small-employer market generally covers 1–50 employees; the OIC describes large-employer plans as 51 or more. These categories differ from the federal ACA employer-responsibility calculation. Source: Washington OIC rate guidance.

Make every proposal answer the same questions

Give each quoting source the same census, renewal date, employee eligibility and dependent tiers. Put the current plan, renewal and alternatives in separate columns. Record monthly premium, annual employer contribution, employee deductions, deductible, out-of-pocket limit, network, prescription coverage and additional fees.

Show two employer totals where relevant: expected spending and the maximum contractual funding obligation. Put potential refunds in a separate line. A comparison becomes unreliable when one column assumes a favorable claims year while another includes its full annual cost.

Ask for every missing item in writing. A blank cell means a question remains open; it should never be treated as zero.

An example: who actually saves?

Illustration only: Assume the same enrollment throughout the year. Your current medical premium totals $12,000 a month, with the employer paying 75%. A 20% renewal raises the total to $14,400. Employer spending rises from $108,000 to $129,600 a year; employees together pay $43,200 in annual premiums.

Suppose a comparable alternative costs $13,600 monthly plus a hypothetical $100 monthly employer administration fee. At the same 75% contribution, annual employer spending becomes $123,600. That saves the business $6,000 against the renewal. Employees together save $2,400 in premiums. Combined annual spending falls by $8,400.

Those are premium and fee savings only. A larger deductible or weaker drug coverage could change the employee result. The $100 fee is an example, not a claim that all alternatives charge it. Request actual quotes and calculate each coverage tier separately.

Compare fully insured and eligible association options

Start with comparable fully insured coverage so you have a reference point. Ask whether another plan design, network or employee buy-up option produces a useful difference. Lower employer contributions can reduce the company’s bill while increasing employee deductions; label that as a contribution change.

The OIC lists both the small-employer market and association health plans among Washington small-business options. Association eligibility, benefits, membership charges and plan terms need their own review. Availability through an association does not establish that its coverage is cheaper or equivalent. Source: Washington OIC small-business options.

In Washington, examples include the BIAW Health Insurance Program, offered through local home builders associations, and AWB HealthChoice for Association of Washington Business members. Each has its own eligibility, membership and renewal rules; AWB HealthChoice, for example, renews every December 1. See BIAW health insurance alternatives and what to compare at an AWB HealthChoice renewal.

Washington Insurance Brokers is an independent broker, not affiliated with or endorsed by BIAW, its local associations, its administrators, or its insurers. We’re an appointed AWB HealthChoice producer, so we can quote it for eligible members, but we aren’t owned by or endorsed by the Association of Washington Business.

Make level funding show its full obligation

Level funding generally combines self-funded expected claims with stop-loss insurance. Ask for the administration charge, claims funding, stop-loss premium, maximum liability and any costs at termination. Compare the contract’s funding obligation with the insured premium before counting a possible surplus refund. Source: CMS, discussion of level-funded arrangements, pages 183–184.

Stop-loss insurance protects the employer or plan under its terms. It does not turn every uncovered expense into an insured claim. Underwriting, exclusions, claim-payment periods and renewal terms can change the value of a proposal. A favorable first-year quote is a starting point for review.

Test an ICHRA against employee net costs

An individual coverage HRA, which federal consumer guidance now calls a CHOICE Arrangement, can reimburse qualifying individual coverage. Employers of different sizes can consider it, but employee-class rules, notices and premium-tax-credit interactions matter. Employees cannot simply combine the reimbursement with Marketplace tax credits. Source: HealthCare.gov.

Build confidential sample comparisons using employees’ counties, ages, household coverage needs and actual individual-plan choices. Include administration fees and the employee’s remaining premium. An employer budget cap does not guarantee affordable coverage for every employee. For an applicable large employer, separately verify ACA obligations before replacing group coverage. Source: IRS.

If your deadline is approaching, use our 90-day renewal plan for Washington employers to organize the comparison and enrollment work. For an overview of employer medical coverage, explore our group health insurance services before requesting a comparison.

Choose the option your business can explain

Before signing, verify important providers and prescriptions, confirm employee deductions and write down the assumptions behind the recommendation. Give employees a clear explanation of what changes and a private route for individual questions.

Request a group health comparison from Washington Insurance Brokers. Bring your renewal, current benefit summary, census and contribution schedule. The useful result is a decision you can defend with actual numbers and coverage details.

Washington Insurance Brokers helps employers explore QSEHRA and other HRA arrangements. We are Exchange certified and can also help employees compare and enroll in qualified individual coverage through Washington Healthplanfinder. Reimbursement eligibility and premium-tax-credit coordination still need an arrangement-specific review.

Common questions

Does a 20% renewal mean every Washington employer has the same increase?

No. Your renewal is specific to your coverage and group. Do not use individual-market averages as estimates for employer coverage.

Should we count a possible level-funded refund as savings?

Show it separately as a possible outcome. Compare the guaranteed charges and contractual funding obligation first, then review the refund formula and conditions.

General educational information, not legal or tax advice. Examples are hypothetical. Quotes, eligibility, benefits and employer obligations depend on current plan and contract terms. No savings are guaranteed.