If you’re a CFO or owner, there’s a decent chance your renewal felt like this:

“Same plan… bigger bill… and somehow employees are still unhappy.”

You’re not alone.

The data backs up the pain, and these #’s are light considering what we’ve seen in the market.

A few signposts that explain why this renewal season felt brutal:

• Employer family premiums are now ~$27,000/year on average, up 6% in 2025 (and single premiums up 5%).
• Total employer health benefit costs are projected to rise ~6.5% in 2026, and Mercer called it the highest increase since 2010.
• Medical cost trend is hovering at levels reminiscent of ~15 years ago, with inflationary pressure from both services and Rx.
• For small group insurers, 2026 filings show a median proposed increase ~11% across many carriers, with Rx + utilization + provider costs cited as key drivers.
• The all-in cost to insure a family of four through employer coverage has topped $35,000 (Milliman Medical Index).

So yes: the market’s been pushing employers into the corner.

But here’s the part most leadership teams miss:

The renewal isn’t the problem. The funding strategy is.

Most companies are shown one path:

“Here’s your renewal. Want Option A, B, or C?”

Those are usually just different versions of the same model.

When employers only see one funding approach, they miss what could matter most:

• More transparency (what’s actually driving cost)
• More control (which levers you can pull)
• More protection (from volatility)
• More upside (when claims run better than expected)

7 CFO-friendly moves to control renewals going forward

1) Stop shopping plans. Start shopping funding

Fully insured vs level-funded vs self-funded isn’t jargon. It’s how risk and cash flow are handled. If you’ve never been shown these side-by-side, you likely haven’t seen the full menu.

2) Build a “claims story” before the carrier tells one for you

Your renewal is a narrative: high-cost claimants, pharmacy trend, outpatient shifts, chronic conditions, utilization spikes. If you don’t know the story, you can’t negotiate it.

3) Treat pharmacy like its own P&L

GLP-1s and specialty drug trend are a major driver in today’s cost environment (and employers are responding with targeted strategies). 

This is where plan sponsors can create real leverage: formulary strategy, prior auth, carve-outs, clinical programs, site-of-care.

4) Protect employees’ take-home pay without “death by deductible”

Most employers default to higher deductibles because it’s simple. It’s also a morale tax.

There are smarter ways (plan design + support layers) to reduce out-of-pocket pain while still controlling total cost.

5) Audit what you’re paying for, not just what you’re buying

Admin fees, network contracts, PBM contracts, rebates, stop-loss terms, Rx spread, “hidden” vendor fees. You don’t need a revolution. You need a flashlight.

6) Use targeted solutions instead of broad cuts

Steer high-cost care to high-value settings: imaging, infusion, outpatient surgeries, specialty drug sites-of-care. Broad cuts feel fair. Targeted strategies actually work.

7) Create a 12-month plan so renewal isn’t your only lever

If the only time you manage the plan is renewal, you’re playing defense once a year. The winners run a calendar: quarterly reviews, vendor scorecards, pharmacy checkpoints, and employee communication.