The renewal arrives, and the number is higher than last year. Again.
For most practices, the first instinct is to reach for one of two levers: trim the plan or pass the increase along to employees. Both are understandable. Both carry costs that never appear on the renewal.
A thinner plan can make recruiting harder in a market where good medical assistants, billers, and nurses have options. A larger paycheck deduction can quietly erase the raise you gave in the spring. And neither response addresses why the number moved in the first place.
There is a better path, and it starts with treating the renewal as the beginning of a decision, not the decision itself.
The Increase Is Real, and It Isn’t Easing
This is not a local anomaly. According to Marsh, employer health benefit costs are projected to rise 8.2% on average in 2027, the largest increase since 2003 and the fifth consecutive year of elevated growth. Employers in the same survey estimated their costs would climb closer to 11% if they made no changes at all.
The gap between those two numbers is the point. It represents decisions employers are making right now. The question for your practice is whether those decisions are made deliberately or by default.
Start With What Moved the Number
Before changing anything, understand what drove the increase. Some of it is market trend that every group faces. Some may reflect your group’s size or age mix, or, under a level-funded arrangement, your own claims experience. Each points to a different response. Reacting to a headline percentage without that context is how practices end up solving the wrong problem.
Five Ways to Absorb an Increase Without Taking Benefits Away
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Rethink contribution strategy before plan design. How the cost is shared often matters as much as what the plan covers. Moving from a percentage-based contribution to a defined dollar amount, or contributing differently for employee-only coverage than for family tiers, can keep the core plan intact while making future increases more predictable for the practice. Any change should be reviewed against the eligibility and affordability rules that apply to your group’s size.
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Offer a choice instead of a single compromise. A base plan paired with a richer buy-up option lets employees decide what they value most. Those who want more coverage can pay the difference, and the practice is no longer forced into one plan that fully satisfies no one.
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Adjust where it will be felt least. Not every design change lands with the same weight. A higher copay on services nearly everyone uses will be noticed immediately. A change to a benefit few employees touch may barely register. Understanding how your plan is used as a whole helps you protect the parts your team values most.
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Revisit how the plan is funded. For some small and midsize groups, a level-funded arrangement can offer predictable monthly costs and the potential to share in a surplus when claims run low. It is not the right fit for every practice, but it deserves a look before a fully insured renewal is accepted at face value.
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Strengthen what surrounds the medical plan. Dental, vision, and voluntary benefits are often low-cost or employee-paid, yet they are some of the most visible parts of a benefits package. When the medical plan has to change, a stronger overall package changes how the adjustment is received.
The Step Most Practices Skip: Explaining the Change
Even a well-designed response can land poorly if all employees see is a larger deduction. A clear, plain-language explanation of what changed, why it changed, and what the practice did to protect their coverage turns a frustrating moment into evidence that leadership is paying attention. A spreadsheet of rates will not do that. A thoughtful conversation will.
How Unity Approaches It
At Unity, a renewal is where our work begins, not where it ends. We look at what is driving the increase, benchmark your plan against comparable practices in Maryland and the surrounding region, model contribution and design alternatives side by side, and help you explain the outcome to your team in language they will understand.
And because our benefits and business insurance teams work together, the conversation about your health plan never happens in isolation.
Timing Matters
The best time to plan for an increase is before the renewal arrives. For January renewals, many decisions are already in motion. For practices renewing later in 2027, now is the right time to start the conversation.
