Breaking the Cycle: Steps to Take in 2025 to Regain Control of Your Health Plan

As 2025 approaches, many employers are once again facing the frustration of health plan renewals. The rising costs, limited transparency, and lack of control leave many organizations feeling boxed in by their insurance carriers. If you’ve found yourself in this situation year after year, it’s time to take a proactive approach to break the cycle and regain control of your health plan.

Here are three steps you can take to shift the balance in your favor:

1. Start the Renewal Process Early

One of the biggest mistakes employers make is waiting until the last minute to review their health plan options. Starting the renewal process early allows you to evaluate alternative plan designs, negotiate more effectively with carriers, and identify cost-saving strategies before deadlines force hasty decisions. By beginning months ahead of time, you put yourself in a position to make thoughtful, informed choices.

If you haven’t received your 2025 health plan renewal yet, contact your broker right away.

2. Audit Your Claims Data

Understanding how your employees use their benefits is necessary to controlling costs. Conduct a detailed audit of your claims data to identify trends and opportunities for cost containment. Are there specific areas where your plan is overutilized? Are there services being paid for that are underused? This data will help you make informed decisions about plan adjustments that can reduce waste without compromising coverage quality.

If your insurance carrier won’t provide full claims data, ask for aggregate reports on utilization, costs, and trends. You can also request de-identified data that doesn’t contain protected health information or summary information on high-cost claimants and conditions.

3. Explore Self-Funding Options

For companies frustrated by the lack of control with fully insured plans, self-funding is an option worth exploring. With self-funding, employers can design a plan tailored to their workforce’s specific needs and keep any unused premium dollars. While this approach isn’t for every employer, it’s an option that opens doors to significant financial and strategic advantages.

Breaking the cycle of frustrating renewals requires a shift in mindset. Employers who take a proactive, data-driven approach to managing their health plans are far more likely to regain control and see improved results in 2025.

If you want to discuss these strategies further, DSG Benefits is here to guide you through the process.