7 Signs Your Group Benefits Plan Needs a Review

1. Your Benefits Costs Keep Increasing

A single premium increase does not necessarily mean something is wrong with your plan.

However, repeated increases without a clear explanation deserve attention. Claims experience, prescription drug costs, dental utilization, healthcare trends, and other pricing factors can all affect renewal premiums.

The important question is whether you understand what is driving the increases and whether your current plan remains sustainable.

Ask your broker:

• Which benefit categories are contributing most to the increase?
• What does our claims experience tell us?
• Are unusually high claims affecting the results?
• What plan design adjustments, if any, are worth considering?

Understanding the reasons behind your renewal can help you evaluate your options more effectively.

2. Your Company Has Changed Significantly

Your benefits plan should evolve alongside your business.

If your company has grown from 10 employees to 50, the original plan may no longer be the best fit.

The same applies if your business has:

• Added new locations
• Changed employee classes or eligibility requirements
• Introduced remote or hybrid work arrangements
• Experienced significant hiring or turnover
• Acquired another company
• Changed its compensation or contribution strategy

A plan designed for your previous workforce may not reflect your current needs. Reviewing it can help ensure your benefits remain appropriate as your organization grows.

3. Employees Are Asking for Benefits You Don't Offer

Employee feedback can reveal gaps in your current benefits package.

Employees may be asking for more mental health support, higher paramedical maximums, improved prescription drug coverage, or other benefits that better reflect their needs.

Benefits may also come up repeatedly during recruitment conversations, particularly if candidates are comparing your employment package with those offered by other employers.

That does not mean every requested benefit should automatically be added.

Instead, use employee feedback to identify priorities and determine whether changes would provide meaningful value without placing unnecessary pressure on your budget.

4. Employees Don't Understand Their Benefits

A benefits plan can provide valuable coverage and still fall short if employees do not understand how to use it.

Employees may be unsure about:

• What their plan covers
• Reimbursement percentages and annual maximums
• Which healthcare practitioners qualify
• How to submit claims
• What their employee assistance program offers
• Where to find plan information or ask questions

If employees regularly ask the same questions or are unaware of available services, the issue may be communication rather than plan design.

A benefits review should therefore examine both the coverage itself and how information is shared with employees.

Clear explanations, accessible plan documents, and regular reminders can help employees better understand the benefits available to them.

5. You Haven't Compared the Market in Years

Staying with the same insurance carrier is not automatically a problem. Your existing arrangement may still offer competitive pricing, appropriate coverage, and reliable service.

However, employers should periodically assess whether their current plan remains suitable and competitive.

A market review can help answer an important question:

What would comparable coverage cost with another insurance carrier?

Look beyond the monthly premium. Compare:

• Coverage levels and exclusions
• Contract terms and conditions
• Claims administration and service
• Prescription drug management provisions
• Administrative requirements
• Overall cost and long-term sustainability

A market review does not necessarily mean switching carriers. It provides additional information to help you decide whether your current arrangement remains the right choice.

6. Your Benefits Plan Was Designed for a Different Workforce

Your employees' needs can change over time.

A company that originally had a small, relatively uniform workforce may now employ people with different family circumstances, career stages, and healthcare needs.

Similarly, a business that has expanded from a startup into an established organization may need to reconsider its original benefits structure.

These changes do not automatically mean the plan needs to be redesigned. They do, however, provide a reason to assess whether the current coverage remains relevant.

Review employee feedback, workforce changes, and available utilization information to identify potential gaps.

The objective is to maintain a benefits package that reflects your workforce without adding unnecessary cost.

7. You Only Discuss Benefits Once a Year

If group benefits only come up when the renewal arrives, your company may be missing opportunities to address issues earlier.

A renewal is an important checkpoint, but it should not be the only time you evaluate your plan.

Periodic reviews can help identify:

• Emerging cost pressures
• Changes in claims and utilization patterns
• Employee feedback and coverage gaps
• Communication issues
• Workforce changes
• Opportunities to improve plan design

You do not need to redesign your benefits plan every year. You do need to understand whether it continues to serve your business and employees effectively.

What Should a Group Benefits Review Include?

A useful review should examine the financial side of the plan alongside coverage and employee experience.

Financial Review

• Current monthly premiums and renewal history
• Claims experience and available utilization reports
• Employer and employee contributions
• Major cost drivers
• Renewal pricing methodology

Coverage Review

• Prescription drug coverage
• Dental and vision benefits
• Paramedical services
• Mental health coverage
• Life insurance
• Disability benefits

Workforce Review

• Employee demographics and dependants
• Employee locations and benefit classes
• Hiring and turnover trends
• Changes in eligibility or workforce structure

Employee Experience Review

• Employee feedback
• Understanding of available coverage
• Ease of submitting claims
• Access to covered services
• Effectiveness of benefits communication

Reviewing these areas together provides a more complete picture of whether your plan remains appropriate and where adjustments may be worth considering.

Don't Wait for a Difficult Renewal

One of the least convenient times to discover that your benefits strategy needs attention is when the renewal deadline is approaching and there is limited time to evaluate alternatives.

A proactive review gives your business more time to understand cost changes, assess coverage, and consider available options.

It also leads to a more productive conversation.

Instead of asking only, "How do we reduce this renewal?" you can ask:

"What is changing, why is it changing, and what should our benefits strategy look like going forward?"

That shift helps put the focus on informed decisions rather than reacting to a premium increase at the last minute.

The Bottom Line

A group benefits plan should not be considered finished simply because it has been in place for several years.

Your business evolves. Your employees' needs change. Healthcare costs and available coverage options can also change over time.

Regular reviews help you determine whether your plan remains appropriate, competitively priced, and financially sustainable.

Next Benefits helps Canadian employers review their group benefits plans, understand renewal cost drivers, and evaluate opportunities to improve plan design and long-term sustainability.

Contact Next Benefits to discuss your current benefits plan and determine whether a review makes sense for your business.