7 Signs Your Group Benefits Plan Needs a Review
A group benefits plan can remain in place for years without anyone taking a serious look at whether it still meets the needs of the business and its employees.
That can create challenges.
Your company may have grown. Your workforce may have changed. Healthcare costs may have increased, or employees may need different coverage than they did when the plan was first introduced.
A renewal increase is not the only reason to review your group benefits plan.
Here are seven signs that it may be time for a closer look.
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.
