Know what you're paying for. Understand what you can change.
The question is rarely whether someone can beat the rate.
A lower quote can be the right answer. It can also move the same problem to a new carrier for a year. The more useful question is what is driving the cost: which claims, which assumptions, and which parts of the plan design.
Once that is clear, the decision usually is too. Sometimes it means changing the plan. Sometimes it means challenging the renewal. Sometimes it means leaving a well-run plan exactly where it is.
Five numbers that decide the increase.
Every renewal is built from a handful of assumptions. They are rarely shown to the owner, and each one can be explained in plain language.
- Target loss ratioTLR
- The share of premium the carrier expects to pay out in claims. The rest covers administration, premium tax and the carrier's margin. A higher target means more of each dollar is expected to come back to your employees as claims.
- TrendCost assumption
- The carrier's assumed increase in claim costs for the year ahead. It is applied before any of your own experience is considered, so a small change in trend moves the whole renewal.
- IBNRClaims reserve
- A provision for claims incurred but not yet reported or processed. It increases the claims figure the renewal is calculated on, and the size of that provision is worth understanding.
- PoolingLarge-claim protection
- Large individual claims above a set level are shared across the carrier's pool, so one serious illness does not drive your rates. You pay a charge for that protection, and the level it starts at matters.
- SurplusExperience
- When claims come in below what was expected, some arrangements hold or return the difference. Knowing where it goes is part of knowing what the plan costs.
Smaller groups are often priced largely on pooled experience, so a review there looks different. The review is still worth doing; the levers are different.
Reviewed by Zachary Sikorski, CHS · EPC · CEA · October 2026
Seven questions worth asking about any renewal.
Carriers will generally answer these when asked. The renewal letter rarely invites them. Ask in writing, and keep the answers with the plan file.
- 1
What changed, benefit by benefit?
A single percentage hides where the pressure is. Ask for the increase split across drugs, other health, dental, life and disability.
- 2
Which benefits are priced on our own claims?
Some lines respond to your group's experience. Others move with the carrier's wider pool. Only the first kind is something you can influence.
- 3
What trend did you assume?
Ask for the figure on each benefit, and how it compares with last year's. Trend is applied to the whole renewal, so a small difference carries a long way.
- 4
What target loss ratio did you use?
If it moved since the last renewal, ask why. A lower target means less of each premium dollar is expected to return as claims.
- 5
Were any large claims pooled?
Ask how much was pooled, what the protection cost, and where the pooling level sits. One serious claim should not decide your rates for years.
- 6
How was the claims reserve set?
The provision for claims not yet reported raises the figure the renewal is built on. Ask how it was calculated and whether it changed.
- 7
What would a different design cost?
Ask the current carrier to price an alternative before asking another carrier for a quote. The better answer is often inside the existing plan.
Renewal review
A written review of your latest renewal: what changed, which assumptions drove it, and which points are worth raising with the carrier before you sign.
Plan design
Health, dental, vision, life and disability coverage built around the people you employ and the budget you set, with the trade-offs laid out before anything changes.
Funding structure
How the plan is funded affects both cost and volatility. Changing the structure can matter as much as changing the carrier.
A first plan
For a business putting benefits in place for the first time: what a small team actually needs, what it costs, and how to start without overbuilding.
The owner and the leadership team
A group plan protects the staff. The owner's own exposure usually sits outside it: disability coverage above group limits, key-person risk, and the benefits that keep senior people in place. That is where benefits meet the rest of Sheldrake's work.
Four steps, and no obligation to change.
Send the renewal
Your latest renewal package, or the current plan summary if you are earlier in the year. If there is no plan yet, a conversation about your team is enough to begin.
Read the math
Claims by benefit, the renewal assumptions, and how the plan compares with the ranges we would typically expect for a group of your size.
Lay out the options
A short written report with the options side by side, including keeping the plan as it is. You see the trade-offs before anyone recommends a change.
Stay with it
Renewals come every year. We review each one, help with eligibility and plan changes as the team grows, and raise issues before they reach the renewal.
Every review ends in one of four places.
The report says which one, and why. Two of the four involve no change of carrier at all.
Keep
The plan fits the team and the renewal is fair. The right advice is to sign it, and we will say so.
Challenge
The design is sound, but an assumption looks high. Raise it with the carrier in writing, well before the renewal date.
Redesign
The cost comes from how the plan is built. Adjust coverage, cost-sharing or funding with the carrier you already have.
Move
Pricing, design and service have all stopped fitting. Take the plan to market and compare every option on identical terms.
A renewal should not be decided in its final two weeks.
A renewal handled well starts months before the letter arrives. This is the rhythm we keep with every client plan.
- Three months before
Know the date
Find the renewal date and the notice period in your contract. Request the last twelve months of claims, by benefit.
- When the renewal arrives
Read before reacting
Set the headline percentage aside. Ask the seven questions, and get the answers on paper.
- Thirty days before
Decide
Keep, challenge, redesign or move. Whatever the choice, confirm the final terms in writing.
- The effective date
Close the loop
Payroll deductions reflect the new rates. Employees hear what changed before they discover it at the pharmacy counter. Coverage continues without a gap.
Tell us when your plan renews and we will be in touch three months ahead of it, whether or not we manage the plan today.
Our objective is not the cheapest plan.
It is a plan you understand, priced on assumptions you have seen, and designed for the people it covers.
We will not promise savings before we have read your renewal. If your plan is well run, we will tell you so, and suggest you leave it alone.
Zachary Sikorski
Your contact from the first call through each renewal. Zachary coordinates the review and connects the group plan to the owner's own insurance and succession planning.
Tom Lowden
Tom brings more than twenty years of work on group plans to Sheldrake reviews, and leads the plan design and restructuring work when a plan needs to change.
Does a review cost anything?
No. The review is provided at no cost and with no obligation to change your plan, your carrier or your current arrangement.
Do we have to switch carriers?
No. Many of the useful changes happen within the current plan: design adjustments, a challenge to a renewal assumption, or a change in funding. Moving carriers is one option among several.
When is the best time to have a plan reviewed?
When the renewal arrives, and ideally before the date it takes effect. Carriers usually send renewals weeks ahead of that date, which leaves time to ask questions.
We only have a few employees. Is a plan realistic?
Often, yes. Plans for small teams are built differently from those for larger groups, and the right starting point is usually simpler than owners expect.
Where does Sheldrake work?
Sheldrake Group is licensed in Ontario and works with Ontario businesses.
Send us your latest renewal or plan summary. We will review it at no cost and with no obligation to change anything.
Sheldrake Group Inc. is a licensed life insurance agency in Ontario. Information on this page is general in nature and is not a quote or a recommendation for any specific plan.