# Broker renewal calculator

Source: https://www.getprescience.com/tools/broker-renewal-calculator
Author: Rishab Jain, Cofounder and CEO, Prescience
Published: 2026-11-09
Updated: 2026-11-09
Cite as: Rishab Jain. "Broker renewal calculator." Prescience, November 9, 2026. https://www.getprescience.com/tools/broker-renewal-calculator

A renewal percentage is the least useful number in the conversation. What the client needs is the monthly increase, the employer's share of it, the employee's share, and what a competing quote would cost instead. Enter the group's current premium to see all four before the carrier's notice arrives.

- **Input:** Current group premium
- **Output:** Employer and employee increase
- **Comparison:** Renewal vs. competing quote
- **Lead time:** Start 90 to 120 days out

## Model the renewal

_Interactive calculator: open the page in a browser to use it. The rules and figures it applies follow._

Enter the group's total monthly premium, the carrier's increase, the share the employer pays, and a competing quote if you have one. The default is a 30-person group at $18,000 a month with a 14% renewal and a 75% employer contribution, which is roughly what a fully insured small group looks like after a bad claims year.

Everything runs in the browser. No census, no member data and nothing that identifies an employee leaves the page, so you can use it in a meeting without a data question.

## What each number means

**Renewal premium** is the contract rate the carrier is offering for the new plan year. **Monthly increase** is the difference, and it is the number the employer will actually budget. **Employer annual increase** applies the employer's contribution share, which tells you whether the company is absorbing the increase or passing it to staff.

**Employee monthly change** is the group's total employee share of the monthly increase at the contribution share, not one person's cost. If the employer pays 75% of the premium, the group's employees carry 25% of the increase between them; divide by the employee count for a rough per-person figure, and note that the per-person split depends on each person's tier. That number is small in the total but large in a household budget, and it is the number employees actually compare to their paycheck.

**Savings against a competing quote** is the annual difference between the renewal and the alternative. Use it only when the alternative covers the same population, the same benefit level and the same effective date. A cheaper quote that drops a tier or narrows the network is not a saving until someone prices the difference.

> **The rate is not the renewal:** Administrative fees, association fees, state assessments and carrier-specific charges sit outside the percentage. Ask for the total billed rate, not the medical rate, or the client will find the extra line on the first invoice.

## When to run this

- **At the carrier's first indication.** Even a rough number is better than silence, because it starts the client budgeting process.
- **Before you accept a rate hold.** A hold that costs an extra fee may be worse than the increase.
- **When a design change is on the table.** Run the renewal as quoted, then the same premium with the changed deductible.
- **When a competing quote arrives.** Put the alternative against the renewal on the same page.
- **Before the employer sets contributions.** The employee share of the increase is decided here, not at open enrollment.

The useful habit is to run the renewal the day you receive it, not the week before the deadline. A number you can change in a meeting is a plan; a spreadsheet that arrives after the client has already seen the carrier's letter is a defense.

If the group has more than one rate class, run this once per class or use the blended total premium. For small groups the carrier typically applies the increase across all classes, so the blended figure lands close to the sum of the parts.

## A worked renewal

**A 30-person group facing a 14% renewal**

Illustrative numbers. A 30-person group pays $18,000 a month, or $216,000 a year, and receives a 14% renewal. The employer pays 75% of the premium. A competing quote for the same benefit level comes in at $16,400 a month.

- Renewal: $18,000 × 1.14: $20,520 per month
- Monthly increase: $20,520 − $18,000: $2,520
- Annual increase as billed: $30,240
- Employer annual share at 75%: $22,680
- Employee monthly share across the group at 25%: $630
- Competing quote annual cost: $196,800
- Renewal vs. alternative, annual: $49,440

The 14% is really a $2,520 monthly increase, $1,890 of it for the employer and $630 across the group's employee share, or about $21 per employee spread evenly across 30 people. Against the competing quote the difference is $49,440 for the year, which is the number worth putting in front of a CFO. Note that the alternative is a quote, not a contract, so present it as a quote.

If the carrier offers a 9% renewal with a $1,500 deductible increase instead, rerun the comparison with the new rate and put the deductible change next to it. Employees see the deduction every pay period and the deductible only at the pharmacy counter, so a smaller increase with a larger deductible is often the harder sale.

## Presenting the renewal without losing the client

Lead with the driver. If the increase is trend, say so. If it is the group's claims, say that too, and say what the group can do about it. The worst renewal conversation is the one where the client learns a percentage and nothing else, because the client fills the gap with the assumption that you are not managing the account.

Then put the numbers on one page in this order: renewal premium, employer monthly and annual impact, employee monthly impact, alternatives with their effective dates, and the decision deadline. Everything else is supporting material.

If the client is considering a change of carrier or structure, the deadline drives the calendar. A competing quote needs a census and roughly four to six weeks, and a broker of record change adds paperwork that will not compress. Start early or accept the incumbent's number.

> **Prescience Diamond: A company health plan with an effective $0 deductible.** A fixed quote sits next to the renewal as the alternative structure, which makes the comparison about design rather than only about rate.
> - **An effective $0 deductible** and simple copays shown before a visit
> - **A broad national PPO network,** plus providers we contract with directly
> - **24/7 physician-led care navigation** that books visits and explains costs
> - **Usually 10–20% below comparable fully insured coverage,** fixed in your quote, with no admin fees
> Best for teams of about 15 or more that want one great group plan. [Get a Diamond quote](https://www.getprescience.com/get-started?p=Employer&product=diamond)

**Turn the renewal model into a comparable client proposal**

Use the same client census, contribution policy and coverage date across the alternatives. Keep the modeled change separate from the employer and employee costs in the written proposal.

[Create a broker account](https://www.getprescience.com/brokers/apply)

## Contribution policy decides who pays the increase

The employer share input matters more than most brokers expect, because it determines whether a renewal is a company budget problem, an employee relations problem, or both. An employer that pays a fixed percentage absorbs a defined part of any increase and passes the rest on. An employer that contributes a fixed dollar amount keeps its own cost flat until it resets the contribution, so employees absorb the additional premium in the meantime, and the employer absorbs the employee backlash when the contribution is reset.

**Who bears the increase under each contribution policy**

| Policy | Employer exposure | Employee exposure |
| --- | --- | --- |
| Fixed percentage of premium | Their share of every increase | Their share of every increase |
| Fixed dollar contribution | None, unless the contribution is raised | The additional premium, until the contribution is reset |
| Fully employer paid | All of the increase | None |
| HRA or allowance | Capped by the allowance | Any cost above the allowance |

Enter the proposed share in the second field when the client is considering a contribution change. The calculator then prices both today's share and the proposed one against the renewed premium, and shows the difference the change makes for employees and for the employer's own budget. Rerunning it at a single share cannot show that shift, because it applies the same percentage to the old and the new premium.

Affordability rules also enter here for employers with 50 or more full-time equivalents. A contribution that leaves the cheapest self-only plan above the affordability threshold creates pay-or-play exposure, and our [affordability calculator](https://www.getprescience.com/tools/aca-affordability-calculator) checks the current limit.

## What this calculator cannot tell you

It models premium, not total cost. Deductibles, copays, out-of-pocket maximums, network breadth and prescription formularies all change what employees pay, and none of them appear in a premium percentage.

It assumes the census is unchanged. If the group grew or shrank, run the renewal on the actual census before comparing it to anything, because the rate is often priced on last year's enrollment.

It does not model claims or the plan's funding arrangement either. A level-funded renewal includes a claims reserve and a possible refund, so the rate the carrier quotes is not the whole of what the group pays, and a self-funded arrangement has its own exposure. Use this for the premium trend and read the funding document for the rest.

It does not model taxes or the employer's pre-tax benefit. Section 125 treatment changes the net cost of an employer contribution, and a full comparison should include it. Our [paycheck calculator](https://www.getprescience.com/tools/health-insurance-paycheck-calculator) handles the employee side of that arithmetic.

## Frequently asked questions

**How do I calculate a health insurance renewal increase?**

Multiply the current monthly premium by one plus the increase percentage to get the renewal, then subtract the current premium for the dollar increase. Apply the employer's contribution share to see the employer's part and the remainder for employees.

**Should employees pay part of the renewal increase?**

It depends on the contribution policy. If the employer pays a fixed percentage, employees automatically absorb their share of any increase. If the employer pays a fixed dollar amount, the employer's cost stays flat until the contribution is reset, so employees pay the additional premium in the meantime. Enter a proposed share in the calculator to price that change.

**What is a rate hold?**

A carrier agreeing to keep all or part of the current rate for a period, sometimes for a fee or in exchange for a plan design change. Compare the fee against the increase it avoids before accepting.

**How long does a competing quote take?**

Usually four to six weeks from a complete census, plus time for the client to review it. A change of carrier adds enrollment and payroll work, so start 90 to 120 days before the renewal date.

**Why is the renewal higher than the increase percentage suggests?**

Administrative fees, association fees, state assessments and any benefit changes sit outside the medical rate. Ask the carrier for the total billed rate rather than the medical rate alone.

**Can a renewal be negotiated?**

Sometimes. A specific competing quote or a design change gives the carrier something to respond to. Favorable claims add room only for experience-rated, level-funded or self-funded groups, not ACA fully insured small groups. Ask before the deadline, not after.

## Sources

- [KFF, 2025 Employer Health Benefits Survey](https://www.kff.org/health-costs/2025-employer-health-benefits-survey/)
- [CMS, Medical Loss Ratio](https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio)
- [HealthCare.gov, SHOP Marketplace overview for small employers](https://www.healthcare.gov/small-businesses/)
- [U.S. Department of Labor, Understanding your fiduciary responsibilities under a group health plan](https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/publications/understanding-your-fiduciary-responsibilities-under-a-group-health-plan)