Your Rates Are Competitive. But Compared to What?

Most employers have no idea if their health insurance premiums are high, low, or average. They accept the renewal, trust the broker's explanation, and move on. That's not a strategy.

There's a simple question that exposes the gap: can your broker show you a benchmark? Not a pitch deck. A real comparison, tied to real data. If they can't, you're flying blind.

What does a premium benchmark report actually show you?

A premium benchmark report compares your health plan's average premium against survey averages for employers of similar size and plan type. The numbers come from research like the KFF Employer Health Benefits Survey, which covers thousands of employers and breaks down costs by firm size, plan type, and region. Your broker maps your current premiums against those figures.

You see whether you're above, below, or near the median. That's the whole output.

It sounds simple. Most employers never ask for it.

Which sections of the KFF survey should your broker reference?

Section 1 of the KFF Employer Health Benefits Survey covers overall plan cost, including average total premiums for single and family coverage by employer size. Section 7 covers employee cost-sharing, including what employees pay in premiums and deductibles. Those two sections give you the baseline.

Section 1 tells you if your total plan cost is out of line. Section 7 tells you if you're shifting more cost to employees than comparable employers are. Both matter.

A broker who hands you a benchmark built only on Section 1 is giving you half the picture.

Is a benchmark report enough to know if your plan is working?

No. A benchmark tells you where your premiums land relative to the market. It doesn't tell you why. Two employers can have identical premiums and wildly different cost drivers underneath.

One might be running efficiently with a healthy workforce. The other might have three chronic condition claims eating 40% of annual spend, offset by low utilization everywhere else. The benchmark looks the same. The plan design shouldn't be.

That's why claims data matters more than the benchmark number. As we covered in Self-Funding Doesn't Save You Money. The Data It Unlocks Does., the real value isn't the funding structure. It's the visibility into what's actually driving your costs.

What should you do if your premiums are above the benchmark?

Start asking questions, not making changes. Above-benchmark premiums can signal several things: a carrier with aggressive trend assumptions, a population with real utilization issues, or a broker who hasn't marketed the plan in three years. A plan design attracting adverse selection can do it too.

The benchmark flags the problem. Your claims data explains it. If you're fully insured and don't have access to claims data, that's its own conversation.

Renewal increases without explanation aren't normal, even if everyone treats them that way. The piece Carrier Renewal Trend Assumptions: The 12% Increase They Can't Justify walks through exactly how to push back. If your broker can't produce a benchmark report using current KFF data, ask why not.

What to do before your next renewal

Ask your broker for a premium benchmark report before renewal conversations start. Not during. Before. Give them four weeks.

The report should show your current premiums, the KFF survey median for your firm size and plan type, and a gap analysis. If you're below benchmark, that's useful context. It doesn't mean you stop asking questions.

Below-benchmark premiums with rising trend assumptions is still a problem worth solving. Use the Benefits Blueprint to map where your plan design may be creating cost pressure the benchmark isn't capturing.

Frequently asked questions

How current is the KFF Employer Health Benefits Survey data?

KFF publishes the Employer Health Benefits Survey annually, updated each fall. Your broker should always reference the most recent edition. Using an outdated edition understates current market rates. The link in this article points to the 2024 edition; confirm with your broker that they're pulling from the latest available year.

What size employer does benchmark data apply to?

The KFF survey breaks down data by firm size, including small employers under 200 workers and larger groups. Mid-market employers, typically 100 to 500 employees, often fall in the middle of the distribution. Your broker should filter to your size band, not present an all-employer average, which skews the comparison.

Can a fully insured employer get a benchmark report?

Yes. A premium benchmark doesn't require claims data. It only requires your current premium contributions, your plan type, and your firm size. Any broker can run this comparison using KFF data. If yours hasn't offered one, ask for it directly. Understanding who actually controls your claims data is a related question worth asking — Claims Data Ownership: Fully Insured vs. Self-Funded covers exactly that.

What if my premiums are below the benchmark?

Below-benchmark premiums aren't a reason to stop asking questions. Trend assumptions, plan design, and population health can still be moving against you. A benchmark is a single data point. It doesn't tell you where you're headed, only where you stand today.