Renewal season has a way of narrowing the conversation. Rates come in, deductibles get reviewed, contribution strategy gets debated, and the meeting ends. For many large group clients, that cycle repeats itself year after year without anyone stepping back to ask a more useful question: is the plan actually working?
Plan design matters. But for large employers, the forces driving cost and employee experience have moved well beyond what deductible levels and network tiers can address. Pharmacy spend is accelerating. Chronic condition management is uneven. Data sits inside carrier reports that rarely get read. Clinical programs go underutilized. Employees make costly decisions because no one helped them understand their options.
WHY LARGE GROUP DECISIONS NEED A BROADER VIEW
The numbers tell a clear story. Large employers experienced median health care cost increases of 7.5% in 2024, exceeding what most had projected and budgeted for.1 Pharmacy costs are projected to rise 11% to 12% in the current plan year, and PwC is projecting a 9% group medical cost trend for 2027, the highest in nearly two decades.2
The Business Group on Health has said directly that rising pharmacy costs are “not, and have not been, a situation that can be remedied by plan design changes.”3 A large group client still treating plan design as the primary lever has a real gap in strategy.
Cancer remains the top condition driving health care spend among large employers, with diagnoses appearing at younger ages and later stages than guidelines typically anticipate.3 Musculoskeletal conditions, cardiovascular disease, and diabetes follow closely. These conditions are often the downstream result of gaps in preventive care, chronic condition management, and access to the right clinical support at the right time. Helping a client think about those upstream factors turns the renewal conversation into something very different from a rate negotiation.
WHAT DATA CAN REVEAL BEFORE THE NEXT RENEWAL
Most large employers have more data available than they are actually using. Monthly claims reports come in from the carrier or TPA, get skimmed by someone in HR, and sit in a shared drive until renewal forces a scramble. That gap between data access and data action is where real advisor value lives. Combining a client’s own claims data with publicly available transparency information unlocks the ability to audit vendor performance, benchmark costs against regional and national averages, identify savings tied to employee utilization patterns, and strengthen negotiations with carriers and TPAs.4 That visibility changes what is possible at the table.
Building a regular cadence around data review, not just an annual renewal look but monthly tracking of key metrics and quarterly strategic conversations, gives clients a clear, ongoing picture of what is actually driving cost in their population.5
AI-powered analytics tools are accelerating what is possible here. Machine learning now identifies cost patterns, flags high-risk claimants earlier, and benchmarks performance against comparable populations in ways that would have taken weeks of manual analysis just a few years ago. The technology sharpens the advisor conversation. It does not replace it.
This also means asking harder questions of the vendors providing that visibility. Not all TPA contracts make data easy to access, and not all reporting is built for strategic use. Helping a client understand what they should be getting from their data, and whether they are actually getting it, is a form of advocacy that changes the relationship.
PHARMACY, ACCESS, AND QUALITY AS CORE DISCUSSION POINTS
Pharmacy deserves a conversation that goes well beyond formulary tiers.
Specialty medications now represent approximately 55% of total pharmacy benefit spend, and pharmacy costs rose 11% in 2025 alone.6 Employers now spend roughly one out of every four healthcare dollars on pharmacy. GLP-1 medications, high-cost oncology therapies, and cell and gene treatments are reshaping the pharmacy picture fast. Sixty-four percent of large employers say GLP-1 drug coverage has moderately or significantly impacted their prescription drug spending.7
The strategic questions in this space tend to reveal real opportunity: What does the client’s PBM arrangement actually look like? Are rebate structures transparent? Is there a clear clinical framework around high-cost specialty medications, including prior authorization and site-of-care considerations? Are biosimilars being used where clinically appropriate? These questions rarely get asked. They should.
AI-driven underwriting tools are also changing how stop-loss and self-funded plans price pharmacy risk. Predictive models that analyze claims history, diagnosis trends, and population demographics are giving advisors a far more accurate picture of expected pharmacy spend than traditional actuarial models could provide. For large group clients evaluating self-funded or level-funded options, that accuracy translates directly into better pricing and fewer surprises at renewal.
Access and quality round out the picture. Emergency room utilization increased 2.1% in 2025 while virtual care utilization dropped 16.1%, a pattern that suggests employees are not finding their way to the most cost-effective point of care.8 Centers of Excellence for high-cost conditions like cancer and musculoskeletal surgery consistently show better outcomes and lower total costs. Asking how well current clinical programs are being used, and what the barriers to utilization are, tends to surface gaps the employer has not fully examined. Getting real value from these programs takes someone who knows the right questions and cares enough to keep asking them.
ACCOUNT OWNERSHIP IS THE STRATEGY
Account ownership goes beyond a service model. Done right, it becomes a growth strategy. Large group clients who feel genuinely owned by their advisor, not just serviced at renewal, expand the relationship, refer peers, and stay through market changes. That kind of ownership gets built between renewals, not during them.
A mid-year review built around claims data, pharmacy trends, and program utilization gives a client the chance to adjust before patterns harden. It creates a seat at the table that is not tied to renewal pressure. The topics worth raising include whether vendor partners are performing against their commitments, whether employee communications around clinical programs are reaching people, and whether the employer’s data is being reviewed regularly enough to catch cost trends before they compound. These conversations require preparation. They are also exactly what distinguishes a strategic advisor from a transactional one.
BOTTOM LINE
The large group market rewards depth. Holding and growing these relationships comes down to the consistency and quality of strategic support, not just at renewal, but throughout the year.
CRC Benefits connects large group advisors with account management resources that stay engaged between renewals, access to clinical and pharmacy strategy expertise, analytical support that helps translate claims data into actionable conversations, and carrier relationships across fully insured, self-funded, and level-funded markets. These are the conversations CRC Benefits is built to support.
Connect with the CRC Benefits large group team to see what a more strategic client relationship could look like.
CONTRIBUTOR
Yun Mei Chalif is Large Group Director for CRC Benefits. With nearly two decades of experience and a broker-first mindset, she is the kind of advisor partner who believes the real work starts after the renewal closes.
ENDNOTES
- HR Dive. “Daunting healthcare costs exceed employer projections and could hit employees, analysts say.” Aug. 21, 2025. https://www.hrdive.com/news/daunting-healthcare-costs-exceed-employer-projections/758302/
- PwC. “Medical Cost Trend 2027: Behind the Numbers.” 2026. https://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html
- Business Group on Health. “2026 Employer Health Care Strategy Survey: Executive Summary.” August 2025. https://www.businessgrouphealth.org/resources/2026-employer-health-care-strategy-survey-executive-summary
- Leader’s Edge Magazine. “Data Access Opportunities for Self-Insured Employers.” July 2025. https://www.leadersedge.com/healthcare/data-access-opportunities-for-self-insured-employers
- Captive Resources. “Using Claims Data to Execute Your Health Plan Strategy.” May 2026. https://www.captiveresources.com/insight/using-claims-data-to-improve-health-plan-strategy/
- UnitedHealthcare. “2026 Health Trends Report.” May 2026. https://www.uhc.com/agents-brokers/employer-sponsored-plans/news-strategies/annual-health-trends-report
- Carrum Health. “Why Drug Prices Are So High and What Employers Can Do.” January 2026. https://carrumhealth.com/blog/specialty-care-drug-prices/
- UnitedHealthcare. “2026 Health Trends Report.” May 2026. https://www.uhc.com/agents-brokers/employer-sponsored-plans/news-strategies/annual-health-trends-report