Renewal Season Playbook: Building a Defensible Plan Migration Strategy
By the PlanVantage engine teamPublished April 23, 20263 min read
Renewal season is when benefits consulting work is judged. Every other engagement leads to it. This playbook is the workflow that separates an analysis a client trusts from one they second-guess.
Phase 1: Data Intake (T-120 to T-90 Days)
Renewal recommendations are only as good as the data underneath. The intake checklist:
- • Current plan documents (SBCs, full plan documents, rider docs)
- • Current rate sheets by tier
- • Current contribution schedule by tier
- • 24+ months of paid claims (if self-funded)
- • Enrollment census with date of birth, gender, tier, zip
- • Stop-loss policy with attachment points and any lasers
- • High-claimant report (de-identified)
- • Pharmacy utilization detail (top 50 drugs by spend)
- • Network access fees and admin fees
The fastest way to lose a renewal is to discover a data gap two weeks before the board meeting. Run the intake checklist before quoting the engagement timeline.
Phase 2: Baseline Modeling (T-90 to T-60 Days)
Before scenarios, you need a defensible status-quo baseline. That means:
Re-rate the current plan with the renewal's trend assumptions. The carrier's quoted renewal is one number; your independent re-rate is your sanity check.
Compute actuarial value on every plan in scope so relative richness is comparable in a single metric.
Project enrollment migration. If the plan lineup changes, where do current members go? Write down the migration assumption and its rationale before you build scenarios.
Phase 3: Scenario Development (T-60 to T-30 Days)
A defensible scenario set has structure. Three scenarios with a clear rationale beats eight ad-hoc ones:
Status Quo
Carrier's renewal, no design changes, no contribution change. The "do nothing" budget.
Cost-Targeted
Plan design changes to hit a specific employer-cost target (typically the prior year's budget plus inflation).
Strategy-Driven
Aligned with the client's stated benefits philosophy (e.g., HDHP-forward, recruiting-competitive, equity-focused).
Every scenario should include: total employer cost, total employee cost, employee cost by tier, AV by plan, and a one-line summary of the rationale.
Phase 4: Contribution Strategy (T-30 to T-15 Days)
Once the plan designs are selected, the contribution strategy is the second-most consequential decision. The minimum work:
- • Year-over-year change in employee monthly cost, in dollars, by tier
- • Affordability check against payroll for the lowest-paid employees
- • Migration projection: who moves between plans under the new contribution
- • ACA affordability safe-harbor check for full-time employees, a compliance step outside the model
Phase 5: Presentation (T-15 to T-0)
The deck that lands is the one organized around the client's decision, not the consultant's process. Recommended structure:
Slide 1: One-page summary of current vs. recommended, in dollars.
Slide 2: What changed at the carrier (claims experience, trend, plan-specific drivers).
Slide 3: Scenario comparison, three options side by side.
Slide 4: Employee impact, tier-by-tier change in monthly cost.
Slide 5: The recommendation, with rationale.
Appendix: Everything else, including AV detail, plan-by-plan rate cards, migration assumptions, and methodology notes.
Key Takeaways
A renewal isn't a spreadsheet. It's a decision framework. Get the intake right, model the baseline before the scenarios, give the client three real options instead of eight cosmetic ones, and lead the presentation with the dollar impact. The consultants who keep clients for a decade are the ones whose recommendations are still defensible three renewals later.