Renewal Season Is Over. The Smartest CFOs Are Already Fixing 2027.
It’s late October 2026. Open enrollment is underway, renewal decisions are largely on the table, and employees are choosing coverage for the year ahead. For CFOs and HR leaders at small and mid-sized companies, that can feel like the finish line.
It isn’t. It’s the point to start managing what happens next.
A renewal quote is a once-a-year snapshot, not a cost-control strategy. With self-funded health plans and level-funded health plans, employers can look at claims and plan performance throughout the year, then work with a third-party administrator (TPA) to respond. Instead of waiting for the next renewal to discover what drove costs, you can build a plan to monitor and address them as they emerge.
The opportunity is meaningful. Quilt Benefits offers up to 30% savings potential and reports 48% savings on large claimants. These are opportunities, not guaranteed results: your company’s experience depends on its workforce, claims, plan design, and contracts. The strategic advantage is 100% access to your plan's data — and acting on it year-round across every cost lever, not just at renewal.
Renewal sets the terms. Year-round action shapes the results.
The latest KFF Employer Health Benefits Survey reports that average employer-sponsored premiums increased 5% in 2026. That’s a national benchmark, not a forecast for your company. Your own renewal depends on factors such as workforce, location, plan design, and claims experience.
But one annual quote can’t tell you everything you need to know. It doesn’t, by itself, show which services are driving costs, whether a high-cost claim could benefit from earlier support, or whether the current network and plan design are the right fit for your employees.
A more effective approach is to use renewal season to set direction, then review performance throughout the year. That gives CFOs a clearer view of spending and gives HR a chance to improve the employee experience before the next enrollment window.
Self-funded vs fully insured: choose how you want to manage risk
In a fully insured plan, the employer pays a set premium for a defined period, while the insurer takes responsibility for covered claims. That can make monthly budgeting more straightforward. At renewal, though, the employer may have limited insight into the drivers of its costs and fewer ways to adjust the plan beyond changing benefits, networks, or employee contributions.
With self-funded health plans, the employer funds claims as they are incurred and typically partners with a TPA for plan administration. This structure can provide more claims visibility and flexibility, but costs can vary, and the employer needs to plan for that risk.
Stop loss insurance can help protect an employer against high individual claims or total claims above a contracted threshold. It is important protection, but it does not mean the employer has no responsibility for the plan. Specific and aggregate coverage, attachment points, exclusions, and reimbursement terms all matter. Review the contract carefully with qualified advisors.
Level-funded health plans offer another route. They generally bundle expected claims funding, administration, and stop-loss coverage into a set monthly payment. Depending on the contract, favorable claims experience may lead to a surplus or refund. Level funding can offer a more predictable payment structure while giving employers a way to explore greater claims visibility and plan flexibility.
For employers weighing health insurance for small business, the right option depends on risk tolerance, cash-flow needs, available data, and administrative support, not a one-size-fits-all rule.
Where the money hides in a self-funded plan
A renewal quote tells you what the plan cost. It rarely tells you where the money actually went — or where it could be recaptured. In a self-funded plan, the answer is usually five places:
Pharmacy transparency — rebates, spreads, and fees that never show up clearly in plan reports.
High-cost specialty drugs — the fastest-growing spend category in most plans.
GLP-1s — a drug class that can quietly dominate trend without a deliberate strategy.
Large claims — a handful of members who can drive a disproportionate share of total spend.
Stop loss — the protection layer that only works if it's managed as part of the plan, not bought and forgotten.
Because Quilt Benefits is a third-party administrator (TPA), not a benefits broker, we administer the plan end to end — which means we see 100% of your data and act on all of it, treating these five levers as one integrated process rather than five separate vendor conversations. The typical result: recapturing around 30% of benefits spend. (Network access, for what it's worth, is table stakes: your employees keep access to competitive national provider networks — that's a must-have, not a differentiator.)
Large-claim management shouldn’t wait for renewal
A small number of high-cost claims can have an outsized impact on plan performance. Yet renewal season often arrives too late to do much about the claims already shaping the year’s results.
A year-round approach starts with appropriate, privacy-conscious reporting and regular reviews with experienced partners. When permitted and appropriate, those reviews can help identify emerging cost drivers and opportunities for clinical support, care navigation, or more efficient care settings. The goal is not to interfere with medical decisions. It is to help members access appropriate care while managing avoidable cost where possible.
Stop-loss insurance is an important part of the financial protection strategy, but it is not the entire strategy. Employers should also understand their large-claim exposure, how their plan and administrator handle complex cases, and what support is available to employees.
Quilt reports 48% savings on large claimants through its approach to large-claim management and cost-containment solutions. Results vary by employer and plan experience; no savings figure is guaranteed. For a deeper look at practical considerations, see Quilt’s guide to managing high-cost claimants.
100% customization gives your plan room to evolve
Your workforce isn’t generic, so your benefits strategy shouldn’t be either. A TPA-led arrangement can give employers more flexibility to shape plan design, network strategy, and services around their employees and business priorities.
Quilt supports 100% plan customization within applicable requirements and contract terms. Through its Full Stack Benefits Platform, Quilt brings plan administration, analytics, and cost-containment solutions together — so pharmacy transparency, specialty drug management, GLP-1 strategy, large claim management, and stop loss all run as one integrated process, not five disconnected vendors. That gives CFOs more visibility into the plan and helps HR build benefits that can support employee needs and talent goals.
And this isn't a choice between your trusted advisors and a new way of running your plan. A good TPA and a good broker work well together: your broker advises on benefits strategy, while Quilt runs the plan day to day. You keep the guidance you already rely on and gain an administrator with no insurance sales and no commissions on your plan.
Benefits don’t have to be confusing. With the right partner, greater flexibility doesn’t have to mean greater administrative burden.
Start the 2027 plan now, and keep improving it
Open enrollment is a critical moment for employees, but it shouldn’t be the only time employers examine benefit costs. If your 2027 decisions are already in motion, use this period to set expectations, communicate clearly, and establish what data and support you’ll need once the plan year begins.
Then make ongoing review part of the strategy:
CFOs: Set a regular cadence for reviewing claims trends, funding, and stop-loss protection.
HR leaders: Track employee questions and access issues so you can address friction early.
Both teams: Revisit networks, plan design, and cost-containment opportunities as experience develops, not just when the next renewal quote arrives.
Whether you choose fully insured, self-funded, or level-funded coverage, the best health insurance for small business is a strategy you can understand and actively manage. Quilt partners with CFOs and HR teams to turn benefits data into practical decisions, with a focus on cost control, strong access to care, and a better employee experience.
The 2027 strategy starts now.Partner with Quilt Benefits to explore a plan built around your company, not just its next renewal.
Curious what your plan could save?
Tired of high renewal costs with no data visibility? Wondering whether fully insured, level-funded, self-funded, or reference-based pricing is actually the right fit for your company? Unlock the Quilt Benefits Employee Benefits Guide & Calculator: enter your details and generate a custom 3-year savings report for your plan in minutes.