The Renewal Readiness Framework
Stop Reacting to Renewal Start Influencing It
Employers receiving 20%+ renewal increases are dealing with more than rising trend. They are dealing with decisions that were not made soon enough.
The Renewal Readiness Framework gives HR leaders, benefits teams, and finance executives a structured way to evaluate the four drivers shaping your next renewal— Cost, Care, People, and Risk—before Q4 pressure forces a reactive response.
What's Inside
Built for the Decisions That Shape Renewal Outcomes. This framework is designed for employers who want to move from managing renewal increases to understanding, and influencing, what is driving them.
Understand what is actually driving medical and pharmacy spend, before it shows up as a 20%+ increase. Including specialty drug strategy, PBM performance, funding alternatives (fully insured, level-funded, self-funded), and benchmarking your renewal against comparable employers by size, industry, and geography.
Identify the gap between the benefits available and the benefits used. Utilization gaps are cost gaps. Evaluate navigation tool adoption, telehealth integration, preventive care completion, and where delayed care is driving avoidable spend.
66% of employees are financially stressed, and it shows up in care decisions, engagement, and retention risk. Evaluate whether your benefits reflect the actual life-stage needs of your workforce today, not the plan design you inherited three years ago.
ERISA fiduciary scrutiny is expanding into health and pharmacy benefits. In FY2025, the DOL’s Employee Benefits Security Administration recovered more than $1.4 billion for benefit plans and their participants, with more than half tied to enforcement actions. Review vendor oversight, compliance documentation, and your plan governance posture before renewal.
Get the Insights You Need to Strengthen Renewal Readiness
Renewal outcomes are shaped long before the carrier delivers an increase. Explore the framework to understand how decisions across cost, care, people, and risk influence your benefits strategy, and what your organization can do now to prepare.
8–10% Projected Increase
OneDigital projects group health plan costs will increase between 8% and 10% in 2026.Greater visibility into high-cost claims, pharmacy utilization, and population health trends can help you identify opportunities before they become renewal increases.
52% of Employees
More than half of employees do not consider their medical plan competitive.Programs only create value when employees understand, trust, and use them. Is your engagement strategy helping employees take action?
56% Financially Exposed
More than half of employees say they could not manage a major unexpected expense.Financial pressure can affect healthcare decisions, productivity, engagement, and retention. Your benefits strategy should reflect the needs employees are managing today.
Independently Audited
OneDigital’s systems meet rigorous standards for security, availability, and confidentiality.Strong governance, documentation, and vendor oversight can help protect your organization from penalties, litigation, and operational disruption.
Frequently Asked Questions
Renewal readiness is the discipline of reviewing the decisions, data, and risks that shape renewal outcomes, before the carrier quote forces a reactive response. It includes evaluating healthcare and pharmacy spend drivers, employee benefit utilization, workforce needs, vendor performance, and plan compliance posture throughout the year, not just at renewal.
HR leaders, benefits directors, finance leaders, operations executives, and business owners involved in benefits strategy and renewal planning, especially those preparing for plan design changes, funding strategy evaluations, vendor reviews, or market checks.
Ideally, 90–180 days before your renewal effective date. Earlier if you are considering self-funded or level-funded alternatives, a PBM carve-out, or a market check. The framework includes a quarter-by-quarter calendar to guide the full year.
Cost (healthcare and pharmacy spend drivers, funding strategy, benchmarking), Care (utilization, navigation, telehealth, employee engagement), People (workforce needs, financial wellbeing, retention risk), and Risk (ERISA fiduciary governance, HIPAA compliance, vendor accountability, documentation).
No. The strongest renewal outcomes are built year-round. This framework is designed to be used as a 12-month operating cadence, with specific decisions mapped to each quarter.
Access Your Renewal Readiness Framework
