When was the last time you truly went back to the drawing board?
Health insurance is one of the largest expenses most companies face — yet many still treat it as a passive, check-the-box exercise each year.
At TBC Benefits, we believe your health plan deserves the same strategic attention you’d give to hiring, pricing, or operations. That means looking deeper at cost drivers, getting feedback from your people, and evaluating whether your current model still fits your business — or if there’s a better path forward.
When was the last time you went back to the drawing board to explore what’s possible — not just what’s familiar?
If it’s been a while (or never), here are five signs your benefits plan may be stale — and what you can do about it.
1. You’re Always Dreading Renewal Season
If renewal time feels like déjà vu — another double-digit increase, another scramble to shift costs — you’re stuck in reactive mode.
TBC Insight: We help employers take control by starting renewals early, analyzing claims trends, and exploring funding alternatives — so you’re not just reacting to carrier decisions.
2. You Haven’t Explored Models that Offer More Control
Traditional insurance plans have their place — but they often leave employers with limited insight or influence over costs. If you haven’t looked into Reference-Based Pricing, Direct Primary Care integration, or alternative funding models (like level-funded or self-funded plans), you could be missing opportunities to contain costs without cutting value.
Many small and mid-sized businesses assume that self-funded plans aren’t a fit — but that’s not always true. If you have a relatively healthy group and you're willing to engage your employees through education and smarter care access, a level-funded or self-funded model could offer better value, more transparency, and even refund opportunities.
TBC Insight: We help employers evaluate their risk tolerance, claims profile, and plan goals to determine if a more “aggressive” cost-control model makes sense — and guide them every step of the way.
3. Your Plan Isn’t Built on Data or Feedback
If your plan hasn’t changed in years — and you’ve never surveyed your employees or reviewed claims analytics — you’re likely overpaying for things that don’t matter and under-serving the things that do.
TBC Insight: We use customized employee surveys and population-level data to design plans that are efficient, responsive, and aligned with what your team values most.
4. You’re Paying More but Getting Less
Premiums are going up. Deductibles are going up. And employees are still frustrated. Sound familiar?
TBC Insight: Modern models — like Direct Primary Care integration or transparent pricing strategies — can improve access and satisfaction while reducing total claims spend over time. It’s about building a smarter ecosystem, not just shifting costs.
5. Your Broker is Managing — Not Strategizing
If your broker’s role ends at renewal, you’re missing out on real strategic partnership.
TBC Insight: We help small and mid-sized businesses take control, whether they want a traditional plan with smarter tools or a fully reimagined strategy. We offer technical expertise, alternative models, and year-round support.
Final Thoughts:
Many smaller employers assume they’re too small for sophisticated strategies — but that’s no longer true.
Today’s market offers options that used to be reserved for large groups — from level-funded plans to custom pharmacy programs to Direct Primary Care integration — that give employers more control over costs and a better experience for employees.
The key is understanding where you fall on the “control spectrum” — from fully passive to fully engaged — and building a strategy that matches. That’s what we do best at TBC Benefits.
Let’s go back to the drawing board — with data, creativity, and a fresh perspective.
Contact us | Let’s talk benefits
FAQ: Is Your Benefits Plan Stale?
| What does it mean for a benefits plan to be “stale”? | A stale plan is one that hasn’t evolved with your workforce’s needs or rising healthcare costs. It likely hasn’t been re-evaluated using data or employee feedback and continues using the same structure year after year, regardless of performance. |
| How can I tell if a self-funded or level-funded plan is right for my business? | These models can be a great fit for businesses with a relatively healthy employee population and a willingness to engage employees in smarter healthcare decisions. TBC Benefits evaluates your claims data, risk profile, and goals to determine if it's the right fit. |
| What are some alternatives to traditional insurance plans? | Options like Reference-Based Pricing (RBP), Direct Primary Care (DPC), pharmacy carve-outs, and level-funded/self-funded models can reduce costs and improve transparency while maintaining or improving employee satisfaction. |
| How does TBC Benefits support clients year-round — not just at renewal? | We provide strategic planning, plan design, employee engagement support, claims analysis, and funding model evaluations throughout the year — so you’re not reacting at renewal time, you’re leading. |
| Can I switch brokers before my renewal date? | Yes — and doing so gives us time to help you build a better plan well before renewal season. You don’t have to wait to get better service or smarter strategies. |