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A good benefits renewal should answer three simple questions for an employer: what changed, what drove the change, and what choices do we have now. That matters because the Canadian market is under real pressure. The Canadian Life and Health Insurance Association said insurers paid $53.3 billion in health claims in 2024, up from $48.2 billion the year before, and that paramedical claims such as mental health and massage rose 16%, which was the fastest-growing health category named in the release. [1]
But a higher renewal does not automatically mean a plan is being misused. Canadian renewal pricing is shaped by several moving parts, including the group’s own claims experience, the insurer’s manual or “book” rates, trend assumptions, reserves for claims incurred but not yet reported, pooling charges for high-cost claims, and the Target Loss Ratio or TLR. These factors affect renewals across insurers, and it notes that lack of transparency around some adjustments can make renewals hard for employers to decode.
That is why transparent renewals matter. When the renewal clearly shows claims, fees, TLR, reserves, pooling, and trend, an employer can tell whether the increase is being driven by real claim pressure or by pricing assumptions and noise. Beneplan’s public materials lean into exactly that kind of scrutiny. The company tells employers to ask for the TLR, trend factor, reserves, premium calculation, commission, refunds, and other fees, and it markets a model where surplus can be refunded rather than simply retained. [3]
For Beneplan specifically, two public facts are clear. First, Beneplan says it publishes annual reports on a public transparency page. Second, its 2025 annual-report announcement says $2.54 million in dividends was payable to member-owners based on 2025 benefit-plan surpluses, which is consistent with the rounded $2.5 million figure provided for this article. I did not locate a public primary source confirming the separate company-provided figure that Beneplan achieved 3.8% renewal increases across its full book, so that number should be treated here as Beneplan internal data supplied for this article, not as a publicly verified statistic. [4]
What changed in Canada
The biggest national change was simple: claims got larger. CLHIA said total health claims reached $53.3 billion in 2024, compared with $48.2 billion in 2023. Prescription drugs remained the largest health-benefit item at $16.6 billion, while paramedical services such as mental health and massage were the fastest-growing area mentioned in the release, rising 16% in 2024. In plain language, that means employer plans were hit both by broad cost growth and by especially strong use of services that employees often access more frequently and more directly than large one-time hospital events. [1]
For employers, the practical takeaway is that “health claims are up” is too vague to be useful. A renewal should show which line moved. Was it drugs, dental, massage, counselling, vision, or something else? Trend factors can reflect standard inflation, increased use of services, cost-shifting from provincial plans to private plans, new drugs entering the market, and dental fee-guide adjustments. If all of that is rolled together without explanation, a plan sponsor cannot see the true issue.
That is also why line-by-line reporting matters more in 2026 than ever. If paramedical claims are the growth leader nationally, an employer should not assume every benefit category is equally responsible for a renewal. A transparent report can isolate the real pressure points and prevent blunt, across-the-board cuts that solve the wrong problem. [5]
What really drives a renewal
At a basic level, Beneplan describes experience-rated benefits in plain terms: premiums = employee claims + insurer fees. That is useful because it cuts through the jargon. If paid claims move up, premiums usually move up. If fees or assumptions are aggressive, premiums can also move up even when claims are not the whole story. [6]
The fuller Canadian picture is more detailed. There are seven key renewal factors: credibility of claims experience, manual rates, weighting of prior years, trend factors, IBNR reserves, pooling charges, and TLR. In other words, the renewal is not only about “how much your employees claimed.” It is also about how much trust the insurer puts in your group’s own data, how the broader block of business is priced, how much reserve is built in for delayed claims, how catastrophic claims are pooled, and how much of each premium dollar is expected to go to claims versus expenses and margins.
TLR is one of the clearest examples of why transparency helps. If the TLR is 80%, the insurer expects about 80 cents of each premium dollar to pay claims, while the balance covers administration, commission, claims-paying costs, profit charge, and premium tax. Beneplan’s own explainer similarly says TLRs commonly fall in a range around 70% to 83% and that a higher TLR generally means more premium dollars are going to claims instead of overhead. A renewal that hides or glosses over TLR makes it much harder for an employer to judge value. [7]
IBNR is another important source of confusion. Beneplan explains that “incurred” claims are higher than “paid” claims because they include claims that have been incurred but not yet reported. Its article argues that some insurers base renewals on incurred claims using higher IBNR estimates, while Beneplan says it targets IBNR to 8% of paid claims and bases renewals on paid claims. Whether or not an employer agrees with every part of that argument, the broader point is sound: a renewal should show whether the increase is being driven by actual paid claims or by estimated reserves. That is exactly how transparent renewals separate signal from noise. [6]
Beneplan’s own negotiation guide makes the same point from an employer angle. It tells plan sponsors to ask: What is our TLR? What trend factor is being used? What reserves are built in? How are premiums calculated? How much commission is being paid? If claims are low, do we get a refund? What other fees are not explicitly stated? Those are not small details. They are the core test of whether a renewal is really evidence-based. [8]
What choices employers have
The first choice is better information. A renewal meeting should not start with “your rate is going up.” It should start with a simple breakdown of paid claims by category, recent trend by category, TLR, IBNR or reserve assumptions, stop-loss or pooling charges, and the portion of the renewal coming from your own claims versus book-rate blending. Employers should be aware of these factors and feel empowered to ask questions, and Beneplan explicitly encourages that kind of disclosure. [9]
The second choice is plan design, especially in categories showing the most pressure. If paramedical services are rising faster than the rest of the market, employers can review annual maximums, frequency limits, and whether support is best delivered entirely through insured coverage or partly through a spending account.
The third choice is targeted cost management instead of broad cuts. Beneplan’s perks page says its Drug Assistance Program helps employees access government support for prescription costs and helps avoid major premium increases at renewal. That matters because very high drug costs and claims above pooling thresholds can distort the whole renewal. An employer that tackles a few concentrated cost drivers can often protect the wider plan. [11]
The fourth choice is funding structure and surplus treatment. Beneplan’s refund model says that if claims and fees are below premiums, the member is entitled to a refund, and if claims exceed premiums, the co-operative covers the deficit. Economically, that means surplus can come back to the employer instead of always remaining with the insurer, which lowers the employer’s net effective premium as an inference from the refund. Beneplan also notes that employers wanting greater direct control over surplus can consider self-insured or ASO-style funding for health and dental. [12]
How Beneplan can help lower renewals
The Beneplan value story, based on its public materials, has three parts. First, it says it prices on claims experience and aims to provide very competitive rates. Second, it emphasizes public transparency through annual reports. Third, it offers a co-operative refund model so surplus can be returned to members rather than automatically retained. Those features directly address the two biggest employer complaints about renewals: “I don’t understand what drove this” and “if we overpaid, where did the money go?” [13]
The company’s more specific renewal argument is also clear in its educational content. Beneplan says employers should scrutinize TLR, trend, reserves, commissions, and premium calculations; it says renewals should focus on paid claims rather than inflated incurred-claim estimates where possible; and it publicly promotes refunds when claims plus fees come in below premiums. It also says its Drug Assistance Program can help avoid steep renewal jumps tied to prescription costs. Taken together, that is a practical playbook for lowering or stabilizing renewals without relying on guesswork. [14]
The strongest publicly verifiable Beneplan number in the research is the surplus/refund figure. Beneplan’s 2025 annual-report announcement says $2.54 million in dividends was payable to member-owners from 2025 surpluses. That supports the article’s point that a surplus, if refunded, reduces the employer’s effective net premium. The 3.8% full-book renewal figure, by contrast, should be presented carefully as a Beneplan-supplied internal metric because I did not find a public primary source that independently confirms it. If that internal figure is accurate, it would suggest Beneplan turned a hard claims market into a much smaller average renewal outcome than many employers fear when reading a broad market headline. [15]
For employers, the best immediate move is to ask for a renewal template that always shows the same core fields: Premium to Claims by LOB for the year, TLR, trend, IBNR, pooling, fees, and refund position. For us at Beneplan, the most useful conversation is not “Can you beat this rate?” but “Show me the renewal math, show me where surplus goes, and show me which claim categories are the real problem.” Those are the questions most likely to produce better plan decisions.
[1] [5] [10] Claims in Canada rising: $143.3 billion paid to help keep ...
[3] [8] [14] Beneplan - How to Negotiate your Benefit Premiums [small business guide]
https://www.beneplan.ca/blog/how-to-negotiate-your-benefit-premiums
[4] [15] Beneplan Annual Report 2025
https://www.beneplan.ca/blog/beneplan-annual-report-2025?utm_source=chatgpt.com
[6] Beneplan - Top 5 Tricks Insurers Use To Make Benefit Plans "Appear" More Affordable
https://www.beneplan.ca/blog/top-5-tricks-insurers-use-to-make-benefit-plans-appear-more-affordable
[11] Beneplan - Free Health Perks For Your Employees
[12] [13] Beneplan - Refunds On Employee Benefit Premiums
https://www.beneplan.ca/refunds
