Your HMO renewal checklist: what to review before you sign again
Renewal is your best chance to fix what did not work this year. Here is what to check, who to ask, and when to start.
Many companies let their HMO plan renew without looking at it. That is a missed chance. Renewal is when you have the most leverage: you can ask for better terms, change tiers, or move to a different HMO.
When to start
Start two to three months before your renewal date. That gives you time to collect feedback, compare options, get sign-off and, if needed, switch without a gap in cover.
Step 1: Ask your staff
A short, anonymous survey tells you more than any report. Ask:
- Did you use the HMO this year? If not, why not?
- Was it easy to get care at your primary hospital?
- Did you ever wait a long time for a referral code?
- Were you ever asked to pay for something you thought was covered?
- Is your primary hospital convenient for you?
Step 2: Ask your HMO for a usage report
HMOs can share how much the plan was used, without naming individuals. Look for:
- How many staff used the plan. Very low use can mean people do not know how to use it.
- Which benefits were used most. This shows what your team really needs.
- Claims that were declined and why.
- Complaints and how quickly they were resolved.
Step 3: Review the renewal offer
| Check | What to look for |
|---|---|
| Price change | How much has the premium gone up, and why? |
| Benefit changes | Has anything been removed or capped lower? |
| Hospital list | Have any hospitals your staff use been dropped? |
| Headcount | Is the staff list correct? Are leavers removed? |
| Payment terms | Is there a discount for paying the year up front? |
Step 4: Compare the market
Even if you are happy, compare. You may find a similar plan for less, or a better plan for the same price. Having an alternative also gives you a stronger position when you negotiate with your current HMO.
Step 5: Decide, and tell staff
Whether you stay or switch, tell your staff what is changing. If you switch, give clear dates, explain how to register and choose a hospital, and make sure nobody is left without cover between plans.
Action plan
Your renewal action plan
- 1
90 days out: survey staff
Send a five-question anonymous survey about their experience with the HMO.
- 2
75 days out: request a usage report
Ask your HMO for usage, declined claims and complaints for the year.
- 3
60 days out: compare the market
Run your team profile on Yousure and shortlist alternatives.
- 4
45 days out: negotiate
Take your feedback and alternatives to your HMO and ask for better terms.
- 5
30 days out: decide and announce
Get sign-off, update the staff list, and tell your team what is changing.
