The 120/90/60/45 day renewal calendar

Short answer. Work backward from the renewal date. At 120 days, ask for your claims report and clean up the census. At 90 days, take the plan to market. At 60 days, Texas law says the carrier’s written notice of any increase is due, and market pricing should be back. At 45 days, decide, so enrollment isn’t rushed. If you’re changing brokers, the broker-of-record letter should go through by 150 days out.

The calendar

What each step is for

150 days: the broker decision. If you want a different broker running this renewal, decide now. Broker-of-record change, explained.

120 days: get the data. Ask the carrier in writing for your claims report (how). Check the carrier’s enrollment against payroll, so you’re priced on the right people. Write down what this renewal has to do: hold the budget, change the contribution split, keep the network.

90 days: go to market. The same census, claims and plan go to other carriers, and to level funded or self funded options if they fit. Stop-loss basics.

60 days: line it up. Put the renewal and every alternative on one page, same census, same plan. How to compare a renewal to the market.

45 days: decide. Accept the renewal, negotiate it, or approve a change. Then it’s paperwork, not a scramble.

The two 45s

The 45 on this calendar is a planning target. The law has a different one: the insurer can’t require your answer before the 45th day after its notice (§1254.001(g)). If the notice arrives exactly 60 days out, that’s about 15 days before the effective date. That’s the floor. Don’t plan around it.

More on the rules: Texas renewal notice rules.

When should a company with 100 or more employees start its renewal?

About 120 days before the renewal date for the data, and earlier if you’re changing brokers. The claims report alone can take 30 days to arrive.

Why not just wait for the renewal letter?

It’s only due 60 days out (Texas Insurance Code §1254.001). Market pricing usually takes 20 to 25 days from submission, so waiting leaves little room to compare, negotiate, and enroll.

What if our plan year doesn't start January 1?

The calendar runs off your renewal date, whatever month it is. Count back from that date.

We're already inside 90 days. Is it too late?

Not always. If the census, claims and renewal are in hand more than 60 days before the renewal date, the market can still be tested. If not, negotiate this renewal as it stands and start the calendar now for next year.

Does the calendar change for level funded plans?

The steps are the same. Ask the administrator when the stop-loss renewal terms and the claims reports will arrive, and put those dates on the calendar.

I built and sold a health insurance agency: grew it to 60 agents in about 3 years, then sold it. Licensed insurance agent since 2014: Texas license 2501238, NPN 17369817.