Every renewal conversation with a small group ends in the same place: the premium goes up, or the deductible does. Usually the deductible. The employees feel that one later, when a bill arrives.
Quick answer
The renewal squeeze
KFF's 2025 employer survey put average annual premiums at $9,325 for single coverage and $26,993 for family, up 5% and 6% in a year, and 26% for family coverage over five years. Small employers absorb that by moving more cost to employees, and level funding has become one of the main tools: 37% of covered workers at firms with 10 to 199 workers are now in level-funded plans.
The plan design works. The employee experience is what suffers. More of each bill lands on the employee, and the bills themselves are no easier to read than they were.
Where bill support fits
Most of what a broker brings to a small group works on plan dollars: plan design, the stop-loss attachment point, network and pharmacy. Medical bill support works on the other side, the dollars the employee owes after the plan has paid. It checks the bill, applies for hospital financial assistance, helps with denial appeals and talks to the provider.
For a broker it has three things going for it:
- It answers the complaint you hear at renewal. "Our people can't afford to use the plan" is a hard thing to fix with plan design alone.
- It doesn't touch the plan. No change to the claims administrator, network or stop-loss.
- It is visible. Employees remember the benefit that dealt with their ER bill.
What it doesn't do
Be careful how you position it, because the client will hold you to it:
- It doesn't lower premiums or plan spend. It works the employee's balance, not the claim.
- It doesn't adjudicate, reprice or edit claims, and it isn't a replacement for claim audits or cost containment.
- It doesn't give HR access to anyone's bills. The client gets aggregate reporting.
Our piece on the bills employees pay goes further into where plan cost containment stops and the employee's share starts.
How to bring it to a client
- Ask HR one question. "How often does someone come to you with a medical bill?" If the answer is never, move on. If it is "all the time", you have the conversation. Our article on what HR can do when an employee asks for help is a useful thing to send.
- Check what they already have. An EAP or navigation line may already handle some bills. Ask how far.
- Propose a short pilot. A defined population, a fixed period and an agreed report, so the client can judge it on use and outcomes.
- Review it at renewal. The pilot report gives you something concrete to bring to the next meeting.
Questions to ask a vendor
Before you put any vendor in front of a client, get written answers to these. The full list is in our vendor checklist.
- Which bills qualify, and is there a minimum balance?
- Who contacts the provider: a person, or a letter generator?
- What does the employee pay, and what does the client pay?
- How is a saving counted, and is there a guarantee?
- What exactly does the client see?
- What does launch take from HR?
mediloop works with brokers on exactly this: the broker introduces it, and the scope, pilot and reporting are agreed with the employer. Details are on the broker page.
Sources
- KFF, 2025 Employer Health Benefits Survey
Average annual premiums in 2025 reached $9,325 for single and $26,993 for family coverage, up 5% and 6% in a year and 26% for family coverage over five years. 67% of covered workers are in self-funded plans, 37% of covered workers at firms with 10 to 199 workers are in level-funded plans, and 53% of covered workers at those firms face a general single deductible of $2,000 or more.
Sources last checked 3 November 2026. Medical billing rules change, so if you spot something out of date, tell us and we will correct it.
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