HR Leaders Push for Strategic Benefits Partners as Renewal Cycle Fails to Control Costs

Healthcare premiums keep climbing, and for many employers, the response has been the same every year: compare a handful of plans, pick the least expensive, and repeat. As double-digit increases strain budgets across the United States, that cycle faces fresh scrutiny, and the brokers who have managed it are facing pressure to show what they are actually delivering.

Stephanie Porrino has sat on the employer side of that equation. The Founder and CEO of Empower Healthcare Insights and a speaker on healthcare innovation, Porrino spent years in HR leadership before turning her focus to benefits strategy. She sees the annual renewal cycle not as an inevitability but as a choice, and one that costs employers more than they realize. "Brokers just bring the same three or four solutions to the table every year, and you pick the best of the worst. That doesn't bend the cost curve."

• Double-standard spending: Most procurement decisions get scrutinized line by line, but healthcare has long operated under a different assumption. The inconsistency is a core part of the problem. "The increases have been unsustainable. Companies look at every line item when they procure something else, but with healthcare, there's this assumption that it's always going to go up. That shouldn't be the case," Porrino says.

• A different kind of partnership: The alternative to the renewal cycle is a model built on accountability, where advisers act as co-fiduciaries, establish measurable KPIs, and provide full compensation transparency beyond the Form 5500. That last point matters more than it might seem. Hidden compensation arrangements not captured in standard disclosure requirements can obscure what a broker is actually earning, making it difficult for employers to assess whether their adviser's incentives align with their own. "The brokers are really doing their friends and family members a disservice by bringing them the same things."

Changing the external advisory relationship is only part of the equation. HR departments are frequently handed a benefits strategy to execute without having had any meaningful input in shaping it. When benefits decisions are left to finance alone, workforce needs get deprioritized. When they are left to HR alone, the fiscal discipline can suffer. Closing that gap requires both functions to share ownership, with HR at the table alongside finance and the C-suite when consequential decisions about health spend are being made.

• Behind the curtain: That shift in perspective doesn't happen in the abstract. When her company was hit with a steep premium increase, leadership began exploring reference-based pricing as a way out. She pushed back at first, skeptical of a model she didn't yet understand. But once she took the time to learn it, the opaque system of network discounts and carrier pricing that had always felt off suddenly made a different kind of sense. "It's like seeing the wizard behind the curtain after years of looking at renewals and wondering what, exactly, they were doing," Porrino says.

Growing oversight from the Centers for Medicare and Medicaid Services means plan administrators carry real legal responsibility for how their health plans are managed. Too few HR leaders fully reckon with that, and the industry's habit of deferring to outside advisers has left many companies exposed. One structural fix is a dedicated internal healthcare strategist, someone whose job it is to manage benefits strategy year-round rather than treating it as an open enrollment exercise. Benefits decisions require the same ongoing attention as any other major operational function.

The pressure is building, but broad market change is far from guaranteed. More employers are beginning to explore alternative models, from self-funding to Individual Coverage Health Reimbursement Arrangements (ICHRAs), yet inertia remains a powerful force. Leaders who recognize the system is broken often hesitate to act because they have never managed a self-funded plan and are not sure where to start. Overcoming that hesitation requires both sides of the relationship to move. Employers need the courage to demand something different, and advisers need to fundamentally rethink what they bring to the table. For Porrino, the shift is inevitable. "A company can only sustain increases for so long before they say, we need to do something different."