Is Your Group Benefits Plan Working? 7 Signs It Isn't

By Ralph Gardner, Licensed Insurance Agent, Sterling Benefits · Kelowna, BC · Last updated November 10, 2026

Most business owners set up an employee benefits plan for good reasons: to look after their people, and to hire and keep good staff. Then the plan renews every year, the premium goes out every month, and nobody stops to ask whether it's actually doing that job.

The short answer: a group benefits plan is working when your team understands it, uses it, values it, and the cost makes sense to you. If staff don't know what they have, turn it down, or never mention it when you're hiring, or if you can't explain your own renewal, the plan likely needs a closer look. Here are the seven signs I watch for.

1. Do your employees actually use their benefits?

If hardly anyone submits claims, it's tempting to see that as savings. Usually it means one of two things: the plan covers things your team doesn't need, or nobody ever explained what's in it. A plan nobody uses is a cost with no return.

2. Are employees opting out or asking for cash instead?

When staff waive coverage, or ask whether they can have the money instead, they're telling you the plan doesn't match what they value. Sometimes they have coverage through a spouse. Often the plan design simply doesn't fit their stage of life.

3. Is your plan helping you hire and keep people?

Good candidates ask about benefits. If your answer doesn't land, or new hires seem unimpressed once they see the booklet, the plan isn't doing one of the main jobs you bought it for.

4. Does your renewal go up and nobody can explain why?

Renewals change for real reasons: your claims, the wider pool, medical inflation, or the way your plan is structured. If you get a new rate every year with no explanation, that's a service problem as much as a cost problem. I explain how the type of renewal drives your rate in The Three Types of Group Benefits Renewals, Explained.

5. Are claims a hassle for your team?

Slow repayments, paper forms, confusing denials. When claiming is painful, employees stop bothering, and a decent plan starts to feel worthless. How easy a plan is to use matters as much as what it covers.

6. Does one plan have to fit everyone?

A 24-year-old apprentice and a parent of three rarely want the same coverage. One design for everyone can leave half your team over-insured and the other half short. Employee classes, or a health spending account on top of a core plan, are common ways to give people coverage that fits.

7. Can you say what your plan costs per employee and what's in it?

If you, the owner, can't explain your own plan in a couple of sentences, your team can't value it either. Knowing your cost per employee, and the two or three things your plan does best, is where good decisions start.

What I see when I review plans

When I review a plan, I often see that it meets the needs of some of the team some of the time, but it isn't a good overall fit. Teams need a design flexible enough to include a broad mix of ages and needs. Offering employees a few plan design options to choose from often increases engagement and satisfaction with the plan.

My view: a traditional "one size fits all" plan doesn't always serve everyone, or the company, well. Offering staff a few options to choose from often costs less than you'd expect, and it can also open the door to adding a group RRSP.

What should you do if you see these signs?

Start with a review, not a replacement. Look at who is using the plan and for what, what your team actually values, and how your renewal is built. Then decide what to change.

If you'd like a second set of eyes, I offer a free plan review. Send me your benefits booklet and your latest renewal, and I'll show you what's working and what isn't.

Frequently asked questions

How often should I review my group benefits plan?

A review doesn't have to be as painful as a trip to the dentist. It can be done anytime, and with a proper review outline it's easy to assess. As a rule, review at least once a year, before your renewal date. A review is also worth doing when your team changes size or makeup.

Is low claims use a good thing?

Not always. It can mean a healthy team, but it can also mean the plan doesn't fit or employees don't understand it.

Can I change my plan without switching carriers?

Often, yes. Many changes, such as adjusting coverage levels or adding employee classes, can be made with your current carrier at renewal.

What if some employees want coverage and others don't?

That's common, and it doesn't have to be a problem. What matters most is that each employee understands the rules and ramifications of their options. Then they can make their decision. Plan design options such as classes or a health spending account can help, depending on your carrier and group size.

General information to help you think it through — personal advice starts with a conversation.

Sterling Benefits is an independent insurance brokerage. Ralph Gardner, Licensed Life & Accident and Sickness Insurance Agent.