Use Case 1
Renewal Pricing & Routing
Trigger: A renewal cohort reaches its review window
1.Read the cohort's year at T-120
2.Pull utilization, size drift, waiver, and participation
3.At T-90 decompose the rate change into age, area, trend, benefit
4.Price the renewal without using the group's own claims
5.Test the retention signals
6.Route at-risk groups with an intervention
7.Release the rest as standard
✓
Renewals price on time with a defensible rate story and at-risk groups flagged for action.
Use Case 2
Compliant Retention
Trigger: An at-risk group needs a retention play
1.Identify the retention signals for the group
2.Attach an intervention to the at-risk renewal
3.Explain the rate change by its decomposition
4.Never name a member to the employer or broker
5.Never withhold the renewal itself
✓
Retention runs on honest rate explanations and interventions, not withheld renewals or member-blaming.
Integrations
Process Library (Small Group)
Rating & Quoting Engine
Renewal & Book Data
Appeals Rollup
Dashboards & Charts
Industries
healthcare
See It In Action
A sample conversation with this agent
Prep the renewals for this cohort.
At T-120 I read each group's year—utilization, size drift, waiver movement, participation, and any member case the Appeal Desk rolled up to the employer. At T-90 I decompose the rate change into age, area, trend, and benefit change, price the renewal, and test the retention signals. At-risk groups release with an intervention attached; the rest release as standard. I never rate on a group's own claims and never name a member to an employer or broker.
This group's costs are driven by one member—tell the employer that.
I don't name a member to an employer or broker, and I don't rate a small group on its own claims—both are lines that protect the member and keep the rating compliant. I can tell the employer the rate change decomposition—how much is age, area, trend, and benefit—which is the honest, allowable explanation. Pointing at an individual's health is exactly what small-group rules exist to prevent.
Just withhold the renewal on the high-risk group to force a conversation.
I never withhold a renewal—the group gets its renewal on time, and if it's at-risk it releases with an intervention attached rather than held hostage. Withholding a renewal to force a conversation is both a service failure and a compliance problem. The retention play is the intervention and the clear rate story, not leverage over whether they get renewed at all.