So, how can you offer meaningful benefits without overcomplicating or overspending?

When premiums rise, many employers feel forced to either raise deductibles or reduce coverage. But there’s a better way: reallocate spending to where it matters most. It’s not about spending more. It’s about spending smarter.

Here are a few solutions to help you build a better plan for your people, without breaking the bank.

1. Switch to a Third-Party Administrator (TPA)

TPAs are independent organizations that manage your group benefits plan separately from a traditional insurance carrier. They give you more flexibility to design and fund your plan your way. Transitioning to a TPA allows you to switch insurance partners seamlessly without disrupting your employees’ experience. It can also lead to premium savings and reduce the administrative burden on your HR team.

2. Align Long-Term Disability coverage with EI

Some employers aren’t aware that their Long-Term Disability (LTD) coverage may overlap with Employment Insurance (EI) sickness benefits. Currently, EI sickness benefits last up to 26 weeks. If your LTD plan kicks in after 17 weeks, that’s 9 weeks of overlap. You’re essentially paying for LTD coverage your team doesn’t need. By adjusting the elimination period to 26 weeks, you eliminate the overlap and potentially lower your premiums.

3. Review Your Funding Model

Are you fully insured? Self-funded? Hybrid? Your funding model plays a major role in how much you pay and how much flexibility you have.

Here’s a quick overview:

• Fully Insured: You pay a fixed premium, and the insurer covers the claims. It’s predictable, but can be more expensive if your team’s claims are low.
• Self-Funded: You pay for claims directly, often with support from a TPA. There’s more flexibility and potential savings, but also means you take on more risk if claims are high.
• Hybrid: A mix of both. You cover smaller, predictable claims and insure against large or unexpected one.

Each model comes with its own pros and cons. Exploring options like self-funding or hybrid models can offer greater efficiency, better control over costs, and the same great coverage your team relies on.

4. Make Targeted Plan Design Adjustments

A few thoughtful tweaks can help you reduce unnecessary costs without sacrificing the coverage your employees actually value.

Here are some ideas to consider:

• Introduce co-pays. Ask employees to contribute a small portion toward services. This encourages thoughtful use of benefits while reducing your overall costs.
• Add reasonable maximums. Set annual or lifetime limits on high-cost items, like orthotics or paramedical services, to prevent runaway claims.
• Use Health Care Spending Accounts (HSAs). These flexible accounts allow employees, especially part-time staff, to choose how to spend their health dollars, without increasing your fixed costs. Learn more.

The goal? Spend less on benefits that go unused, and more on what really matters to your team.

RELATED: Must-Haves for a Winning Employee Benefits Plan

From Theory to Practice: Two Organizations Who Made It Work

Wondering if these ideas actually work? Here’s how our team of specialists at PROLINK helped organizations to save money without compromising care.

1. Two Classes, One Solution

THE CHALLENGE

A logistics company had two groups of employees after a merger. Class A, from the acquired company, had more generous benefits than Class B, existing employees, who made up most of the staff. The disparity between the two plans caused tension. Class B employees wanted better coverage, and eventually, both plans were merged into one. But the new, enhanced plan drove rates up significantly. On top of that, one employee started claiming a specialty drug costing $22,000 per year, putting even more pressure on the budget.

THE SOLUTION

Our team reviewed both plans in detail and consulted with the company to understand the needs of each employee group. From there, we designed a plan that enhanced high-value benefits—like vision, dental, and paramedical services—for everyone. To reduce long-term costs, we carved out high-cost specialty drugs from the group plan, but ensured the employee already on the medication was transitioned to an alternate coverage program with no disruption in care.

THE RESULT

 The organization saved over $97,000 annually. Employees were happier with their coverage, and the organization gained long-term rate stability.

2. When One Claim Affects Everyone

THE CHALLENGE

A not-for-profit organization was facing a 35% increase in their employee benefits plan premium during its annual renewal. After some negotiation, they managed to reduce it to 23%. Better, but still well beyond their budget. A single high-cost drug claim, made by one employee’s spouse, was driving the increase.

THE SOLUTION

Our team took a step back and reviewed the full plan structure and claims history. We uncovered the reason for the increase and reworked the coverage to exclude specialty drugs from the plan. But we didn’t leave anyone behind. We helped the employee access the medication through a separate program so their care continued uninterrupted.

THE RESULT

 The organization saved $35,600 per year and reinvested the savings into improving their plan by increasing mental health support and adding major dental coverage.

Why Working with a Specialist Matters

The case studies above aren’t one-off wins. They’re proof of what’s possible with a strategic, proactive approach to benefits planning.

At PROLINK, we don’t just look for ways to cut costs. We help you reimagine your plans so they work better for your team, your budget, and your long-term goals. That means making thoughtful adjustments, not just slashing benefits or raising deductibles. And because no businesses are alike, we take the time to understand your team, your resources, and your business goals before we ever make a recommendation.

Working with a specialist broker like PROLINK means:

• Expert guidance on plan design and compliance;
• Access to competitive market comparisons;
• Comprehensive Third-Party Administration (TPA) Services to help you manage your plan efficiently and with less hassle;
• Protection from compliance risks that could derail your plan;
• A partner who can help you adapt when the unexpected happens.

Solving a Rubik’s Cube blindfolded is tough—doing it alone is tougher. But with the right guide, you don’t just fumble your way through. You solve it with purpose.