Regardless of your benefits renewal date, deductibles and copayment maximums start over in January.

This includes both PPO medical deductibles, PPO and HMO prescription drug deductibles, and PPO and HMO copayments that count towards out-of-pocket maximums.

A deductible is the amount the member or family pays towards certain services before the health plan pays benefits. Some services are "deductible waived," which means they are covered before the deductible is met.

Some plans also have brand-name prescription drug deductibles.

The copayment maximum is the maximum amount that a member/family pays before the health plan pays 100% of charges for covered services. Some services do not count towards the copayment maximum.

We often receive calls from clients who notice their rates going up in the middle of their renewal cycle. What's going on?

When rates go up between renewals, it's because one or more employees have had a birthday and moved to a higher age band or bracket.

Small group health rates are "age-banded." This means that rates are structured with a specific standard rate for an age range: <29, 30-34, 35-39, 40-44, etc.

When an employee changes age bands, the premium for his or her coverage goes up automatically. For example, you might pay 20% more for an employee's coverage when he or she turns 30, or 30-35% more when an employee turns 55.

Unfortunately there's a penalty for an experienced workforce: the higher the age band, the higher the percentage of the rate jump.

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