M&A Read

What benefits issues should we look at during an acquisition?

An acquisition is the moment benefits get messy. Two plans, two renewal dates, two sets of employees comparing what they had. It's also one of the best moments to restructure, because everyone already expects change, and a private equity sponsor is watching every line that touches EBITDA.

Before close. Benefits diligence is too often a last-minute checklist item. The questions that matter:

  • How is the target's plan funded, and are there self-funded run-out liabilities or stop loss gaps that come with it?
  • Who are the large claimants, and how will they affect the combined plan's renewal?
  • Are plan documents, SPDs, and compliance filings current?
  • Are there executive benefit promises, severance, or retiree commitments buried in employment agreements?
  • What does the target's broker get paid, and does anything trigger on a change of control?

A hidden liability found after close becomes the buyer's problem.

After close. Most buyers eventually move everyone to one plan. Move too fast and you create employee anger, especially if one group loses a richer plan. Move too slow and you run duplicate vendors and duplicate renewals. Set a target date, model cost and employee impact for each group, and communicate early.

The opportunity. Combining two groups often creates enough size to consider self-funding or a captive for the first time. For a buy-and-build, build the plan to absorb future add-ons, so you're not rebuilding it with every deal.

Questions to ask

  • What benefits liabilities did diligence uncover, and how were they priced into the deal?
  • What is our target date and plan for moving everyone onto one plan?
  • Can our current contracts add new acquisitions without a new renewal?

More answers

  • Renewals

    How do underwriters actually price our renewal?

    Your renewal is a number the carrier decides, not one it simply calculates. The underwriter projects your claims, adds trend, blends in a manual rate based on credibility, applies pooling charges for large claims, then adds retention for admin, taxes, commissions, risk, and profit. Every one of those inputs has a range, which is why two carriers can look at the same data and come back 15 percent apart.

  • Renewals

    When should we start working on our health plan renewal?

    Five months or more before the effective date. Requests for quotes typically go out three to four months before renewal for fully insured groups and four to five months out for self-funded and captive groups, because stop loss quotes and lasers depend on current large claim detail. Most renewals fail because they start 60 days out.

  • Renewals

    Why did our renewal go up when our claims were good?

    If you are fully insured, very little of your renewal is based on your own claims. It is driven by a large, generally unhealthy risk pool, and when your claims come in under what the carrier priced, the carrier keeps the difference. Changing how the plan is funded, even with the same carrier and plan, is often what fixes it.

All questions

Contact

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