> Before I worked for a contractor and we cost THEM a million bucks Was this a large group insurance plan (usually 50+ or 100+ employees depending on the state

> Before I worked for a contractor and we cost THEM a million bucks Was this a large group insurance plan (usually 50+ or 100+ employees depending on the state)? If it were a small group insurance plan I don't believe your utilization would increase the rates, since AFAIK all the small groups in one state/region and insurance provider are combined. If the employer was large enough to have a large group insurance plan, but still fairly small, I suppose one person's utilization could noticeably increase rates at the next plan negotiation. I believe this is why some companies that are too big for small group insurance plans utilize "professional employer organizations" to participate in a larger risk pool.