Building Benefit Tiers That Actually Work

If there's one truth every benefits broker learns over time, it's this: No two employee populations are the same.

Yet, too often, we present benefit options as if they are.

We talk about "participation," "affordability," and "engagement," but we offer a single major medical plan and call it a strategy.

The reality is that approach is outdated, especially heading into 2026.

Today's employers need layered benefit tiers that meet employees where they are: financially, demographically, and behaviorally. And brokers who know how to build those layers are the ones who will win the next chapter of this market.

The Tiered Model: Good, Better, Best

At Evolved Benefits, we teach brokers to build every benefits strategy like a ladder:

Good: Minimum Essential Coverage (MEC) for everyone.

Better: Minimum Value (MV) for full-time employees who need more coverage.

Best: Major Medical for the core team, leadership, or union employees.

This structure doesn't just check the ACA box. It creates balance.

It gives employers flexibility, employees choice, and brokers the ability to deliver something few competitors can: a benefits strategy that actually fits.

A Real-World Example

One of our brokers in North Carolina was working with a large hospitality client: five hotel properties, roughly 480 employees total.

The challenge was clear. They couldn't afford to offer major medical to everyone, but they also couldn't risk non-compliance.

Our team helped them design a layered plan: ✅ MEC for all employees (even those working variable hours) ✅ MV for full-time, benefits-eligible staff ✅ PPO major medical for managers and executives

Here's what happened:

• Waiver rates dropped from 47% to 18%

• ACA exposure was eliminated

• Employee satisfaction increased (based on HR's exit surveys)

• The broker grew their revenue by 40% from the same group

That's what a working tiered model looks like in action.

Why Tiered Benefits Are Winning

The brokers who thrive in today's market understand that benefits aren't about products. They're about alignment.

Every workforce has layers: full-time staff who value depth of coverage, part-time or variable-hour employees who need affordable access, and high-turnover roles that require flexibility and simplicity.

A well-built tiered approach ensures no one is left out and no money is left on the table.

It turns your proposal from a spreadsheet into a strategic roadmap.

Breaking the "All or Nothing" Mindset

Too many employers still think, "If we can't offer major medical to everyone, we won't offer anything." That thinking made sense a decade ago, but not today.

The modern workforce expects inclusion. And the government expects compliance.

MEC + MV plans bridge those worlds perfectly.

They allow employers to say: "We care about everyone here, and we're compliant while doing it."

And that message is more meaningful than any plan document.

How to Position This to Clients

Here's how to introduce the tiered model:

Start with compliance. "Let's make sure you're offering coverage to 95% of your full-time employees."

Add affordability. "We know not everyone can afford $200 per paycheck. Let's layer in a low-cost MEC option."

Finish with flexibility. "For employees who want more, we'll include MV or Major Medical tiers."

When you lead with compliance and end with care, clients listen.

The Evolved Benefits Advantage

At Evolved Benefits, we help brokers implement tiered solutions that protect employers while driving organic revenue.

Our plans are built to fit almost any industry: staffing, hospitality, manufacturing, restaurant franchises, and transportation and logistics.

We help you analyze client data, identify participation gaps, and design strategies that are compliant, affordable, and scalable.

Because when brokers deliver balance, everyone wins.

Looking Ahead to 2026

The next wave of successful brokers won't be the ones chasing renewals. They'll be the ones re-engineering benefit programs.

By offering a layered solution, you're not selling insurance. You're building infrastructure. And infrastructure lasts.

So as you continue to guide your clients through Q4 2025 and into the new year, ask them: "Does your current benefits structure fit every layer of your workforce, or just one?"

Because in 2026, one-size-fits-all won't cut it anymore. But the brokers who master "good-better-best"? They'll own the future.