The Real Cost of Waivers and the Revenue Hiding Inside Them
Every waiver form tells a story.
It's the story of an employee who looked at their paycheck, saw the cost of major medical coverage, and quietly decided, "I just can't do it."
For most employers, those waivers get filed away.
For most brokers, they get overlooked.
But we've learned that those waiver lists aren't a dead end. They're a map showing you exactly where to help.
The Hidden Impact of Waivers
Picture a mid-sized restaurant franchise group with 600 employees. Roughly 250 of them are full-timers who enrolled in major medical. The other 350 waived.
On paper, that looks like a participation rate issue. In reality, it's a compliance exposure and a revenue leak.
Those waived employees still count toward ACA calculations. If even a handful of them were full-time under the look-back rule, the employer could face §4980H(a) penalties.
At the same time, every one of those 350 waivers represents a lost commission, a missed enrollment, and a workforce left unprotected.
The Numbers Behind the Story
Let's run the math:
If just half of those waived employees enrolled in a MEC plan averaging $60/month, that's $10,500+ in new monthly premium. Over $125,000 annually.
That's fresh revenue for the broker, affordable protection for the employee, and compliance relief for the employer.
And that's from one client.
Multiply that by 10 similar groups in your book, and you start to see the scale of what's being left behind.
From HR Paperwork to Business Intelligence
Waiver forms shouldn't just be archived. They should be analyzed.
When we partner with a broker, we look at those waiver reports through three lenses:
Compliance risk: Are any waived employees counted as full-time under ACA?
Affordability reality: Is the major medical premium the real barrier?
Opportunity creation: Could MEC or MV coverage meet those employees where they are?
Nine times out of ten, the answer is yes. The same data that once represented loss can now generate growth.
Why Brokers Miss It
Many brokers assume waivers are just part of the game. They focus on the major medical renewal because that's where the big dollars are.
But Q4 2025 and the transition into 2026 will reward the brokers who think differently. Who see the unenrolled population not as "out of scope," but as the next layer of client service.
Because when you help your clients reduce waiver rates, you're not just adding premium. You're showing them you understand their business, their compliance risk, and their culture.
A Real-World Example
One of our broker partners in the Midwest inherited a manufacturing group that had 312 employees. 148 were uninsured.
We helped him design a MEC plan that cost the employer less than one potential ACA penalty.
Six months later:
Participation climbed to 92%
Employee satisfaction rose
The broker added nearly $70,000 in recurring annual revenue
All from the waiver list he used to ignore.
Turning Loss Into Leverage
Here's the mindset shift: Every waiver is an invitation.
It's your signal that something about the current offering doesn't work for that employee segment (price, access, communication, or relevance).
Instead of viewing waivers as failure, view them as feedback.
We often say: "Waivers don't end conversations. They start them."
The Playbook for Q4 2025
As you review renewals this season, build a simple three-step habit:
Pull the waiver report before the renewal meeting
Identify the patterns (part-timers, low-wage earners, high payroll deductions)
Offer a tiered solution with MEC as the foundation
It's a conversation that turns HR headaches into compliance wins, and lost revenue into recurring income.
The Takeaway
Brokers often tell me, "I wish my clients would stop sending me stacks of waiver forms."
My response?
"Be glad they're sending them, because buried in that stack is your next six figures of growth."
The brokers who thrive in 2026 will be the ones who read those forms differently. Not as rejection slips, but as opportunities to protect, to educate, and to grow.