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Mid-Market · 7 Funding Paths

Find the lowest-cost health plan your company can actually live with.

We model your renewal across all seven funding arrangements (fully-insured, level-funded, self-funded, ICHRA, captive, PEO-integrated, Taft-Hartley) and surface the lowest-cost option that matches your risk tolerance. No quota, no carrier preference.

Seven funding arrangements 15 to 40 percent typical savings No-cost analysis
Coverage breadth
7 funding arrangements
Fully-insured, level-funded, self-funded, ICHRA, captive, PEO-integrated, Taft-Hartley.
Typical mid-market savings
15 to 40 percent
Range observed between the most-expensive and least-expensive arrangement on the same census.
Broker model
No carrier quota
Independent. Compensation does not vary by carrier or funding path picked.
Analysis cost
No cost
Written funding-fit analysis delivered as a PDF. No obligation to engage as broker.
What Benefitra covers

Four pillars. One platform.

The lowest-cost-plan analysis lives inside the employee-benefits pillar but uses the tools, content, and calculator infrastructure from across the BENEFITRA platform.

Insurance

Health, dental, vision, life, disability. Individual, family, group.

Funding strategies →

Employee Benefits

Seven funding paths: fully-insured, level-funded, self-funded, ICHRA, PEO-integrated, captive, Taft-Hartley.

Compare paths →

Marketing & SEO

Lead-engine and rankings for growing employers. Page-2-to-page-1 in months.

See trajectories →

Business Tools / SaaS

586 free calculators: ACA, COBRA, ROI, valuation, projector.

Browse tools →
How we find the lowest-cost plan

Five-step analysis, run for every mid-market group.

The cheapest premium is not always the lowest-cost plan. We work through the five steps below to find the option that actually minimizes total cost for your specific census, network needs, and risk tolerance.

Renewal data review. We start with the artifact your current broker probably did not walk you through line by line: the renewal letter itself. Carrier renewal increases are made up of three components (trend, demographic shift, claim experience) and the right next move depends on which component is driving the increase. A renewal driven by claim experience requires a different response than one driven by trend, and an analysis that does not separate them will pick the wrong move.

Funding-fit modeling. We then model your group across all seven arrangements. For each, we run an expected-case cost (what you should pay if claims land at trend) and a worst-case cost (what you pay if a high-cost claimant materializes). The expected-case math tells you which arrangement is cheapest in a normal year; the worst-case math tells you which arrangement you can survive in a bad year. Both numbers matter; mid-market groups often see a 15 to 40 percent gap between the most expensive and least expensive arrangement on the same census.

Network access mapping. Switching funding without checking network impact is how employers end up with a cheaper plan and an angry workforce. We pull your current claim utilization (where the carrier shares it), identify your top 20 most-utilized providers and facilities, and confirm those are in-network on every arrangement we recommend. If a meaningful provider is out-of-network in the cheaper option, we flag it before you ever see the recommendation.

Pharmacy is where the savings often live. Pharmacy benefit manager arrangements can move 5 to 15 percent of total medical spend depending on group size and rebate flow. On self-funded and level-funded paths we audit the PBM contract for rebate retention, spread pricing, and exclusive formulary terms before signing.

Pharmacy carve-out analysis. Once you are on a self-funded or level-funded path, the pharmacy benefit manager becomes the most-leveraged single decision in the plan. Carve-out arrangements where the PBM is contracted separately from the medical TPA can recapture rebate dollars and shut down spread pricing. We model whether a carve-out makes sense for your group; on groups under 100 lives it usually does not, on groups over 250 lives it usually does, and the band in between depends on your script utilization mix.

Decision matrix. Finally we deliver a one-page decision matrix: seven funding options scored across expected cost, worst-case cost, administrative burden, network impact, employee experience, and renewal-stability outlook. Boards and CFOs can sign off on the right answer in twenty minutes because the trade-offs are explicit, not buried in a 60-page broker deck.

Step 1-2

Renewal review & modeling

Separate trend, demographic, and claim-experience drivers. Model seven arrangements expected and worst-case.

Step 3-4

Network & pharmacy audit

Map your top 20 utilized providers. Audit PBM contract for rebates, spread, and formulary fit.

Step 5

Decision matrix

One-page scoring across cost, risk, admin burden, network impact, and renewal stability.

What employers say after the analysis

Mid-market employers who actually saved.

Our renewal came in at 18%. The funding-fit analysis surfaced a level-funded option that priced 14% below fully-insured on our census. We switched and the savings paid for our 401(k) match increase.

— CFO, mid-market services

Three brokers told us self-funded was too risky for 75 employees. Benefitra ran the stop-loss math and showed us we could absorb a worst-case year. Year one we saved 23%; year two, 31%.

— Owner-operator, professional firm

The decision matrix was the first time anyone gave us a one-page summary the board could actually act on. Approved the switch in our next meeting without a second analyst review.

— HR director, regional employer
Frequently asked questions

Lowest-cost health plan analysis — answered.

Switching funding, level-funded reality check, ICHRA economics, timeline, and what to do with a 30-day renewal.

Will switching funding cut my employees' network?
Not necessarily. Level-funded and self-funded plans can use the same major networks that fully-insured plans use because the network is licensed from a network administrator separately from the funding arrangement. The disruption risk shows up if the new arrangement does not include your most-utilized providers; we run a provider-disruption analysis on your top 20 utilized providers and facilities before recommending any switch.
Is level-funded actually cheaper or just a renaming?
Level-funded is a real arrangement, not a rename. Premium is fixed for the year like fully-insured, but the carrier funds a claims account and refunds the unused balance at year-end. On a healthy census it typically prices 10 to 25 percent below fully-insured because the carrier returns underwriting margin instead of keeping it. On a high-claims census the savings shrink or disappear; the math has to be run for your group, not assumed.
What does ICHRA mean for my budget?
ICHRA (Individual Coverage Health Reimbursement Arrangement) lets you set a fixed monthly reimbursement per employee class and let employees pick their own ACA plan. From a CFO's view, ICHRA converts an unpredictable group-plan renewal into a fixed line-item; from an employee's view, it offers plan choice the group market cannot match. The trade-off is administrative complexity and the loss of group-pooling on high-utilization employees. ICHRA fits some groups extremely well and others poorly; we model it alongside the other six paths so the math, not the marketing, decides.
How long does the analysis take?
From census submission to a written funding-fit analysis is typically two business days for groups under 100 employees and three to five business days for groups over 100. The 12-question intake itself takes about five minutes. If you have your current renewal letter, census, and prior 12 months of claims data ready, we can move fast; if any of those are missing we will tell you what we need and where to find it.
What if our renewal is in 30 days?
Thirty days is tight but workable. We typically can deliver a comparison and bind coverage within three to four weeks if you have your current renewal letter, current census, and prior 12 months of claims (where the carrier provides them). We will be honest if the timing is too tight to do the analysis justice; sometimes the right call is to accept the current renewal for one cycle and re-market mid-year for the following plan year, using the time to assemble a proper data file and shop the market without pressure.

Start the 12-question Funding-Fit Discovery.

Five minutes of intake. Two to five business days for a written analysis. Seven funding paths scored on your actual census. No-cost, no obligation.

Start the discovery →