Which of the seven ways should you fund your health plan? Simulate your next five renewals 2,000 times: fully-insured, PEO, self-funded, self-funded captive and Taft-Hartley, priced on your own premium, with your state's rating and stop-loss rules built in.
Four moving parts, each calibrated to published data and real placement experience. Change any input and everything recomputes live in your browser.
State, group size, average age, group health where small-group rules apply, your current premium and any real quotes you hold. Entry prices come from Benefitra's field-calibrated relative pricing model.
Community-rated plans ride the state pool trend and cannot single you out. Experience-rated plans load your own claims, with credibility rising as you grow. Small-group PEO master plans re-underwrite beyond a normal claims corridor. Self-funded paths feel claims directly, capped by stop-loss and carve-outs.
Each run draws five years of claims from a right-skewed lognormal distribution scaled to your group size by classical credibility, with market trend noise on top. The winner of each run is the path with the lowest five-year total.
If your enrollment plan crosses a legal threshold, that year changes the rules: community rating ends or begins, and state stop-loss gates lift or close, exactly as they would in the market.
Calibrated to: KFF Employer Health Benefits Survey · AHRQ MEPS concentration data · SOA group medical large-claims experience
Stop-loss law blocks self-funded and captive strategies for groups of 100 or fewer enrolled in NY and D.C., under 11 in Maine, under 10 in Utah and at 5 or fewer eligible in Delaware. The simulator gates these automatically, and shows a growing company the year self-funding unlocks.
Medical underwriting lets young, healthy small groups price far below community rates, with documented client savings up to 52 percent. The advantage fades above 50 enrolled and is generally gone by 200 lives, where experience rating catches up.
Pooled stop-loss purchasing, rate caps and surplus distribution give captives the best five-year odds for mid-size groups, and Benefitra captive placements carry a five-year savings guarantee.
A community-rated plan absorbs a $250k claimant for the price of trend, a real shield for a sick small group. The same pool quietly overcharges young, healthy groups every month they stay.
A multi-employer trust prices on the pool, not on your group: small crews below carrier minimums get real group coverage, and older groups get shelter, with six consecutive renewals at 3 percent or less on record.
It runs your next five renewals 2,000 times. Each simulated year draws a claims outcome from a right-skewed distribution calibrated to public actuarial data (KFF, AHRQ MEPS, SOA), applies your state's rating and stop-loss rules, and reprices each funding path by its own renewal behavior. The winner of each run is the path with the lowest five-year total.
Not always. New York and the District of Columbia block small-group stop-loss for groups of 100 or fewer enrolled, Maine blocks it under 11 enrolled, Utah under 10 and Delaware at 5 or fewer eligible. The simulator applies these gates automatically and shows when a growing company unlocks self-funding.
PEO medical underwriting helps most below roughly 50 enrolled employees, where young, healthy groups can price far below community rates. The documented advantage fades above 50 and generally disappears by about 200 lives, where direct experience rating catches up.
For roughly 50 to 400 enrolled employees a captive typically wins: pooled stop-loss purchasing, rate caps and surplus distribution improve renewals, and Benefitra captive placements are backed by a five-year savings guarantee. At larger sizes solo self-funding converges with the captive.
A Taft-Hartley plan is a multi-employer trust with a flat rate card, priced on the pool rather than your group. It shines for small crews below carrier minimums and for older or higher-risk groups that community pools would otherwise punish, with a track record of six consecutive renewals at 3 percent or less.
Level funding is self-funding in a carrier package: bundled stop-loss, TPA and fixed monthly payments, with part of a good year's surplus refunded. Below the small-group line the simulator's Self-Funded path is priced on the level-funded chassis, because that is how small groups actually self-fund. For larger groups a toggle shows both flavors; the packaging convenience typically costs about 3 to 10 percent over traditional self-funding, shrinking as groups scale.
You can type your current premium and any real quotes you hold, and every chart, renewal scenario and simulation recomputes on your numbers. Without quotes it uses a conservative model anchored to published rating data.
Deliberately not modeled: ICHRA (individual-market reimbursement is a different decision) and PEO administrative fees (this is a health-rates-only comparison). If either matters to your case, talk it through with us.