Tell us a little about your group and see, in plain numbers, what each path is likely to cost — and where the real savings are. Hover any bar for the detail.
See how much you may be overpaying →
Live simulation · your state's rules · five funding paths, five renewals deep
$
%
Paid claims or loss ratio anchors self-funded / level-funded to your own dollars. Blank ⇒ we use premium × 78%.
National default 13%/yr — the mean of a right-skewed spread (95th ≈ 3×). PEOs serve members nationwide, so this is not state-specific.
Self-Funded / Level-Funded
State law typically sets the floor between 110 and 125 percent of expected claims.
Level-Funded surplus & corridor
Taken off the surplus before the refund (real: 5–6%).
Where aggregate stop-loss attaches. 120% market default; Trustmark 115% ASL is a valid lower pref; editable.
Surplus-return varies by carrier (a national carrier 50% · Trustmark 100% · Allstate selectable) — not 100% by default. Specific deductible & your own claims are set above; enter 0 as the specific for an aggregate-only book (e.g. Trustmark).
Stop-Loss Renewal Accuracy
Higher deductible ⇒ more leverage (fixed deductible vs rising severities). Blank ⇒ baseline.
Caps how much your stop-loss PREMIUM can rise at renewal — not your total cost. Your claims fund can still rise above this.
Bounds the per-claimant adverse-year contribution.
Yes
No
Self-Funded Captive
Yes
No
Dividend is now based on the captive pool/risk-sharing premium, not aggregate stop-loss. Blank fields run on modeled defaults.
Stop-Loss Renewal Accuracy
Higher deductible ⇒ more leverage (fixed deductible vs rising severities). Blank ⇒ baseline.
State law typically sets the floor between 110 and 125 percent of expected claims.
Caps how much your stop-loss PREMIUM can rise at renewal — not your total cost. Your claims fund can still rise above this.
Bounds the per-claimant adverse-year contribution.
Yes
No
MEWA / Pooled Trust
Yes
No
Modeled range
Yes
No
The modeled range is centered on this figure.
This MEWA re-rates each employer group on its own claims experience (like a PEO), so groups do not all move together. Your group’s own claims (set in the main inputs above) now drive the swing — bad years pass through at your credibility, good years are partly credited — giving a wider, experience-rated range than the pooled band.
The experience-rated range is centered here; your own claims widen it. Blank ⇒ uses the pooled expected default.
Assumes the MEWA stays financially healthy. This band holds only while the MEWA’s underlying financials are sound. If those financials begin to fail, a MEWA can fail quickly — with renewal increases surging well beyond this modeled range.
Quotes in hand? Set any path's price yourself — every chart, renewal and simulation recomputes on your numbers.
Starting cost
At renewal
2-year totals
5-year odds
iWhat this shows: the price to begin each way of paying for your health plan, side by side. Why it matters: the cheapest start isn’t always the best deal — the other tabs show what happens after year one.
What each path costs to start
Per employee / mo
Total / mo
Total / yr
Pricing basis
Conservative model
Our clients’ typical results
Level-funded ⇆ Self-funded
Level-funded
Self-funded
Taft-Hartley ⇆ MEWA
Taft-Hartley
MEWA
iWhat this shows: how each path’s price would change next year in a good, a bad, and a really bad (catastrophic) claims year. Why it matters: some paths barely move; others jump a lot. That gap is your risk if claims run high.
What happens next year
How each path's premium moves in a good, a bad, and a catastrophic claims year — side by side. Hover any bar for what's driving it.
iWhat this shows: Year 1 and Year 2 added together, under a good, bad, catastrophic, or one-big-claim year. Why it matters: one year can fool you. Two years together shows which path holds up when a bad year hits.
Two-year totals, four kinds of year
Per employee
Group / mo
Group total
Year 1 + Year 2 together under a good, bad, catastrophic, or big-claim year. Hover any bar for the year-by-year split.
iWhat this shows: we run thousands of pretend futures and count how often each path ends up cheapest, and by how much. Why it matters: it turns “it depends” into real odds — how likely you are to save, and how big a bad year could get.
Enrolled by yearpick a growth rate above or type your own plan — every run follows this schedule
🎯 Odds of savings — how often each path comes out aheadThe share of simulated renewals in which each funding path finishes cheaper. Read it together with your amount of savings below — how often you win, and by how much.
🛡️ Turn on cost containment strategies
On
Off
Layer clinical cost-containment levers — Centers of Excellence, reference-based pricing, specialty-Rx management and more — directly into the analysis above. When on, the worst-case cards, wins/loses, recommendation and the distribution explorer all switch to the post-containment outcome — the self-funded bad-year tail tightens. Off by default; every number above stays exactly as modeled.
<35
35–45
>45
Choose containment strategies — tune the specific levers
The condition mix below is drawn from your group’s Average age and Group health inputs — no separate age control needed.
Show pre/post detail & per-percentile decomposition
Upload your census / claims for per-member accuracy? i
Yes
No
Adjust the high-leverage assumptions behind the catastrophe engine — network discount, demographic mix, claims severity — or upload your census for exact, per-member accuracy. Off by default; every number above stays exactly as modeled.
commercial-billed → allowed0.70(default 0.70)
drives NICU / maternity50% (default 50)
pediatric drugs / gene therapy25% (default 25)
scales all severity gates together1.00× (default 1.0×)
Blank ⇒ uses the Average age selector above (default).
Upload your census precision mode
Load a member list and the engine uses each member's exact age and gender instead of the sliders above — the most accurate way to model your group's catastrophe risk (dependents included: they drive NICU, maternity and pediatric conditions).
🔒 Your census is processed entirely in your browser and never leaves your device. No file is uploaded or stored.
Supported format: CSV. Using Excel? In Excel choose File → Save As → CSV and upload that. Columns are auto-detected — date of birth (or age), gender/sex, and optionally relationship/tier (employee / spouse / child). Header names are flexible.
We couldn't confidently auto-detect every column — map them here:
Upload your claims data precision input
The single most accurate input. Two optional files: (A) your aggregate paid-claims history anchors the group's claims level and trend, and (B) a high-cost claimant list lets the engine carry each ongoing claimant forward as a known case — so persistence in years 2–5 becomes fact, not just probability.
🔒 Claims data is protected health information. It is processed entirely in your browser and never leaves your device — no file is uploaded, transmitted or stored. Close the tab and it is gone.
CSV with a period (month or year) and paid claims $ column; an optional enrolled (member count) column sharpens the PMPM. Header names are flexible; you can also paste CSV below.
B · High-cost claimants
CSV with annual $, condition/category and ongoing (Y/N) per claimant. Conditions map to the engine's buckets (cancer, dialysis, cardiac, transplant, NICU, MSK, specialty-Rx, autoimmune, other).
We couldn't confidently auto-detect every column — map them here:
recalculating…
🔬 Check our math — the distribution explorerThese are the actual simulated distributions behind the numbers above. Every year the tool overlays two curves together: the claims your members are expected to incur (slate) and the net premium you actually pay (path color, net of reimbursements). Overlay any funding paths, step through each year, and drag the plan-design controls to watch the curves move. Tighter and further left is cheaper and steadier; a long right tail is downside risk.
Click a point on this year’s claims curve to project next year’s premium & expected claims, conditioned on that outcome — a bad year carries forward (health has memory), a good year eases off. Click again to walk another year forward.
How to view it
Which year
🛡️ Cost containment strategies
On
Off
Which renewal transition
Compare arrangements — tap to add or remove; the click-conditioned curves shift together
Expected claims & premium based on…
🎯 Your clicked prior year
📊 A typical (median) prior year
These come straight from the same simulation that powers the odds above — computed on our server from your inputs, then drawn here. Change any control and watch the curves and the numbers move.
A clean, branded PDF of this analysis — the recommendation, the 5-year funding comparison and your percentile projection — ready to hand to your CFO or broker. Enter your email and we’ll build it now.