PEO 93% chance of beating Fully Insured
$149,095
median five-year savings
+19% expected savings
5th−$21,88125th$93,838 75th$185,41295th$218,253
Pennsylvania Health-Plan Funding Guide
Pennsylvania 2027 funding analysis by employer size
Plan year 2027 Rates used: PY2027 final approved rates
Compare your options based on what matters most: Year 1 cost, five-year savings, and the likelihood of outperforming Fully Insured.
10 Employees
10-employee funding analysis · 2027
Modeled with Benefitra's average client savings assumptions, 2,000 Monte Carlo runs, and 2027 Pennsylvania market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO93%
Level-Funded78%
Taft-Hartley1%
Five-year median savings versus staying Fully Insured
PEO $149,095
Level-Funded $117,245
Taft-Hartley −$50,782
5th to 95th percentile 25th to 75th Median
Level-Funded 78% chance of beating Fully Insured
$117,245
median five-year savings
+9% expected savings
5th−$251,97925th$18,355 75th$157,88895th$183,065
With additional cost containment: $148K to $267K more potential savings; win rate rises to ~94%.
Taft-Hartley 1% chance of beating Fully Insured
−$50,782
median five-year savings
-8% expected savings
5th−$85,76525th−$64,782 75th−$36,03995th−$15,327
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$962 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 final approved rates$0 saved
Day-one and five-year context
Lowest modeled day-one costPEO · ~28% cheaper
Highest modeled five-year medianPEO · $149,095
These are separate measures, not a recommendation or a single “best” pick. Probability, downside range, eligibility, administration, and risk tolerance also matter.
Cost containment: Reference-Based Pricing · Cash Pay · Centers of Excellence · Specialty Rx Management · Care Navigation · High-Cost Dialysis Carve-Out · Direct Primary Care. Most strategies do not affect employees’ provider access or care.
Illustrative profile: Average age (~42), average health, state-adjusted premium, and approximately 10 enrolled employees. Actual quotes and underwriting can materially change results.
2027 renewal assumption: 2027 small-group filed rate 10.28% (final, approved by the Pennsylvania Insurance Department). Fully-insured renewal expectation used here: 7.2% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 9.4%.
30 Employees
30-employee funding analysis · 2027
Modeled with Benefitra's average client savings assumptions, 2,000 Monte Carlo runs, and 2027 Pennsylvania market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO93%
Level-Funded89%
Self-Funded Captive92%
Taft-Hartley1%
Five-year median savings versus staying Fully Insured
PEO $447,286
Level-Funded $531,891
Self-Funded Captive $471,422
Taft-Hartley −$152,346
5th to 95th percentile 25th to 75th Median
PEO 93% chance of beating Fully Insured
$447,286
median five-year savings
+19% expected savings
5th−$65,64225th$281,513 75th$556,23595th$654,758
Level-Funded 89% chance of beating Fully Insured
$531,891
median five-year savings
+21% expected savings
5th−$294,24225th$322,154 75th$623,74795th$698,259
With additional cost containment: $377K to $598K more potential savings; win rate rises to ~99%.
Self-Funded Captive 92% chance of beating Fully Insured
$471,422
median five-year savings
+20% expected savings
5th−$135,89625th$299,775 75th$573,62995th$667,967
With additional cost containment: $390K to $557K more potential savings; win rate rises to ~99%.
Taft-Hartley 1% chance of beating Fully Insured
−$152,346
median five-year savings
-8% expected savings
5th−$257,29525th−$194,347 75th−$108,11895th−$45,980
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$962 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 final approved rates$0 saved
Day-one and five-year context
Lowest modeled day-one costPEO · ~28% cheaper
Highest modeled five-year medianLevel-Funded · $531,891
These are separate measures, not a recommendation or a single “best” pick. Probability, downside range, eligibility, administration, and risk tolerance also matter.
Cost containment: Reference-Based Pricing · Cash Pay · Centers of Excellence · Specialty Rx Management · Care Navigation · High-Cost Dialysis Carve-Out · Direct Primary Care. Most strategies do not affect employees’ provider access or care.
Illustrative profile: Average age (~42), average health, state-adjusted premium, and approximately 30 enrolled employees. Actual quotes and underwriting can materially change results.
2027 renewal assumption: 2027 small-group filed rate 10.28% (final, approved by the Pennsylvania Insurance Department). Fully-insured renewal expectation used here: 7.2% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 9.4%.
70 Employees
70-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 Pennsylvania market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO44%
Level-Funded91%
Self-Funded Captive100%
Taft-Hartley29%
Five-year median savings versus staying Fully Insured
PEO −$142,391
Level-Funded $402,102
Self-Funded Captive $550,128
Taft-Hartley −$454,825
5th to 95th percentile 25th to 75th Median
PEO 44% chance of beating Fully Insured
−$142,391
median five-year savings
-4% expected savings
5th−$1,694,66225th−$659,581 75th$467,61095th$1,870,380
Level-Funded 91% chance of beating Fully Insured
$402,102
median five-year savings
+11% expected savings
5th−$191,47825th$211,394 75th$741,77095th$1,833,197
With additional cost containment: $1.03M to $1.51M more potential savings; win rate rises to ~100%.
Self-Funded Captive 100% chance of beating Fully Insured
$550,128
median five-year savings
+15% expected savings
5th$183,34225th$357,080 75th$900,01495th$2,010,813
With additional cost containment: $1.00M to $1.32M more potential savings; win rate rises to ~100%.
Taft-Hartley 29% chance of beating Fully Insured
−$454,825
median five-year savings
-7% expected savings
5th−$1,121,37225th−$813,688 75th$117,15595th$1,512,397
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$962 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 final approved rates$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded Captive · ~11% cheaper
Highest modeled five-year medianSelf-Funded Captive · $550,128
These are separate measures, not a recommendation or a single “best” pick. Probability, downside range, eligibility, administration, and risk tolerance also matter.
Cost containment: Reference-Based Pricing · Cash Pay · Centers of Excellence · Specialty Rx Management · Care Navigation · High-Cost Dialysis Carve-Out · Direct Primary Care. Most strategies do not affect employees’ provider access or care.
Illustrative profile: Average age (~42), average health, state-adjusted premium, and approximately 70 enrolled employees. Actual quotes and underwriting can materially change results.
2027 renewal assumption: 2027 small-group filed rate 10.28% (final, approved by the Pennsylvania Insurance Department). Fully-insured renewal expectation used here: 7.2% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 9.4%.
150 Employees
150-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 Pennsylvania market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO37%
Self-Funded96%
Self-Funded Captive100%
Taft-Hartley31%
Five-year median savings versus staying Fully Insured
PEO −$671,204
Self-Funded $1,339,766
Self-Funded Captive $1,330,964
Taft-Hartley −$862,284
5th to 95th percentile 25th to 75th Median
PEO 37% chance of beating Fully Insured
−$671,204
median five-year savings
-8% expected savings
5th−$4,341,24625th−$1,967,309 75th$719,61995th$4,075,018
Self-Funded 96% chance of beating Fully Insured
$1,339,766
median five-year savings
+15% expected savings
5th$50,26925th$876,241 75th$1,994,18895th$4,057,966
With additional cost containment: $2.15M to $3.29M more potential savings; win rate rises to ~100%.
Self-Funded Captive 100% chance of beating Fully Insured
$1,330,964
median five-year savings
+16% expected savings
5th$566,45925th$918,629 75th$2,056,51795th$4,313,028
With additional cost containment: $2.17M to $2.86M more potential savings; win rate rises to ~100%.
Taft-Hartley 31% chance of beating Fully Insured
−$862,284
median five-year savings
-7% expected savings
5th−$2,647,12825th−$1,758,641 75th$522,29495th$3,661,034
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$962 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 final approved rates$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded · ~12% cheaper
Highest modeled five-year medianSelf-Funded · $1,339,766
These are separate measures, not a recommendation or a single “best” pick. Probability, downside range, eligibility, administration, and risk tolerance also matter.
Cost containment: Reference-Based Pricing · Cash Pay · Centers of Excellence · Specialty Rx Management · Care Navigation · High-Cost Dialysis Carve-Out · Direct Primary Care. Most strategies do not affect employees’ provider access or care.
Illustrative profile: Average age (~42), average health, state-adjusted premium, and approximately 150 enrolled employees. Actual quotes and underwriting can materially change results.
2027 renewal assumption: 2027 small-group filed rate 10.28% (final, approved by the Pennsylvania Insurance Department). Fully-insured renewal expectation used here: 7.2% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 9.4%.
250 Employees
250-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 Pennsylvania market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO31%
Self-Funded99%
Self-Funded Captive100%
Taft-Hartley34%
Five-year median savings versus staying Fully Insured
PEO −$1,863,565
Self-Funded $2,374,703
Self-Funded Captive $2,404,720
Taft-Hartley −$1,339,190
5th to 95th percentile 25th to 75th Median
PEO 31% chance of beating Fully Insured
−$1,863,565
median five-year savings
-13% expected savings
5th−$8,434,18325th−$4,134,109 75th$700,22395th$6,239,774
Self-Funded 99% chance of beating Fully Insured
$2,374,703
median five-year savings
+16% expected savings
5th$802,39625th$1,706,575 75th$3,511,82795th$6,540,582
With additional cost containment: $3.56M to $5.38M more potential savings; win rate rises to ~100%.
Self-Funded Captive 100% chance of beating Fully Insured
$2,404,720
median five-year savings
+16% expected savings
5th$1,029,26625th$1,683,056 75th$3,669,41295th$7,035,141
With additional cost containment: $3.62M to $4.79M more potential savings; win rate rises to ~100%.
Taft-Hartley 34% chance of beating Fully Insured
−$1,339,190
median five-year savings
-6% expected savings
5th−$4,561,63825th−$2,933,306 75th$970,98895th$6,524,486
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$962 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 final approved rates$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded · ~12% cheaper
Highest modeled five-year medianSelf-Funded Captive · $2,404,720
These are separate measures, not a recommendation or a single “best” pick. Probability, downside range, eligibility, administration, and risk tolerance also matter.
Cost containment: Reference-Based Pricing · Cash Pay · Centers of Excellence · Specialty Rx Management · Care Navigation · High-Cost Dialysis Carve-Out · Direct Primary Care. Most strategies do not affect employees’ provider access or care.
Illustrative profile: Average age (~42), average health, state-adjusted premium, and approximately 250 enrolled employees. Actual quotes and underwriting can materially change results.
2027 renewal assumption: 2027 small-group filed rate 10.28% (final, approved by the Pennsylvania Insurance Department). Fully-insured renewal expectation used here: 7.2% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 9.4%.
500 Employees
500-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 Pennsylvania market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO27%
Self-Funded100%
Self-Funded Captive100%
Taft-Hartley30%
Five-year median savings versus staying Fully Insured
PEO −$3,690,100
Self-Funded $4,588,124
Self-Funded Captive $4,535,387
Taft-Hartley −$2,644,014
5th to 95th percentile 25th to 75th Median
PEO 27% chance of beating Fully Insured
−$3,690,100
median five-year savings
-14% expected savings
5th−$16,747,94725th−$7,836,032 75th$543,64395th$8,941,888
Self-Funded 100% chance of beating Fully Insured
$4,588,124
median five-year savings
+16% expected savings
5th$1,874,02025th$3,255,033 75th$6,776,76095th$12,766,838
With additional cost containment: $7.19M to $9.37M more potential savings; win rate rises to ~100%.
Self-Funded Captive 100% chance of beating Fully Insured
$4,535,387
median five-year savings
+16% expected savings
5th$1,968,81525th$3,185,643 75th$6,782,57995th$12,876,416
With additional cost containment: $7.25M to $8.78M more potential savings; win rate rises to ~100%.
Taft-Hartley 30% chance of beating Fully Insured
−$2,644,014
median five-year savings
-7% expected savings
5th−$8,185,29425th−$5,417,376 75th$1,018,03595th$8,732,996
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$962 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 final approved rates$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded · ~12% cheaper
Highest modeled five-year medianSelf-Funded · $4,588,124
These are separate measures, not a recommendation or a single “best” pick. Probability, downside range, eligibility, administration, and risk tolerance also matter.
Cost containment: Reference-Based Pricing · Cash Pay · Centers of Excellence · Specialty Rx Management · Care Navigation · High-Cost Dialysis Carve-Out · Direct Primary Care. Most strategies do not affect employees’ provider access or care.
Illustrative profile: Average age (~42), average health, state-adjusted premium, and approximately 500 enrolled employees. Actual quotes and underwriting can materially change results.
2027 renewal assumption: 2027 small-group filed rate 10.28% (final, approved by the Pennsylvania Insurance Department). Fully-insured renewal expectation used here: 7.2% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 9.4%.
2026 analysis vs 2027
For 70-employee groups in Pennsylvania, the modeled median five-year savings for Self-Funded Captive moved from $510,592 to $550,128, and its modeled chance of beating Fully Insured stayed at 100%.
| Employees | PEO | Level-Funded | Self-Funded | Self-Funded Captive |
|---|---|---|---|---|
| 10 | $119,585 → $149,09591% → 93% odds | $90,666 → $117,24575% → 78% odds | Not modeled | Not modeled |
| 30 | $358,754 → $447,28691% → 93% odds | $435,860 → $531,89188% → 89% odds | Not modeled | $385,891 → $471,42290% → 92% odds |
| 70 | −$129,118 → −$142,39144% → 44% odds | $364,619 → $402,10291% → 91% odds | Not modeled | $510,592 → $550,128100% → 100% odds |
| 150 | −$608,637 → −$671,20437% → 37% odds | Not modeled | $1,214,877 → $1,339,76696% → 96% odds | $1,232,064 → $1,330,964100% → 100% odds |
| 250 | −$1,689,848 → −$1,863,56531% → 31% odds | Not modeled | $2,153,339 → $2,374,70399% → 99% odds | $2,222,506 → $2,404,720100% → 100% odds |
| 500 | −$3,346,119 → −$3,690,10027% → 27% odds | Not modeled | $4,160,432 → $4,588,124100% → 100% odds | $4,196,506 → $4,535,387100% → 100% odds |
Fully Insured baseline used: $873 → $962 per employee per month (PY2026 rates → PY2027 final approved rates). Taft-Hartley is priced as a fixed nationwide rate rather than a state-rate model, so it is not compared here.
View the archived 2026 Pennsylvania analysis (last year's model results, not current advice).
Illustrative model results, not a quote, a forecast or insurance, tax or legal advice. Actual premiums, claims, eligibility and underwriting vary by employer, and the rates used here may differ from the rates an employer is quoted.
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