PEO 96% chance of beating Fully Insured
$161,662
median five-year savings
+23% expected savings
5th$9,50925th$112,218 75th$193,89395th$223,452
West Virginia Health-Plan Funding Guide
West Virginia 2027 funding analysis by employer size
Plan year 2027 Rates used: PY2027 requested (filed) rates, not yet final
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 West Virginia market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO96%
Level-Funded79%
Taft-Hartley0%
Five-year median savings versus staying Fully Insured
PEO $161,662
Level-Funded $115,126
Taft-Hartley −$95,859
5th to 95th percentile 25th to 75th Median
Level-Funded 79% chance of beating Fully Insured
$115,126
median five-year savings
+10% expected savings
5th−$227,78525th$23,622 75th$153,11995th$176,718
With additional cost containment: $136K to $247K more potential savings; win rate rises to ~95%.
Taft-Hartley 0% chance of beating Fully Insured
−$95,859
median five-year savings
-15% expected savings
5th−$129,58425th−$109,255 75th−$81,64195th−$62,284
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$855 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 requested (filed) rates, not yet final$0 saved
Day-one and five-year context
Lowest modeled day-one costPEO · ~28% cheaper
Highest modeled five-year medianPEO · $161,662
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 19.69% (proposed, not yet final). Fully-insured renewal expectation used here: 9.6% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 15.7%.
30 Employees
30-employee funding analysis · 2027
Modeled with Benefitra's average client savings assumptions, 2,000 Monte Carlo runs, and 2027 West Virginia market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO96%
Level-Funded89%
Self-Funded Captive92%
Taft-Hartley0%
Five-year median savings versus staying Fully Insured
PEO $484,987
Level-Funded $510,915
Self-Funded Captive $458,931
Taft-Hartley −$287,578
5th to 95th percentile 25th to 75th Median
PEO 96% chance of beating Fully Insured
$484,987
median five-year savings
+23% expected savings
5th$28,52625th$336,653 75th$581,67895th$670,357
Level-Funded 89% chance of beating Fully Insured
$510,915
median five-year savings
+22% expected savings
5th−$254,19225th$315,382 75th$596,21695th$666,987
With additional cost containment: $348K to $553K more potential savings; win rate rises to ~99%.
Self-Funded Captive 92% chance of beating Fully Insured
$458,931
median five-year savings
+21% expected savings
5th−$94,24825th$302,111 75th$552,99595th$641,214
With additional cost containment: $360K to $510K more potential savings; win rate rises to ~100%.
Taft-Hartley 0% chance of beating Fully Insured
−$287,578
median five-year savings
-15% expected savings
5th−$388,75125th−$327,764 75th−$244,92395th−$186,853
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$855 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 requested (filed) rates, not yet final$0 saved
Day-one and five-year context
Lowest modeled day-one costPEO · ~28% cheaper
Highest modeled five-year medianLevel-Funded · $510,915
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 19.69% (proposed, not yet final). Fully-insured renewal expectation used here: 9.6% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 15.7%.
70 Employees
70-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 West Virginia market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO50%
Level-Funded86%
Self-Funded Captive98%
Taft-Hartley19%
Five-year median savings versus staying Fully Insured
PEO $2,203
Level-Funded $327,283
Self-Funded Captive $475,432
Taft-Hartley −$833,716
5th to 95th percentile 25th to 75th Median
PEO 50% chance of beating Fully Insured
$2,203
median five-year savings
+0% expected savings
5th−$1,418,71425th−$477,156 75th$629,31795th$2,085,130
Level-Funded 86% chance of beating Fully Insured
$327,283
median five-year savings
+11% expected savings
5th−$278,67125th$119,858 75th$744,67495th$2,028,078
With additional cost containment: $950K to $1.39M more potential savings; win rate rises to ~100%.
Self-Funded Captive 98% chance of beating Fully Insured
$475,432
median five-year savings
+15% expected savings
5th$70,18725th$259,033 75th$885,10895th$2,261,883
With additional cost containment: $923K to $1.22M more potential savings; win rate rises to ~100%.
Taft-Hartley 19% chance of beating Fully Insured
−$833,716
median five-year savings
-16% expected savings
5th−$1,505,92925th−$1,194,278 75th−$229,39295th$1,271,001
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$855 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 requested (filed) rates, not yet final$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded Captive · ~11% cheaper
Highest modeled five-year medianSelf-Funded Captive · $475,432
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 19.69% (proposed, not yet final). Fully-insured renewal expectation used here: 9.6% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 15.7%.
150 Employees
150-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 West Virginia market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO43%
Self-Funded93%
Self-Funded Captive100%
Taft-Hartley22%
Five-year median savings versus staying Fully Insured
PEO −$317,321
Self-Funded $1,162,899
Self-Funded Captive $1,166,609
Taft-Hartley −$1,640,380
5th to 95th percentile 25th to 75th Median
PEO 43% chance of beating Fully Insured
−$317,321
median five-year savings
-5% expected savings
5th−$3,639,61925th−$1,505,294 75th$1,046,98295th$4,604,001
Self-Funded 93% chance of beating Fully Insured
$1,162,899
median five-year savings
+15% expected savings
5th−$197,06525th$644,575 75th$1,941,89295th$4,494,741
With additional cost containment: $1.98M to $3.05M more potential savings; win rate rises to ~100%.
Self-Funded Captive 100% chance of beating Fully Insured
$1,166,609
median five-year savings
+16% expected savings
5th$309,16225th$712,185 75th$2,032,07495th$4,715,659
With additional cost containment: $2.00M to $2.65M more potential savings; win rate rises to ~100%.
Taft-Hartley 22% chance of beating Fully Insured
−$1,640,380
median five-year savings
-16% expected savings
5th−$3,429,78825th−$2,548,669 75th−$314,45095th$3,176,920
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$855 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 requested (filed) rates, not yet final$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded · ~12% cheaper
Highest modeled five-year medianSelf-Funded Captive · $1,166,609
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 19.69% (proposed, not yet final). Fully-insured renewal expectation used here: 9.6% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 15.7%.
250 Employees
250-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 West Virginia market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO37%
Self-Funded97%
Self-Funded Captive100%
Taft-Hartley23%
Five-year median savings versus staying Fully Insured
PEO −$1,147,384
Self-Funded $2,091,638
Self-Funded Captive $2,176,452
Taft-Hartley −$2,636,669
5th to 95th percentile 25th to 75th Median
PEO 37% chance of beating Fully Insured
−$1,147,384
median five-year savings
-9% expected savings
5th−$7,072,37425th−$3,295,132 75th$1,369,45095th$7,042,607
Self-Funded 97% chance of beating Fully Insured
$2,091,638
median five-year savings
+16% expected savings
5th$326,62925th$1,328,077 75th$3,414,75595th$7,149,812
With additional cost containment: $3.29M to $4.98M more potential savings; win rate rises to ~100%.
Self-Funded Captive 100% chance of beating Fully Insured
$2,176,452
median five-year savings
+16% expected savings
5th$626,47625th$1,363,100 75th$3,609,94895th$7,491,563
With additional cost containment: $3.33M to $4.40M more potential savings; win rate rises to ~100%.
Taft-Hartley 23% chance of beating Fully Insured
−$2,636,669
median five-year savings
-15% expected savings
5th−$5,794,47125th−$4,214,391 75th−$390,95095th$5,055,530
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$855 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 requested (filed) rates, not yet final$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded · ~12% cheaper
Highest modeled five-year medianSelf-Funded Captive · $2,176,452
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 19.69% (proposed, not yet final). Fully-insured renewal expectation used here: 9.6% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 15.7%.
500 Employees
500-employee funding analysis · 2027
Modeled with conservative assumptions, 2,000 Monte Carlo runs, and 2027 West Virginia market rates.
Choose another size ↑Blackwell underwriter reviewed and validated
Chance of beating Fully Insured over 5 years
PEO34%
Self-Funded99%
Self-Funded Captive100%
Taft-Hartley18%
Five-year median savings versus staying Fully Insured
PEO −$2,322,798
Self-Funded $4,056,008
Self-Funded Captive $4,031,200
Taft-Hartley −$5,277,037
5th to 95th percentile 25th to 75th Median
PEO 34% chance of beating Fully Insured
−$2,322,798
median five-year savings
-10% expected savings
5th−$14,080,71325th−$6,178,580 75th$1,662,70095th$11,014,198
Self-Funded 99% chance of beating Fully Insured
$4,056,008
median five-year savings
+16% expected savings
5th$933,23425th$2,504,871 75th$6,598,32895th$14,013,419
With additional cost containment: $6.63M to $8.69M more potential savings; win rate rises to ~100%.
Self-Funded Captive 100% chance of beating Fully Insured
$4,031,200
median five-year savings
+16% expected savings
5th$1,178,50025th$2,533,684 75th$6,642,29995th$14,231,763
With additional cost containment: $6.68M to $8.11M more potential savings; win rate rises to ~100%.
Taft-Hartley 18% chance of beating Fully Insured
−$5,277,037
median five-year savings
-16% expected savings
5th−$10,785,79125th−$8,075,494 75th−$1,552,83795th$6,802,897
Fixed · nationwide · transparent pricing Get your Taft-Hartley rate →
Fully Insured today: ~$855 per employee/month is the baseline. Every savings figure above is measured against it.Rates used: PY2027 requested (filed) rates, not yet final$0 saved
Day-one and five-year context
Lowest modeled day-one costSelf-Funded · ~12% cheaper
Highest modeled five-year medianSelf-Funded · $4,056,008
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 19.69% (proposed, not yet final). Fully-insured renewal expectation used here: 9.6% a year over five years (six-year filed average incl. 2027); next 1 to 3 years 15.7%.
2026 analysis vs 2027
For 70-employee groups in West Virginia, the modeled median five-year savings for Self-Funded Captive moved from $417,948 to $475,432, and its modeled chance of beating Fully Insured moved from 99% to 98%.
| Employees | PEO | Level-Funded | Self-Funded | Self-Funded Captive |
|---|---|---|---|---|
| 10 | $109,746 → $161,66293% → 96% odds | $70,673 → $115,12674% → 79% odds | Not modeled | Not modeled |
| 30 | $329,239 → $484,98793% → 96% odds | $351,521 → $510,91587% → 89% odds | Not modeled | $315,905 → $458,93190% → 92% odds |
| 70 | $1,841 → $2,20350% → 50% odds | $273,442 → $327,28386% → 86% odds | Not modeled | $417,948 → $475,43299% → 98% odds |
| 150 | −$265,119 → −$317,32143% → 43% odds | Not modeled | $971,593 → $1,162,89993% → 93% odds | $1,019,110 → $1,166,609100% → 100% odds |
| 250 | −$958,630 → −$1,147,38437% → 37% odds | Not modeled | $1,747,546 → $2,091,63897% → 97% odds | $1,892,436 → $2,176,452100% → 100% odds |
| 500 | −$1,940,678 → −$2,322,79834% → 34% odds | Not modeled | $3,388,761 → $4,056,00899% → 99% odds | $3,516,092 → $4,031,200100% → 100% odds |
Fully Insured baseline used: $715 → $855 per employee per month (PY2026 rates → PY2027 requested (filed) rates, not yet final). 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 West Virginia 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 PY2027 requested (filed) rates can change before they are final.
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