Employees never see your premium. They see their paycheck deduction and their deductible.
Premium tells you what the plan costs you. Contribution and out-of-pocket exposure tell you what it costs the person using it, and that is what decides whether staff value it, stay for it or waive it. We benchmark those numbers first and put premium in its place.
A plan can be cheap for you and expensive for everyone on it.
Two employers with the same premium can deliver very different plans, because one pays most of the family tier and the other shifts it to payroll deductions and a high deductible. We line up the numbers an employee actually feels.
See how your employee share compares in Michigan →
Contribution by Tier
Employee-only contributions are where most employers look competitive. Family tiers are where they often are not, which is why we benchmark every tier separately, so a gap that only hits parents does not hide inside an average. Tier-by-tier benchmarking reveals hidden contribution gaps.
Deductible and Out-of-Pocket Maximum
The deductible decides what a routine year costs; the out-of-pocket maximum decides what a bad year costs. We compare both, because a plan that looks rich on copays can still leave a hospitalized employee with a bill they cannot pay.
Total Employee Cost in a Real Year
We combine annual contributions with expected cost sharing for a light user, a moderate user and a heavy user, so the comparison shows what each plan costs a real household rather than a single headline figure. Scenario-based cost comparison shows true plan value.
Account Money Counted Honestly
An HSA or HRA contribution offsets the deductible only if the employer funds it and the employee knows it is there. We count employer account money in the comparison, so a high-deductible plan with strong funding is not judged as if it had none.
Check your lowest-cost contribution against the affordability test →
Most renewals shift cost to employees without anyone deciding to.
Holding the employer’s share flat as a percentage feels neutral. Year after year it quietly moves more dollars onto employees, and the benchmark is the only place that drift becomes visible.
The Buy-Down Habit
Raising the deductible is the fastest way to trim a renewal, so it happens again and again. We show where your deductible now sits against peers, which is often further out than anyone intended. Deductible benchmarking shows how far buy-downs have drifted.
The Waiver Signal
When lower-paid employees waive coverage, the plan has usually become unaffordable to them before anyone noticed. We read waiver patterns alongside contribution levels, because the people leaving the plan are telling you what the benchmark will confirm. Waiver patterns reveal affordability problems early.
The Recruiting Mismatch
Candidates compare paycheck deductions, not premiums. If your family contribution is out of line with employers you hire against, the offer loses ground no matter how good the network is, so we benchmark against the employers you actually compete with.
The benchmark does not tell you to spend more. It tells you where to spend.
Matching the market on every line is rarely the goal. The useful question is which gap is costing you people and which one nobody notices.
Where to Close the Gap
If family contributions are the outlier and turnover sits among employees with dependents, a shift in the contribution strategy can do more than a richer plan, so we model that shift before any design change. Targeted contribution strategy can outperform richer plans.
Where to Hold
If you are ahead of the market on employee-only cost, that is a deliberate advantage worth keeping. We say so, because the benchmark should protect good decisions as well as flag weak ones. Protecting a competitive advantage is part of a smart contribution strategy.
Where to Explain
Sometimes the plan is competitive and employees simply do not know it. Then the fix is communication, not cost, and we point you to the message rather than the renewal. Better communication can close a perceived benefits gap. Sometimes the message is the fix.
What employers ask about contribution benchmarks.
Who are we compared against?
Our benchmarking survey covers nearly a thousand employers. We compare you with employers who match on size, industry and region, so the peer group looks like the market you hire in, not a national average. Matched peer groups make contribution benchmarking meaningful.
Is premium ignored?
No. Premium still matters to your budget, and we show it. It simply comes after contribution and out-of-pocket exposure, because those are the figures that shape how employees judge the plan. Contribution and out-of-pocket benchmarks shape employee perception. Premium still matters to budget.
Does affordability for the ACA enter into it?
For applicable large employers it does, because the lowest-cost self-only contribution is tested against employee pay. We flag where a contribution change could affect that test and bring in counsel or a CPA where a judgment call is needed. Contribution benchmarking and ACA affordability go hand in hand.
Where the Rules Come From.
The laws and rules named on this page link to the statute or regulation they come from. This is general information, not legal or tax advice, and rules change, so check the current text.
Affordable Care Act (Public Law 111-148)
The 2010 health reform law, with later amendments, behind employer coverage, reporting and market rules.
Health Savings Accounts (26 U.S.C. 223)
Tax rules for health savings accounts paired with qualifying high-deductible health plans.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
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