Test three ways to split the premium between company and employees. See what each costs you a year, and what it leaves for an employee-only plan.
Example Figures
The model prices each scenario from the same plan and census.
The percentage of the employee-only premium the company covers. This share also drives the affordability test, because the ACA measures what an employee pays for self-only coverage.
The percentage of the extra cost of covering family members the company pays. The extra cost is the family premium minus the employee-only premium.
The employee’s yearly cost for self-only coverage is compared with 9.96% of income for 2026, or 10.22% for 2027, for the income you enter. It is a screening check for one salary.
The model prices the options. It does not tell you which one fits your workforce.
A richer dependent share is valued unevenly. Employees with families notice it, and single employees may not. The tool shows dollars, not how people respond.
What competitors in your area and industry contribute matters as much as your own budget. Benchmarking gives you that context.
Affordability applies to employers subject to the ACA mandate. Other rules, including nondiscrimination, can also shape how you set contribution levels.
The ACA employer mandate requires offering affordable coverage to full-time employees and their children, but it does not require you to pay any part of dependent premiums. Many employers contribute anyway.
Self-only coverage is affordable when the employee’s share of the premium is within 9.96% of household income for 2026, or 10.22% for 2027. The check above uses one income you enter.
The numbers show cost, not fit. A common starting point is a high employee-only share and a lower dependent share, then test it against peers and against what your employees value.
Contribution benchmarks by industry and size give you a reference range. We can run that comparison for your group.
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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