10-Year Benefits Cost Projector

What Does Staying Put
Actually Cost You?

Enter your basics. See the ten-year gap between your current path and a managed strategy — and understand what uncontrolled costs actually look like compounded over a decade.

Know your exact number? →
$
Quick PEPY Calculator
Total Annual Premium
÷
Employees on Plan
=
PEPY
★ $9,500–$10,000 is the typical range for most mid-market employers. Tap a button above, or use the calculator if you know your total premium.
or exact →
%
2026 market: underwriters are pricing 8.5–9.5% trend for the third straight elevated year (PwC 8.5% · Aon 9.5%). Not sure what yours was? Tap one to use it — you can still change it anytime: Sources: PwC HRI · Aon · 2025–26 trend surveys
Takes 2 seconds · No login required · Your data stays on your device
📊

Your 10-Year Projection Appears Here

Fill in all three fields and tap the button above

-
10-Year Uncontrolled Cost
Status quo — no strategy change
-
10-Year Controlled Cost
Managed strategy in place
-
10-Year Savings Gap
The cost of doing nothing
Every renewal you wait costs roughly that never comes back.
-
Current Annual Spend
-
Year 10 Annual (Uncontrolled)
-
Year 10 Annual (Controlled)
-
Year 10 Annual Gap
10-Year Annual Cost Trajectory
Per-year total spend — Projected 2026–2035
Uncontrolled
Controlled
Cumulative Savings Gap — Year by Year
The gap accelerates every year as the two cost lines diverge. By year 10, the compounding effect is dramatic.
What Could You Do With That 10-Year Savings?
👥
-
New Hires Funded
📈
-
Added to Bottom Line / Yr
💰
-
Saved Per Employee / Yr
Where Your Premium Dollar Actually Goes
On a fully-insured plan, here is what you are paying for
60–65%
Actual Claims Paid
15–20%
Carrier Profit + Retention
8–12%
Admin Fees
5–10%
Risk Charge
???
Unused Claims Surplus — Carrier Keeps 100%

The question nobody asks: If only 60–65 cents of every premium dollar goes to actual claims, what happens to the rest? On a fully-insured plan, the carrier keeps it all. On an alternative structure, those dollars flow back to you. Over 10 years, this compounds into a transformational number.

What Is Driving Your Costs Right Now

These forces are hitting every employer — but fully-insured plans absorb the full impact with no tools to manage it.

$36B
GLP-1 Drug Spend
Semaglutide alone projected at $36B in 2026. Avg employer GLP-1 spend doubled in 2 years.
50%+
Specialty Rx Share
Over half of all pharmacy spend is now specialty drugs. 80+ new launches coming 2025–2027.
2x
Oncology Costs
Per-member oncology costs projected to double by 2027. Cell and gene therapies reach $4.25M per treatment.
11%
Pharmacy Trend
Projected pharmacy cost increase in 2026 — the steepest in over a decade. And it compounds every year.

Why this matters to you: On a fully-insured plan, every one of these trends hits your renewal with no filter. On a managed structure, you have pharmacy programs, care management, and data visibility to actively reduce the impact. Over a decade, the compounding difference is staggering.

Maximum Exposure Comparison
What is your actual worst case in each scenario?
Fully-Insured "Safe" Option
Worst case: 8–15% renewal increase every year — compounding — with no ceiling.
Surplus: Carrier keeps 100% of unused claims. Healthy year? They profit. You don't.
Visibility: Zero. You fund the risk without seeing the data.
Managed Strategy
Worst case: Capped by stop-loss insurance. Catastrophic claims hit a defined ceiling.
Surplus: 100% returned to you. Healthy year? That is your money back.
Visibility: Full claims data, real-time. You see what drives costs and act on it.
What This Means for Your Leadership Team
For the CEO

The gap above is capital that could fund growth — new hires, equipment, expansion — instead of going to a carrier. Over a decade, this is a strategic advantage that reshapes what your company can afford.

For the CFO

Stop-loss sets a hard ceiling on catastrophic exposure. The "unpredictable" alternative actually has a tighter risk band than uncapped 10%+ annual renewal increases compounding over 10 years.

For the COO

Your employees keep the same doctors, same network, same pharmacies. They get a new ID card. No disruption, no confusion, no operational burden.

For HR

A dedicated concierge line handles employee benefits questions so your team does not have to. Most HR teams say the experience gets better, not harder.

For Your Employees & Their Families

When your company controls costs at the plan level, it means lower deductibles, better copays, and richer benefits for the people who actually use them. The savings don't just show up on a spreadsheet — they show up as lower out-of-pocket costs for an employee's child at the pediatrician, a spouse's prescription that's suddenly affordable, and a family that isn't choosing between a medical bill and a mortgage payment. A smarter benefits strategy doesn't just protect the business. It protects the people who make the business run.

Your Options at a Glance
Three paths — each with real value depending on your situation
Fully-Insured
10-Year Cost
-
The value: Predictable fixed premium. Zero admin burden.
The trade-off: No data. No surplus return. 8–11% annual trend exposure compounding for a decade.
Best fit: Employers who need absolute simplicity above all else.
Level-Funded
10-Year Cost
-
-
The value: Same fixed payment as FI, but with claims data, surplus return, and care management.
The trade-off: Slightly more complexity. Requires TPA relationship.
Best fit: Employers looking for a smarter structure with built-in protections.
Self-Funded / Captive
10-Year Cost
-
-
The value: Full control. 100% rebates. Real-time data. Captive adds equity.
The trade-off: Variable monthly claims. Stop-loss caps the downside.
Best fit: Employers with stable claims who want the best economics over time.

-

The First Step in Any Strategic Plan

The numbers above tell you what's at stake. But numbers alone don't build a better plan — understanding your options does.

Most employers renew every year without ever seeing the full landscape of how a health plan can be structured. There are multiple funding models — each with different levels of control, visibility, risk, and upside. Knowing what exists and understanding why one structure fits your organization better than another is the foundation of every strategic benefits decision.

A good plan isn't just cheaper. It's the right structure for your workforce, your cash flow, your risk tolerance, and your goals — put in place for the right reasons, with full understanding of how it works.

The Next Question
Before you can build the right plan, you have to see the full picture.
That starts with understanding what's available — and why it matters for your organization specifically.
Next question
Are you ready for renewal?
Score your readiness before the renewal meeting arrives. →
Behind the number
How does health insurance actually work?
Where the dollars go and who touches them on the way. →