Transparency
Scoring methodology
Every audit is scored by a deterministic engine — the same answers always produce the same score. This page documents the inputs, the weights, where the peer benchmarks come from, and what this assessment deliberately does not do.
How the Benefit Score is built
Each answer contributes to a 0–100 score across the factors below, then a readiness band is assigned, so the number and the label never disagree. The relative influence of each factor is shown; the precise point values and thresholds are proprietary to keep the score meaningful and resistant to gaming.
| Factor | Influence | Detail |
|---|---|---|
| Company size | Moderate | Headcount band, since plan economics and compliance obligations shift materially with size. |
| Coverage status | Moderate | Whether group health is offered today, or actively being considered. |
| Renewal timing | High | How close the stated renewal month is — the window where a review is actionable. |
| Renewal increase | High | Reported year-over-year increase, compared against peers in your size band. |
| Reported pain points | Moderate | Cost pressure, retention loss, broker service gaps, and requests for a second opinion. |
| Advisor review interest | High | Explicit interest in a licensed second opinion. |
| Broker satisfaction | Moderate | Self-rated service quality; lower ratings raise the case for a review. |
| Claims loss ratio | Moderate | Applied only when annual premium and claims are both provided. |
Bands
- HotHighest priority for review
- WarmHigh priority for review
- NurtureModerate priority for review
- UnqualifiedLow priority for review
Benchmark sources
Peer comparisons are drawn from published employer surveys, grouped by employee size band. Figures are directional — they describe what employers your size typically do, not what your plan would cost.
Kaiser Family Foundation — Employer Health Benefits Survey (2023)
View sourcePremiums, employer contribution shares, offer rates and year-over-year premium growth, adjusted modestly downward for the smallest size bands.
Covers: employer contribution share, typical renewal increase, health offer rates, employer premium per employee
SHRM — Employee Benefits Survey (2023)
View sourcePrevalence of ancillary and account-based benefits by employer size.
Covers: dental prevalence, vision prevalence, disability prevalence, HSA/FSA prevalence
MetLife — Employee Benefit Trends Study (2023)
View sourceGroup life prevalence and employee sentiment context.
Covers: group life prevalence
Practitioner input — Broker industry notes (2024)
Funding-mix distribution ranges by size band are directional practitioner estimates, not survey data.
Covers: funding mix distribution
Indexed federal figures
The ACA applicable-large-employer threshold and 4980H(a) exposure used in the headcount simulator are stored per plan year. Current plan year in use: 2026 — 50+ full-time equivalents, $3,340 per employee annually beyond the first 30.
- 2024: $2,970 per employee — IRS Rev. Proc. 2023-17 / IRS 4980H Q&A
- 2025: $2,900 per employee — IRS Rev. Proc. 2024-14 / IRS 4980H Q&A
- 2026: $3,340 per employee — IRS Rev. Proc. 2025-25 / IRS 4980H Q&A
Limitations
- This is an educational assessment, not insurance advice, an actuarial analysis, or a quote. No coverage is bound and no rates are guaranteed.
- Results depend entirely on self-reported answers. When a figure is left blank, the engine falls back to the peer benchmark for your size band and labels the report as based on a partial picture.
- Benchmarks are national averages by employee count. They do not adjust for state, industry, workforce demographics, or carrier network.
- Every stored report records the scoring engine version and benchmark dataset version used, so an older report can always be reproduced from its original inputs.
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