Benchmarking and modeling. Your plan against employers like you.

Your plan design and employee contributions only make sense next to employers like you. Ethos Benefits benchmarks deductibles, out-of-pocket limits, contributions and cost per employee against peers, models ACA affordability and the financial impact of each proposed change, and shows your committee the trade-offs before anything is decided.

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What you get.

Benchmarks are often pulled once, at renewal, to justify a decision already made. Used properly, they frame the decision before it is made.

Plan design benchmarkingDeductibles, out-of-pocket limits, copays and coinsurance compared with employers of similar size, industry and region.
Contribution benchmarkingWhat employees pay for each coverage tier, compared with peers.
Affordability modelingEach plan option tested against the ACA affordability standard for your lowest-paid eligible employees.
Financial impact modelingThe cost to the company and to employees of each proposed plan design or contribution change.
Benefits review across employee groupsEvery plan and class of employee checked for accuracy and consistency.

What we benchmark.

Measure	Why it matters
Deductibles and out-of-pocket limits	What employees face when they use care
Employee contributions by tier	What employees pay before they use care
Cost per employee	What the plan costs the company
Pharmacy design	Where drug costs are shared

Benchmarks are a starting point.

An average tells you where the middle is, not where your plan should be. Ethos uses benchmarks to frame the options for your committee, then models what each option would cost and how it would land with employees, so the decision rests on your plan’s own numbers.

Part of your Fiduciary Framework™.

Every Ethos service reports to your benefits committee. The work is reviewed at your quarterly committee meeting, each decision is recorded with the reasoning behind it, and the record lives in your Ethos Fiduciary OS. That is what lets your committee show the plan was run prudently.

See the Fiduciary Framework™ · How fiduciary governance works

Sources

Employer shared responsibility provisions, Internal Revenue Service

Questions employers ask about this.

Who are we compared against?

Employers of similar size, industry and region. The peer group is shown with every benchmark so your committee knows what the comparison means.

Should our plan match the benchmark?

Not necessarily. A benchmark shows where your plan stands. Whether to move toward it depends on your goals, your workforce and your budget.

What is ACA affordability?

Under the ACA, coverage is affordable if the employee’s required contribution for the lowest-cost self-only plan stays under a percentage of income that the IRS sets each year. Employers usually test it using one of the IRS safe harbors.

See what your plan is really costing you.

A Strategic Analysis starts with your plan documents and your broker agreement, then shows you what your plan costs, where the risk sits, and what a committee would decide with the full picture.

Request a Strategic Analysis Call (407) 803-4710