— Core Service
Peer Benchmarking
See how your plan compares to similar organizations across key performance metrics. Without benchmarking, you’re negotiating renewals and making plan design decisions in a vacuum — with no objective frame of reference.
Sample: Your Plan vs. Peer Median
— The Hidden Problem
You Can't Improve What You
Can't Measure Against Peers
Most employers have no idea how their plan stacks up. Is your PMPM cost high for your industry? Is your deductible below market? Are you contributing more to premiums than comparable organizations? Without answers, every renewal is a guess.
- No objective standard for evaluating plan cost or design
- Carrier and broker present data without peer context
- Plan design changes made without understanding market norms
- Leadership decisions based on internal history alone — not external reality
Cost Position
Where you sit vs. peers on total plan cost
Design Gaps
Plan features above or below market norms
Overspend Areas
Unmanaged claimants trigger costly lasers at renewal
Leverage Points
— Deep Dive
What We Benchmark
We compare your plan against peer organizations matched by industry, employee count, geography, and funding type.
01
Per-Member-Per-Month Cost
Total PMPM across medical, Rx, and ancillary — compared against peers in your SIC code and employee size band.
02
Plan Design Comparison
Deductible levels, copays, coinsurance, OOP max, and tier structure compared against industry norms and regional standards.
03
Employer Contribution Strategy
How your employer vs. employee premium split compares. Are you contributing more — or less — than you need to remain competitive?
04
Rx & Specialty Drug Costs
Pharmacy PMPM, generic fill rate, specialty spend as a percentage of total — benchmarked against industry medians.
05
Utilization Patterns
ER visits per 1,000, inpatient admits, outpatient procedures, and preventive care participation vs. peer benchmarks.
06
Trend & Year-Over-Year
How your cost trend compares to market trend. Are you growing faster than your peers — and by how much?
—PROCESS
How Benchmarking Works
01
Gather Your Data
We collect claims, plan design, and contribution data from your current carriers.
02
Match Peer Group
We build a peer comparison set by industry, size, region, and funding type.
03
Deliver the Report
Clear findings showing exactly where you stand — and where to focus.
— What You Get
Expected Outcomes
Clear
Position vs. peer organizations
Specific
Overspend areas identified
Data
For carrier negotiations
Informed
Plan design decisions