Free · Filed 2026 rates · Nothing transmitted
Would a CHOICE Arrangement cost less than your group plan?
A CHOICE Arrangement has no price. It has a contribution you pick. So the question is what equivalent coverage costs on the individual market instead.
What you get: your total plan cost and census, priced against the lowest-cost Silver plan filed in your county for 2026. The answer is a gap, per month and per year.
Not a quote. Not advice about whether to switch. Just the arithmetic, in about 60 seconds.
How to use this
Two steps, then a gap
- Pick your state. The benchmark pre-fills with your state median. Overwrite it with your own county for a real number.
- Enter total monthly plan cost. Employer plus employee, before payroll deductions.
- Enter your census by age band, then covered spouses and children.
Green: the individual market prices lower than your plan.
Orange: your group plan prices lower. Funding to equivalence would cost more.
The gap is the size of the conversation, not the savings. Silver sits at roughly 70% actuarial value, so a richer group plan is worth more than the comparison shows. Nothing you enter is transmitted.
Step 1 · Where your people are
Step 2 · Who is enrolled
How to read your number
Is the gap my savings?
Short answer. No. It's the distance between two prices. Price is one of several things that move when you change funding structure.
Why can the two numbers differ so much?
A group premium is built partly from your own claims. One high-cost claimant and your renewal carries it forward. Individual market rates come from a statewide pool, and your group's experience isn't in it.
↳ Rough claims year: you usually gain more than the comparison shows.
↳ Clean claims year: you usually gain less.
How much does the age mix decide it?
Individual market rates run a 3:1 age band. A 64-year-old pays exactly 3 times a 21-year-old, every carrier, every state on the federal curve. Small group runs the same curve in most states.
↳ Young census: prices well in both, so claims history decides it.
↳ Older census: prices badly in both, so the question is which pool absorbs it better.
What's left out on purpose?
| Left out | Why |
|---|---|
| Premium tax credits | An employee with an affordable CHOICE Arrangement offer can't claim them. Including them would flatter the result. |
| Admin and platform fees | They vary. Publishing a number we can't verify for you would be guessing. |
| Payroll tax effects | Real, but they depend on your contribution design and your CPA's read. |
| Anything bundled on top | Programs layered alongside coverage change the picture for a group plan too. |
Where does the data come from?
Lowest-cost Silver premiums are the final filed 2026 rates from the CMS Qualified Health Plan public use files, at the rating area your county sits in. Age factors are the federal default age curve.
21 jurisdictions run their own exchanges and don't file into that dataset. For those you enter the benchmark yourself. We'd rather ask for a number we can't verify than publish one we reconstructed.
What the freed budget can fund
What can the freed budget actually pay for?
Short answer. Care your people use at $0 copay, sitting on top of whatever plan you run. Funded from the difference, not added to your budget.
| What your people get | Member cost | Why it moves plan cost |
|---|---|---|
| 2,400+ medication formulary | $0 | Fills outside the plan never hit the claims fund |
| Virtual urgent care and telehealth | $0 | Competes with an ER visit that lands on the plan |
| Behavioral health, licensed clinicians | $0 | Untreated, it drives medical claims and turnover |
| Pain and musculoskeletal care | $0 | Among the largest spend categories in employer plans |
| Cardiometabolic care | $0 | Early beats treating the complication later |
| Women's health | $0 | Deferred care presents later and costlier |
| Wellbeing and care navigation | $0 | Site of care steering works without plan changes |
| Accident protection Fixed indemnity. Not major medical, does not replace a health plan | Varies | Keeps a deductible from becoming a hardship |
| Member discount programs Legal, identity, caregiver, pet, household. Discount programs, not insurance | Included | Financial stress shows up as absence first |
Why it's funded out of savings, not out of budget
↳ $0 upfront.
↳ Budget freed on day 1.
↳ Savings realized monthly.
↳ No layoffs, no plan cuts, no disruption to people, systems or processes.
Most employers haven't had visibility or access to this previously. It sits outside the commissioned channels most brokers work in, which is structural and isn't anyone's fault.
Questions this raises
Does this tell me what a CHOICE Arrangement would cost me?
Should I enter my cost or my employees' cost?
My group plan is richer than Silver. Does that break this?
Why don't you include premium tax credits?
How much does the age band midpoint distort this?
My people are in several states. What then?
Why is my state missing a pre-filled rate?
What happens to what I type here?
Sharpen the inputs
Three free tools, all built from filed 2026 rate data. No form, no login.
Get the exact benchmark for your county
Lowest-cost Silver by county and age across 3,143 counties, plus the affordability test number.
Is your group plan high, or is your census just older?
Your percentile against filed small group premiums in your state. All 50 states plus DC.
These are 2 of 6 options
Level funded, self-funded and shelf-rated structures compared by group size, census age and industry.
The next question
You have the gap. Do you know which levers close it without touching your people?
Changing funding structure is one way. It is not the only way, and it's rarely the fastest.
Most of what we find sits on top of the plan you already have. No layoffs, no plan changes, no disruption to people, systems or processes. Budget freed on day 1, savings realized monthly, $0 upfront.
See what's available to youNo obligation. Nothing to sign.
Sources and limits. Individual market premiums are the lowest cost Silver plan filed for the 2026 plan year in the rating area each county sits in, from the CMS Qualified Health Plan public use files, covering the 30 states on the federal platform. Age factors are the federal default age curve. A small number of counties span more than one rating area; where that happens the tool uses the area CMS lists first, and rates for your employees may differ by ZIP. 21 state-based exchanges do not file into the federal dataset and require manual entry. This tool compares premium against premium. It does not account for actuarial value differences between your plan and Silver, administration fees, payroll tax effects, or premium tax credits, which an employee with an affordable CHOICE Arrangement offer cannot claim. Output is general educational information, not a quote, not an offer of coverage, and not insurance, tax or legal advice. All calculation happens in your browser and no inputs are transmitted or stored.