Quantify employee out-of-pocket costs and financial strain
The Member Cost Burden Engine calculates total employee out-of-pocket healthcare spend across premiums, deductibles, copays, coinsurance, and non-covered services. It segments employees by income level, family status, and utilization to identify populations experiencing financial hardship. The analysis quantifies affordability metrics, compares to wage data, and models the impact of benefit design changes on employee financial wellness.
Sum premiums, deductibles, copays, coinsurance, and out-of-network costs per employee
Segment by income, family status, chronic conditions, and utilization patterns
Simulate how changes to deductibles, copays, or plan design affect cost burden
Employee Financial Wellness
High out-of-pocket costs create financial stress, reduce care adherence, and contribute to employee dissatisfaction and turnover.
Benefit Competitiveness
Candidates and employees compare affordability across employers. Excessive cost burden makes your benefits package less competitive.
Optimize Plan Design
Understand which cost-sharing levers (deductibles, copays, HSA contributions) provide the best balance between employee affordability and plan cost.
Get a comprehensive member cost burden assessment with segmentation, affordability metrics, and benefit design optimization scenarios.