Our Methodology
Understand how we evaluate benefits programs and generate actionable insights for your organization.
The ScoreMyBenefits score is a comparative assessment that evaluates your benefits program against normalized industry benchmarks and aggregated market data, designed to support decision-making—it is not an actuarial valuation, financial guarantee, or prediction of future outcomes.
Our benchmarks are derived from aggregated public data sources, including government filings, industry surveys, and normalized market ranges, compiled and updated to reflect current benefits market conditions.
ScoreMyBenefits evaluates your benefits program across multiple dimensions and compares your program to aggregated benchmarks for similar organizations. The process is designed to identify where your program aligns with or differs from market norms.
Cost Positioning (30%)
We compare your premium rates, deductibles, and employee cost-sharing against normalized ranges for your industry and company size. Programs with competitive cost structures relative to coverage receive higher scores.
Coverage Design (25%)
We assess whether your plan includes standard and enhanced coverage features commonly offered by organizations in your market segment, including preventive care access, prescription benefits, and care delivery models.
Wellness and Support Programs (25%)
We evaluate the presence and breadth of wellness initiatives, health management programs, and employee support services that research shows contribute to program effectiveness and employee satisfaction.
Program Administration (20%)
We consider funding approaches, pharmacy benefit structures, cost containment strategies, and administrative features that influence program efficiency and employee experience.
Your program data is normalized and mapped to aggregated benchmark ranges derived from public sources, industry surveys, and government filings. We identify where your program falls within observed market distributions—whether below, within, or above typical ranges for organizations similar to yours.
What the Score Means
Scores reflect comparative positioning, not absolute quality. A higher score indicates closer alignment with or exceeding market benchmarks across evaluated dimensions. A lower score suggests opportunities to evaluate whether your program's design, cost structure, or feature set differs from market norms in ways you may want to address.
Letter Grade Thresholds
What the Score Does Not Mean
The score is not a quality rating, actuarial assessment, or guarantee of program performance. It does not predict employee satisfaction, utilization patterns, future costs, or savings outcomes. It is a comparative snapshot designed to support evaluation and discussion with your benefits advisors.
This is a modeled projection based on stated assumptions and current program data. Actual costs will vary based on utilization, carrier changes, market conditions, and plan design modifications.
Key Assumption:
Our projections use a 4.5% annual medical trend rate based on current industry forecasts from sources including Kaiser Family Foundation and Centers for Medicare & Medicaid Services.
High Confidence
Complete program data was provided, including verified premium rates, plan design details, and participation information. The assessment is based on comprehensive inputs aligned with your stated industry and company size.
Medium Confidence
Most program details were provided, but some information was estimated or derived from industry ranges. The assessment reflects available data and may be refined with additional program details.
Low Confidence
Limited program information was available, requiring significant reliance on industry averages and normalized assumptions. This assessment provides directional guidance but should be considered preliminary until more complete data is provided.
Our benchmarks are compiled from multiple authoritative sources, including:
- Kaiser Family Foundation (KFF) - Employer Health Benefits Annual Survey
- Centers for Medicare & Medicaid Services (CMS) - National Health Expenditure Projections
- Society for Human Resource Management (SHRM) - Health Care Benefits Reports
- America's Health Insurance Plans (AHIP) - Market Surveys
- U.S. Department of Labor - Form 5500 filings (public database)
Benchmarks are reviewed and updated regularly to reflect current market conditions and regulatory changes.
ScoreMyBenefits is a decision-support tool designed to help you evaluate and compare your benefits program against market benchmarks. It is not a substitute for actuarial analysis, legal counsel, or licensed underwriting services.
The scores, projections, and recommendations provided are based on aggregated data and modeled scenarios—they reflect comparative positioning, not guaranteed outcomes. Your actual costs, savings, and program performance will vary based on plan design, carrier contracts, employee demographics, utilization patterns, and market conditions.
We recommend consulting with qualified benefits advisors, actuaries, and legal professionals before making benefits decisions. ScoreMyBenefits does not provide actuarial, legal, tax, or underwriting advice.