TrueCost: Fully Insured Equivalent Rate Calculator

Understanding the true cost of self-funding requires more than adding up stop-loss premiums and admin fees. Brokers need accurate, client-ready rate comparisons that account for tier structures, plan differentials, and proper cost allocation across multiple benefit options.

The challenge isn't just the math—it's presenting FIE rates in a format your clients can understand and trust. Without a systematic approach, you risk underestimating costs, misallocating expenses across tiers, or creating rate structures that don't reflect actual liability.

Our TrueCost Calculator handles the complexity: tier ratio calculations, plan differential weighting, aggregate corridor analysis, and laser liability allocation. In 10 minutes, you'll have professional-grade FIE rates ready to present to clients with confidence.

Calculate Your FIE Rates

Follow the step-by-step wizard to input your census, current rates, and stop-loss costs. Get instant FIE rate calculations with detailed cost breakdowns.

Step 1 of 5Group Setup

Group Setup

Enter basic information about the group to get started with your FIE rate calculation.

Tip: The FIE Calculator helps you compare fully-insured equivalent rates to your current rates. Make sure to have your current plan information and stop-loss quotes ready for the most accurate results.

Your calculations are processed securely on our servers.

All proprietary formulas and logic remain protected.

What Your Calculation Might Miss

Even accurate FIE rates don't tell the complete self-funding story. Here are the complexities brokers often overlook when presenting cost comparisons:

Plan Design Impact on Liability

FIE rates assume your plan design stays constant. But changes to deductibles, copays, or network structures can dramatically shift claims liability—and those changes don't show up in static FIE calculations until it's too late.

Stop-Loss Contract Variations

Not all stop-loss quotes are apples-to-apples. Contract provisions like terminal liability, 12/12 vs. 12/15 contracts, and laser carve-outs can change your effective cost by 10-15% without appearing in headline rates.

Mid-Year Enrollment Changes

FIE calculations use static census data, but real groups add employees, change tiers, and experience life events throughout the year. Budget accuracy requires modeling these dynamics— something standard FIE formulas can't do.

Administrative Overhead Reality

The $35 PEPM admin fee in your quote might not include COBRA administration, Form 5500 filing, ACA compliance support, or audit assistance. Hidden admin costs can add $10-20 PEPM to your true self-funding expense.

Cash Flow Timing Mismatches

Even if annual costs match your FIE calculation, monthly volatility can create cash flow problems. Fully-insured rates spread costs evenly; self-funding creates peaks and valleys that strain smaller employers' working capital.

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Real-World FIE Analysis Success Stories

23% First-Year Savings

Regional Healthcare Provider Uncovers Hidden Savings

Challenge: A 180-employee healthcare provider was quoted fully-insured renewal rates 18% higher than the previous year. Their broker suspected self-funding could save money but needed accurate FIE calculations to present a compelling case.

Solution: Using our TrueCost Calculator, the broker created detailed FIE rate comparisons across four plan tiers. The analysis revealed that even with conservative stop-loss coverage and high admin fees, self-funding would save 23% compared to the renewal.

Result: The client moved to self-funding and saved $340,000 in year one. The detailed FIE analysis gave leadership confidence to make the switch, and the broker strengthened their advisory relationship by demonstrating sophisticated cost modeling.

Avoided $180K Mistake

Manufacturing Firm Stays Fully-Insured After FIE Analysis

Challenge: A 95-employee manufacturer wanted to self-fund after hearing success stories from peers. Initial rough calculations suggested 15% savings, but the broker wanted to verify before recommending the switch.

Solution: The TrueCost Calculator revealed that once proper tier ratios, lasers for two high-risk employees, and realistic admin costs were included, self-funding would actually cost 8% more than their current fully-insured rates.

Result: The client stayed fully-insured, avoiding a $180,000 mistake and significant operational burden. The broker's credibility soared by preventing a costly error, and they used the FIE analysis to negotiate a better fully-insured renewal instead.

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Questions about your FIE analysis?

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