Benefits ROI Model

Tailored Benefit Member Experience Calculator

Estimate the annual value of one AI-guided front door for unbundled self-funded health plans — fewer HR questions, better care-pathway decisions, and less plan waste.

Self-funded plansBenefit navigationHR inquiry reductionCare steerage

Inputs

1. HR inquiry load

Repetitive HR/benefits questions caused by plan complexity.

2. Wrong care pathway

3. Plan waste / utilization

Small reductions matter because self-funded employers pay the claims.

Employer value estimate

Annual value$120,750
Per employee / year$121
PEPM value$10.06
Plan spend addressed1.21%
HR inquiry savings$33,750
Avoided wrong-care-pathway spend$12,000
Reduced plan waste / better utilization$75,000

Positioning language

In a self-funded plan, every wrong turn has a cost. An AI-guided benefits front door helps employees choose the right benefit, provider, and care pathway before confusion becomes unnecessary spend.

Suggested claim range: $25–$400+ per employee per year, depending on plan complexity and usage.

This calculator models potential value across HR time, care navigation, and plan waste reduction. It should be used for education, sales discovery, and pilot sizing — not as a guaranteed savings promise.