Compare any two of six funding arrangements side-by-side — with the working capital, float interest, contract protections, and break-even crossover a CFO actually underwrites.
Plan Inputs
Start with what you already know. Type PEPM (per employee per month) if that is how your broker quotes you, or switch to the total monthly premium if that is easier to read off your current bill.
Pick at least 2 arrangements to compare. Any combination of the six works.
Headcount on the plan
Monthly accommodation typically costs ~1-2% more in stop-loss premium
Industry default ~6 weeks
Calendar month of plan-year month 1
How Will You Fund Cash Flow Volatility?
Self-funded claims arrive unevenly. Whether you cover the spikes with internal cash, a credit facility, or a mix changes the true cost.
▪
Float (Internal Cash)
Opportunity cost — what that cash would have earned
▫
Loan / Line of Credit
Interest expense on drawn balance
◐
Combination
Split between float and credit line
Stop-Loss Contract & Protections
Type your deductibles, then answer the questions below. Funding-flow and structural questions come first; embedded medical protections follow. Any "No" surfaces as a flag on the results with a path to fix it.
$ per-person, per-year
Standard: 120-125% of expected claims
Flat dollar amount from your quote
Derived default: $0
Funding-flow & structural contract questions
Without this, you front full catastrophic claim cash then wait for reimbursement.
Without it, aggregate overage is reimbursed only at plan-year close.
Embedded medical-risk protections
These are clinical and pharmacy cost-containment services some carriers bundle into the stop-loss contract. When present, they typically absorb or reroute the six-figure claims that drive renewal increases, which is why they move the needle on long-term premium trajectory.
Bundled with some captive / advanced stop-loss contracts.
Typical savings: 50-70% on a full-year dialysis claim.
Often saves 15-40% on specialty-drug spend.
Directs members to top-outcome facilities at bundled-payment rates.
Typical impact: 3-8% reduction in total medical spend.
Weeks from claim to reimbursement check · typical 4-8 weeks
#5 asks about the provision. This asks about existing lasers today.
Lasered Individuals · labels kept opaque (A/B/C…), no PHI
Claims Simulation · Month 1 through Month 12
Plan-year claims mapped month by month. The default is an evenly-spread baseline derived from your expected claims. Adjust any month's spread, add named high-cost events (specialty Rx, oncology, transplant, etc.), and the math updates downstream.
Baseline · evenly spread
$0/mo
Baseline claims = expected annual claims ÷ 12. "Lumpy" adds ±25% variance between months. "Q4-heavy" back-loads the year to reflect typical deductible-reset behavior.
Total claims in sim ?
$
baseline + events
Members hitting spec ?
0
of 0 events
$ away from aggregate ?
$0
cushion vs sim
Active lasers ?
0
lasered individuals
High-cost claim events ?
Click to add. Each button seeds a typical-size claim — edit amount/month after.
Claim (amount + category)
Plan-Year Month
Applies To
Months labeled 1-12 rotate off your plan-start selection above. Lasered rows apply the individual's higher attachment. Events keep their category icon; rename or convert back to "Other" anytime.
Disclaimer: Directional modeling only. Validate PEPM quotes with your broker, and funding rates/availability with your treasury team before decisioning.
True Cost of Self-Funding ?
Cash-Flow Cost of Funding ?
The single dollar figure for funding cash flow this plan year — opportunity cost in yield mode, interest expense in loan mode.
Monthly Cash Flow by Arrangement ?
Bars above the line are cash out the door. Bars below the line are stop-loss reimbursements coming back in. Each chart is one of the arrangements you selected.
Claim Simulation Impact ?
Financial effect of the simulated claims on top of baseline expected claims. Shows what a CFO actually feels — timing, opportunity cost, and how break-even shifts.
Per-Claim Detail ?
Keep Going ?
Three companion tools that build on what you just modeled. Use them to stress-test a renewal, quantify benefits ROI, or project total health plan cost.