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Employer Benefits IQ
Transparency

Platform Methodology

Every score, benchmark, vendor profile, and AI-generated analysis on this platform follows a documented methodology. This page explains exactly how each system works, what data it uses, and where its limitations lie.

Assessment system

Three levels of benefits analysis

Start with the Checkup, receive an Employer Benefits Scorecard, build your ongoing Benefits IQ Score, then request the 126-Point Benefits Benchmark when you are ready for a deeper review.

Level 1

Benefits IQ Checkup™

Quick screening — no data required

Time

5 minutes

Scope

6 screening areas

What's covered

  • Cost & Renewal
  • Plan Structure
  • Pharmacy Strategy
  • Data & Vendors
  • Compliance
  • Employee Experience

Outcome: Employer Benefits Scorecard

No claims data needed

Level 2

Benefits IQ Score™

Ongoing score — built from your tool results

Time

Builds over time

Scope

12 performance domains

What's covered

  • All 6 Checkup screening areas, plus:
  • Vendor contract quality
  • Data & analytics access
  • Population health management
  • Fiduciary governance
  • Benefits communication
  • Cost containment strategy

Outcome: Live dashboard score

Tool results aggregate automatically

Level 3

126-Point Benefits Benchmark

Deep-dive — Corry reviews your plan personally

Time

126 evaluation points

Scope

All plan dimensions

What's covered

  • Cohort-matched cost benchmarks
  • Named source citations (9 surveys)
  • Contract red-flag review
  • Pharmacy spend analysis
  • Specific vendor recommendations
  • Corry Hull reviews personally

Outcome: Written findings + recommendations

Claims data welcome (not required)

The Checkup produces your Scorecard. Your Scorecard and tool results inform your ongoing Score, while the 126-Point Benchmark provides the most detailed review. You can start at any level.

Foundation — The EmployerBenefitsIQ Evaluation Framework™

One framework. Every tool. Every vendor.

Every score, vendor profile, and AI recommendation on this platform traces back to the same 10 evaluation dimensions. This is what makes EBIQ recommendations explainable — not arbitrary AI output, but a documented framework applied consistently.

1Cost
2Transparency
3Contract
4Integration
5Clinical Value
6Employee Experience
7Data Access
8Implementation
9Flexibility
10Fiduciary Alignment
View the full framework

Each dimension includes a definition, vendor question, employer question, and red flags.

1 of 4 — Scoring

Benefits IQ Score™

A composite 0–100 score across 12 performance domains, calculated from tool results and employer profile data. Scores are progressive — partial data produces valid but flagged estimates.

How the score is calculated

  • Each of the 12 performance domains receives a 0–100 sub-score based on tool results.
  • Sub-scores are multiplied by their domain weight and summed to produce the composite.
  • A confidence percentage (0–100%) reflects how much data backs each domain.
  • Domains with no data default to 0 with a confidence of 0% — they do not inflate the score.
  • The overall confidence is the weighted average of all domain confidences.
  • Scores update automatically each time a tool is completed.

Score bands

Needs Attention (0–49)

Significant gaps requiring immediate action

Fair (50–69)

Foundational elements in place; key improvements needed

Good (70–84)

Strong performance with targeted optimization opportunities

Excellent (85–100)

Best-in-class — maintain and benchmark continuously

12 performance domains and weights

These 12 domains are the actual scoring units of the Benefits IQ Score™. For navigation and tool grouping, the platform organizes tools under 6 strategic pillars — but the score is always calculated from the 12 domains below. The Benefits IQ Checkup™ (Level 1) uses 6 screening areas as a simplified starting point; those screening areas map into these 12 domains as you complete additional tools.

CategoryWeightWhat it measures
Financial Strategy14%Cost control, trend management, renewal strategy
Compliance12%ACA, ERISA, HIPAA, COBRA, MHPAEA, CAA obligations
Funding Strategy11%Self-funding, captive, and risk-financing sophistication
Pharmacy Benefits11%PBM transparency, formulary design, drug cost management
Plan Design9%Plan structure, deductibles, OOP limits, HSA/HRA
Employee Experience9%Affordability, engagement, satisfaction, access to care
Transparency8%Data access, claims reporting, vendor accountability
Vendor Management8%TPA, PBM, and carrier performance and contract quality
Risk Management8%Stop-loss coverage, catastrophic exposure, risk financing
Care Navigation5%Advocacy, second opinion, centers of excellence
Mental Health Parity3%MHPAEA compliance, EAP quality, behavioral health access
Communication2%SPD quality, open enrollment materials, employee education

Important limitation

The Benefits IQ Score™ is an educational self-assessment tool, not a certified audit or actuarial analysis. Scores reflect the quality of employer decisions and vendor relationships relative to best practices — not absolute financial outcomes. A high score does not guarantee cost savings or legal compliance.

2 of 4 — Benchmarking

Benchmark Methodology

EBIQ benchmarks take three distinct forms depending on whether public data exists. Each form is clearly labeled on every benchmark page.

Form 1

Statistical benchmarks

Percentile data drawn from nationally recognized surveys. Sources include KFF Employer Health Benefits Survey, Mercer National Survey of Employer-Sponsored Health Plans, SHRM Benefits Survey, and Milliman Medical Index. Data is refreshed annually when new survey editions are published.

Examples:

  • Premium contribution %
  • Deductible levels
  • OOP maximums
  • Employer cost per employee
Form 2

Maturity frameworks

For areas where no public benchmark exists, EBIQ uses a 1–5 maturity scale based on industry best practices, Health Rosetta principles, and Corry Hull's 19+ years of employer benefits consulting (since 2007). These are clearly labeled "EBIQ Best Practice" — not external survey data.

Examples:

  • PBM contract transparency
  • Stop-loss structure quality
  • TPA accountability
  • Care navigation sophistication
Form 3

Regulatory guardrails

Statutory limits set by the IRS, CMS, DOL, and HHS. These are not benchmarks in the traditional sense — they are legal thresholds. Sources include IRS Revenue Procedures, CMS NBPP Final Rules, and DOL guidance. Values are updated each plan year.

Examples:

  • HSA contribution limits
  • ACA out-of-pocket maximums
  • PCORI fee rates
  • ACA affordability threshold

Data freshness policy

Every benchmark page displays a "Last reviewed" date. Statistical benchmarks are reviewed annually when source surveys publish new editions (typically Q3–Q4). Regulatory values are updated within 30 days of IRS or CMS publication. Maturity frameworks are reviewed annually for alignment with evolving industry standards.

The full source register — including survey names, publication years, and access URLs — is available on the Benchmark Methodology page.

Projection note

Values labeled "2027 (projected)" are estimates based on IRS inflation-adjustment formulas and CMS proposed rules. They are updated to final values within 30 days of official publication. Projected values are clearly flagged on every benchmark page.

PBM Savings Calculator — specific assumptions

The PBM Savings Calculator uses the following benchmark values. Each is labeled with its source type and the named study or framework it derives from.

AssumptionValueSourceType
Generic fill rate target90%PBMI Drug Benefit Report 2024; EBIQ best-practice consulting frameworkEBIQ Best Practice
Mail order usage target35% of maintenance RxMercer National Survey of Employer-Sponsored Health Plans 2025Statistical
Specialty drug savings rate22% of specialty spendHCCI Employer-Sponsored Insurance Data 2024; published PBM audit findingsStatistical
Spread pricing estimate8–12% of Rx spendFTC Pharmacy Benefit Managers Report (2024); Ohio Medicaid audit; independent PBM audit averagesPublic source
Industry PEPM benchmark$2,200/yearMilliman Medical Index 2025 — employer-sponsored plan average total cost per covered employeeStatistical
Generic fill rate savings rate$8 PEPM per 1% improvementEBIQ analysis of PBMI, Segal, and published PBM audit resultsEBIQ Analysis

Calculator assumptions are reviewed annually. Last reviewed: August 2026. To report a data error, use the corrections form.

3 of 4 — Vendor Intelligence

Vendor Comparison Methodology

EBIQ profiles vendors across 8 categories using a combination of public disclosures, vendor-supplied data, and independent research. Every data point is labeled with its source type.

How vendor data is sourced

Public source

Regulatory filings, CMS disclosures, SEC filings, press releases, and published pricing. Independently verifiable.

Vendor supplied

Data submitted directly by the vendor through our update form. Accepted as-is; not independently audited.

Verified

Cross-referenced against at least two independent sources. Highest confidence level.

Needs verification

Data is present but could not be confirmed against a second source. Treat with caution.

Data architecture

Vendor data is stored in an Entity-Attribute-Value (EAV) schema. Each vendor category has a dedicated table of field definitions — allowing different vendors to have different data completeness without null-padding fixed columns.

The virtual care category uses a three-table EAV model: vc_vendors, vc_field_definitions, and vc_vendor_values — currently holding 20 vendors, 21 field definitions, and 420 value rows.

Vendors can submit corrections or updates at any time via the vendor update form. All submissions are reviewed before publication.

Independence policy

EBIQ does not accept payment from vendors for inclusion, ranking, or favorable treatment in comparison tools or profiles. Vendor profiles are created based on market relevance and employer demand — not commercial relationships.

The full independence and conflict-of-interest policy is available on the Independence page.

Vendor data limitation

Vendor profiles reflect data available at the time of last review. Pricing, contract terms, and service offerings change frequently. Always verify current terms directly with the vendor before making procurement decisions. EBIQ is not responsible for decisions made based on vendor profile data.

4 of 4 — AI Analysis

AI Analysis Methodology

EBIQ uses AI in three distinct ways: rules-based scoring, AI-assisted analysis, and human-reviewed outputs. Each tool is labeled with its classification.

Rules-Based

Deterministic scoring

Tools like the Compliance Health Check and Renewal Impact Calculator use fixed logic trees and regulatory thresholds. No AI model is involved. Outputs are reproducible and auditable. The same inputs always produce the same outputs.

Applies to:

  • Compliance Health Check™
  • Renewal Impact Calculator™
  • Benefits ROI Calculator™
AI-Assisted

GPT-4o analysis

Contract review tools (LTD, Stop-Loss, SPD, PBM) use GPT-4o to extract, classify, and score contract provisions against a structured rubric. The model is prompted with domain-specific criteria developed by Corry Hull, REBC®, CSFS®.

Applies to:

  • LTD Contract AI Review™
  • Stop-Loss Contract Review™
  • SPD AI Review™
  • PBM Contract AI Review™
Human-Reviewed

Expert-validated content

All pillar pages, benchmark data, glossary definitions, and learning modules are written and reviewed by Corry Hull, REBC®, CSFS®. AI may assist with drafting but all published content is human-reviewed before publication.

Applies to:

  • Pillar pages
  • Benchmark data
  • Glossary terms
  • Learning modules

Model and data handling

Model: GPT-4o (OpenAI) via the OpenAI API.

Prompts: Structured domain-specific rubrics developed by Corry Hull, REBC®, CSFS®. Prompts are versioned and reviewed when model versions change.

File handling: Uploaded contract documents are processed in-session and are not stored permanently. Files are deleted from server memory after analysis is complete.

PHI policy: Users are warned not to upload documents containing Protected Health Information (PHI). EBIQ is not a HIPAA Business Associate and does not accept PHI.

Rate limiting: AI tools are rate-limited per user session to prevent abuse. Limits reset on server restart (in-memory only — a known limitation).

AI Advisor: The Benefits Advisor uses streaming GPT-4o with a system prompt that enforces educational framing and prohibits specific legal or financial advice.

AI limitation — critical

AI-generated analysis is educational and informational only. It is not legal advice, actuarial analysis, or a substitute for professional consultation. Contract review outputs identify potential issues for further investigation — they do not constitute a legal opinion. Always engage qualified legal counsel before acting on contract analysis results.

Last reviewed: August 2026. Questions about this methodology? Contact Corry Hull. To report a data error, use the corrections form.