Plan Design Modeling Tool Options
| Tool Type | Accuracy | Cost | Best For |
|---|---|---|---|
| Actuarial software (Milliman, Optum) | Highest | High ($5,000–$20,000/year) | Large employers; complex changes |
| Carrier/TPA modeling tools | High | Free (included with relationship) | Proposed changes to current plan |
| Broker technology platforms (Zywave, BenefitPoint) | Medium | Moderate ($2,000–$5,000/year) | Mid-size employers; standard changes |
| Spreadsheet models | Directional | Low (time investment) | Small employers; simple changes |
Building a Spreadsheet Model
A basic spreadsheet model for plan design changes requires: current utilization data (claims by service category), cost-sharing elasticity assumptions (how much utilization changes with cost-sharing), and the proposed cost-sharing change. The model calculates the expected change in utilization and cost.
Presenting Modeling Results
Pro Tip
Present modeling results with appropriate uncertainty ranges — not as precise predictions. "Our modeling suggests this change will save $150,000–$250,000 annually, depending on employee behavioral response" is more credible than "this change will save exactly $200,000." Clients who understand the uncertainty are less likely to be disappointed if actual results differ from projections.