# Prescience: dated figures and their sources

> Every headline statistic on www.getprescience.com, each with the page that carries it and how to cite that page. Generated from the live pages: a figure removed from its page leaves this list.

Reuse a figure only with the page's own caveat, population and year. Cite the page, not this list.

## TriNet review: the PEO that will not tell you the price

Source: https://www.getprescience.com/guides/trinet-review
Cite as: Rishab Jain. "TriNet review: the PEO that will not tell you the price." Prescience, October 28, 2026. https://www.getprescience.com/guides/trinet-review

- **2%** (TriNet will not publish a price. That is the point.). Chamber of Commerce puts PEO fees at 2% to 12% of monthly payroll, or roughly $50 to $250 per employee per month.
- **12%** (TriNet will not publish a price. That is the point.). Chamber of Commerce puts PEO fees at 2% to 12% of monthly payroll, or roughly $50 to $250 per employee per month.
- **66%** (TriNet will not publish a price. That is the point.). The company states that clients see an average of $234,000 in HR-related time savings over three years, a 66% return on their investment, and payback in under six months.
- **4%** (The renewal is where the relationship changes). A single invoice looks tidy and hides the fact that you cannot tell whether the health coverage went up 4% or the administration fee went up 15%.
- **15%** (The renewal is where the relationship changes). A single invoice looks tidy and hides the fact that you cannot tell whether the health coverage went up 4% or the administration fee went up 15%.
- **75%** (The renewal is where the relationship changes). In fact the administration fee rose 75% while the medical cost rose 6%.
- **6%** (The renewal is where the relationship changes). In fact the administration fee rose 75% while the medical cost rose 6%.
- **7%** (The renewal is where the relationship changes). Year 2 service fee at 7%: $266,028
- **22.6%** (The renewal is where the relationship changes). Total increase: $142,812 (22.6%)
- **10%** (How I would compare TriNet with a real quote). If the all-in figure you are quoted lands more than 10% to 20% above comparable fully insured coverage, the bundle is costing you money you could be putting into the plan itself.
- **20%** (How I would compare TriNet with a real quote). If the all-in figure you are quoted lands more than 10% to 20% above comparable fully insured coverage, the bundle is costing you money you could be putting into the plan itself.

## HDHP vs PPO calculator

Source: https://www.getprescience.com/tools/hdhp-vs-ppo-calculator
Cite as: Rishab Jain. "HDHP vs PPO calculator." Prescience, October 28, 2026. https://www.getprescience.com/tools/hdhp-vs-ppo-calculator

- **7.65%** (How the comparison works). HSA money from payroll skips federal and most state income tax and the 7.65% FICA tax.
- **22%** (How the comparison works). At a 22% federal bracket and 5% state tax, every $1,000 you contribute saves about $347.
- **5%** (How the comparison works). At a 22% federal bracket and 5% state tax, every $1,000 you contribute saves about $347.
- **20%** (Family coverage: embedded and aggregate deductibles). PPO: $1,500 + 20% × $3,500 = $2,200

## The alternative to a fully insured small group plan

Source: https://www.getprescience.com/compare/fully-insured-alternative
Cite as: Aditya Jain, MD. "The alternative to a fully insured small group plan." Prescience, October 28, 2026. https://www.getprescience.com/compare/fully-insured-alternative

- **10–20%** (Typical savings). Usually 10–20% vs. fully insured, fixed in your quote
- **$26,993** (How a fully insured plan works). KFF's 2025 survey put the average employer family premium at $26,993 and single coverage at $9,325, with family premiums up 6% in a year, the third straight year of 6% or more.
- **$9,325** (How a fully insured plan works). KFF's 2025 survey put the average employer family premium at $26,993 and single coverage at $9,325, with family premiums up 6% in a year, the third straight year of 6% or more.
- **6%** (How a fully insured plan works). KFF's 2025 survey put the average employer family premium at $26,993 and single coverage at $9,325, with family premiums up 6% in a year, the third straight year of 6% or more.
- **80%** (Where the premium goes). Under the ACA, insurers generally must devote at least 80% of adjusted premium revenue in the individual and small-group markets, or 85% in the large-group market, to claims and qualifying quality improvement.
- **85%** (Where the premium goes). Under the ACA, insurers generally must devote at least 80% of adjusted premium revenue in the individual and small-group markets, or 85% in the large-group market, to claims and qualifying quality improvement.
- **10%** (What 5, 25 and 75 employees pay in a year). Here is the yearly cost of a fully insured plan at three team sizes, next to a plan priced 10% and 20% lower, the usual range for a Prescience quote.
- **20%** (What 5, 25 and 75 employees pay in a year). Here is the yearly cost of a fully insured plan at three team sizes, next to a plan priced 10% and 20% lower, the usual range for a Prescience quote.
- **15%** (What 5, 25 and 75 employees pay in a year). Hypothetical premium 15% lower: $296,014.20/year

## ICHRA vs. group health insurance

Source: https://www.getprescience.com/compare/ichra-alternative
Cite as: Aditya Jain, MD. "ICHRA vs. group health insurance." Prescience, October 28, 2026. https://www.getprescience.com/compare/ichra-alternative

- **9.96%** (2026 affordability). 9.96% for plan years beginning in 2026
- **10.22%** (What an ICHRA is and how the money moves). The 2027 percentage is 10.22%.
- **75%** (What 5, 25 and 75 employees pay: ICHRA vs. group plans). Group employer budget: 25 × $800 × 75% × 12: $180,000
- **25%** (What 5, 25 and 75 employees pay: ICHRA vs. group plans). Group employee premiums: 25 × $800 × 25% × 12: $60,000
- **10%** (How costs change over two to three years). The 10% increase is a sensitivity test, not a forecast.
- **70%** (How costs change over two to three years). It increases the employee's premium balance by 70% when the allowance stays fixed.
- **10–20%** (How a Prescience plan works). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Level-funded plans vs. Prescience

Source: https://www.getprescience.com/compare/level-funded-alternative
Cite as: Aditya Jain, MD. "Level-funded plans vs. Prescience." Prescience, October 28, 2026. https://www.getprescience.com/compare/level-funded-alternative

- **37%** (What a level-funded plan is). They're now common: KFF's 2025 survey found 37% of covered workers at firms with 10 to 199 workers are in a level-funded plan.
- **7%** (What 5, 25 and 75 employees pay: a good year and a bad year). Under these assumptions the refund reduces annual cost by about 7%.
- **25%** (What 5, 25 and 75 employees pay: a good year and a bad year). The hypothetical 25% renewal adds $87,063 next year.
- **70%** (What 5, 25 and 75 employees pay: a good year and a bad year). Claims fund (70%): $243,776
- **30%** (What 5, 25 and 75 employees pay: a good year and a bad year). Fixed costs and stop-loss premium (30%): $104,476
- **80%** (What 5, 25 and 75 employees pay: a good year and a bad year). Good year: claims at 80% of the fund: $195,021
- **50%** (What 5, 25 and 75 employees pay: a good year and a bad year). Good year: refund at 50%: $24,378, paid after run-out
- **10–20%** (What 5, 25 and 75 employees pay: a good year and a bad year). The Prescience column uses the middle of the usual 10–20% range.

## The PEO alternative for health insurance

Source: https://www.getprescience.com/compare/peo-alternative
Cite as: Aditya Jain, MD. "The PEO alternative for health insurance." Prescience, October 28, 2026. https://www.getprescience.com/compare/peo-alternative

- **10–20%** (Typical savings). Usually 10–20% vs. fully insured, fixed in your quote

## How much does employee health insurance cost per month?

Source: https://www.getprescience.com/guides/average-employee-health-insurance-cost
Cite as: Aditya Jain, MD. "How much does employee health insurance cost per month?." Prescience, October 28, 2026. https://www.getprescience.com/guides/average-employee-health-insurance-cost

- **5%** (The national averages, per month). Single premiums rose 5% and family premiums 6% in a year.
- **6%** (The national averages, per month). Single premiums rose 5% and family premiums 6% in a year.
- **26%** (The national averages, per month). Over five years, family premiums grew 26%, a little below wage growth (28.6%) and a little above inflation (23.5%).
- **28.6%** (The national averages, per month). Over five years, family premiums grew 26%, a little below wage growth (28.6%) and a little above inflation (23.5%).
- **23.5%** (The national averages, per month). Over five years, family premiums grew 26%, a little below wage growth (28.6%) and a little above inflation (23.5%).
- **53%** (Small firms pay about the same premium but shift more to families). KFF reports that 53% of covered workers at firms with 10–199 workers have a single deductible of at least $2,000, versus 28% at larger firms.
- **28%** (Small firms pay about the same premium but shift more to families). KFF reports that 53% of covered workers at firms with 10–199 workers have a single deductible of at least $2,000, versus 28% at larger firms.
- **19%** (Three illustrative team budgets). The dependent share is about 19% of the company's bill.
- **50%** (Three illustrative team budgets). Moving dependents from 50% to 100% would add $75,360 a year; moving to 75% would add $37,680.
- **100%** (Three illustrative team budgets). Moving dependents from 50% to 100% would add $75,360 a year; moving to 75% would add $37,680.
- **75%** (Three illustrative team budgets). Moving dependents from 50% to 100% would add $75,360 a year; moving to 75% would add $37,680.
- **80%** (Where the money goes). Federal medical loss ratio rules generally require insurers to meet an 80% standard in individual/small-group markets and 85% in large group, calculated with statutory adjustments and multi-year averaging.
- **85%** (Where the money goes). Federal medical loss ratio rules generally require insurers to meet an 80% standard in individual/small-group markets and 85% in large group, calculated with statutory adjustments and multi-year averaging.
- **8.2%** (Where the money goes). Employers in Mercer's (now Marsh's) 2026 survey expect total health benefit cost per employee to rise 8.2% in 2027 after planned changes, and about 11% if they changed nothing.
- **11%** (Where the money goes). Employers in Mercer's (now Marsh's) 2026 survey expect total health benefit cost per employee to rise 8.2% in 2027 after planned changes, and about 11% if they changed nothing.
- **10–20%** (How to pay less without a worse plan). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## What is the best health insurance for a small business?

Source: https://www.getprescience.com/guides/best-health-insurance-for-small-business
Cite as: Aditya Jain, MD. "What is the best health insurance for a small business?." Prescience, October 28, 2026. https://www.getprescience.com/guides/best-health-insurance-for-small-business

- **53%** (Five things to judge a plan on). The average small-firm deductible was $2,631 in 2025, and 53% of covered workers at small firms had a single deductible of $2,000 or more.
- **20%** (Compare two years, not one). Plan B: $500 deductible + 20% of $1,500: $800
- **10–20%** (My pick). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Group vs. individual health insurance: what's the difference?

Source: https://www.getprescience.com/guides/group-vs-individual-health-insurance
Cite as: Aditya Jain, MD. "Group vs. individual health insurance: what's the difference?." Prescience, October 28, 2026. https://www.getprescience.com/guides/group-vs-individual-health-insurance

- **9.96%** (2026 affordability). 9.96% for the applicable employer-coverage test
- **79%** (How each one is priced). gov individual-medical landscape file checked for this review, 3,203 of 4,044 distinct standard-component plan IDs are HMOs or EPOs, about 79%.
- **100%** (What changed in the individual market in 2026). The temporary enhanced premium tax credits applied through 2025. Under the IRS rules for 2026, the general household-income range for the premium tax credit returns to 100% through 400% of the federal poverty level, with other eligibility conditions.
- **400%** (What changed in the individual market in 2026). The temporary enhanced premium tax credits applied through 2025. Under the IRS rules for 2026, the general household-income range for the premium tax credit returns to 100% through 400% of the federal poverty level, with other eligibility conditions.
- **10–20%** (A group plan built for small teams). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## HDHP vs. copay plan: which is better for employees?

Source: https://www.getprescience.com/guides/hdhp-vs-copay-plan
Cite as: Aditya Jain, MD. "HDHP vs. copay plan: which is better for employees?." Prescience, October 28, 2026. https://www.getprescience.com/guides/hdhp-vs-copay-plan

- **20%** (Four years in one employee's life, on each plan). HDHP: $718 a month, $2,000 deductible, then 20% coinsurance, $5,000 out-of-pocket maximum, $1,000 employer HSA deposit.
- **22%** (What the HSA is really worth). Federal income tax saved (22%): $440
- **7.65%** (What the HSA is really worth). Social Security and Medicare saved (7.65%): $153
- **3%** (Who each plan suits). KFF found that 3% of workers with single coverage in HSA-qualified HDHPs received an employer contribution at least as large as their deductible.
- **10–20%** (Getting both). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Guide to employee health benefits in 2026

Source: https://www.getprescience.com/guides/health-benefits-guide-2026
Cite as: Aditya Jain, MD. "Guide to employee health benefits in 2026." Prescience, October 28, 2026. https://www.getprescience.com/guides/health-benefits-guide-2026

- **$9,325** (What health benefits cost in 2026). KFF's 2025 Employer Health Benefits Survey put the average annual premium at $9,325 for single coverage and $26,993 for family coverage.
- **$26,993** (What health benefits cost in 2026). KFF's 2025 Employer Health Benefits Survey put the average annual premium at $9,325 for single coverage and $26,993 for family coverage.
- **6%** (What health benefits cost in 2026). Family premiums rose 6%, the third straight year of 6% or more, faster than wages and inflation.
- **16%** (What health benefits cost in 2026). Employers paid most of the cost: workers contributed 16% of the single premium and 26% of the family premium.
- **26%** (What health benefits cost in 2026). Employers paid most of the cost: workers contributed 16% of the single premium and 26% of the family premium.
- **28%** (What health benefits cost in 2026). KFF found 28% of covered workers at small firms pay $12,000 or more a year toward family coverage.
- **9.96%** (What changed this year). For 2026, coverage is affordable under the ACA if the employee's share for self-only coverage is no more than 9.96% of household income, up from 9.02%.
- **9.02%** (What changed this year). For 2026, coverage is affordable under the ACA if the employee's share for self-only coverage is no more than 9.96% of household income, up from 9.02%.
- **37%** (What changed this year). KFF reports 37% of covered workers at firms with 10–199 workers in level-funded plans.
- **27%** (What changed this year). Its 27% reported self-funded figure overlaps; the combined share is 51%, not 64%.
- **51%** (What changed this year). Its 27% reported self-funded figure overlaps; the combined share is 51%, not 64%.
- **64%** (What changed this year). Its 27% reported self-funded figure overlaps; the combined share is 51%, not 64%.
- **10–20%** (How we approach it at Prescience). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.
- **95%** (Apply the employer rules in the right order). The offer test generally includes at least 95% of full-time employees and their dependent children.

## The complete guide to health insurance for YC startups

Source: https://www.getprescience.com/guides/health-insurance-for-yc-startups
Cite as: Aditya Jain, MD. "The complete guide to health insurance for YC startups." Prescience, October 28, 2026. https://www.getprescience.com/guides/health-insurance-for-yc-startups

- **2%** (Why a plan beats a raise of the same size). Owners, more-than-2% S corporation shareholders and coverage for people who do not qualify for the tax exclusion need separate treatment.
- **39%** (Why a plan beats a raise of the same size). Paying the premium costs the company about 39% less than paying the same value as salary.
- **7.65%** (Why a plan beats a raise of the same size). Company cost of that raise, with 7.65% employer payroll tax: $16,472.84
- **10–20%** (Where Prescience fits). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Can I give employees a health insurance stipend instead of a plan?

Source: https://www.getprescience.com/guides/health-insurance-stipend
Cite as: Aditya Jain, MD. "Can I give employees a health insurance stipend instead of a plan?." Prescience, October 28, 2026. https://www.getprescience.com/guides/health-insurance-stipend

- **22%** (What a $500 stipend is worth on a paycheck). A separately identified supplemental payment can use 22% federal withholding when the IRS conditions are met, or an aggregate method; a recurring amount included in regular wages may use regular withholding.
- **6.2%** (What a $500 stipend is worth on a paycheck). Social Security is 6.2% up to the wage base and Medicare is generally 1.45% for each side.
- **1.45%** (What a $500 stipend is worth on a paycheck). Social Security is 6.2% up to the wage base and Medicare is generally 1.45% for each side.
- **5%** (What a $500 stipend is worth on a paycheck). State income tax (5%, assumed): −$25.00
- **7.65%** (What a $500 stipend is worth on a paycheck). Employer FICA (7.65%): +$38.25
- **7.5%** (What a $500 stipend is worth on a paycheck). Individual premiums count toward the itemized medical deduction only above 7.5% of adjusted gross income, and only if the employee itemizes and meets the deduction rules.
- **2%** (Edge cases that trip up small companies). Notice 2015-17 lets an S corporation pay or reimburse individual premiums for a more-than-2% shareholder-employee.
- **10%** (What happens if you get it wrong). For failures due to reasonable cause and not willful neglect, section 4980D caps the tax at the lesser of 10% of what the employer paid for group health plans the prior year or $500,000, and the IRS can waive it.
- **10–20%** (Why stipends disappoint). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## HMO vs. PPO vs. EPO: which should your company offer?

Source: https://www.getprescience.com/guides/hmo-vs-ppo-vs-epo
Cite as: Aditya Jain, MD. "HMO vs. PPO vs. EPO: which should your company offer?." Prescience, October 28, 2026. https://www.getprescience.com/guides/hmo-vs-ppo-vs-epo

- **33%** (The four plan types). KFF counts high-deductible plans with a savings option separately: they cover 33% of workers, with an average single deductible of $2,609. An HDHP is a cost-sharing design, not a network type, so it can sit on an HMO, EPO or PPO network.
- **20%** (What a member pays in three illustrative situations). To show the network effect alone, the examples below give all three plans the same in-network design: a $1,500 deductible, then 20% coinsurance, a $350 ER copay and a $6,000 out-of-pocket maximum.
- **40%** (What a member pays in three illustrative situations). The PPO's out-of-network tier has a separate $3,000 deductible and 40% coinsurance.
- **10–20%** (Which to offer). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## How does FAANG offer top health benefits?

Source: https://www.getprescience.com/guides/how-does-faang-offer-top-health-benefits
Cite as: Aditya Jain, MD. "How does FAANG offer top health benefits?." Prescience, October 28, 2026. https://www.getprescience.com/guides/how-does-faang-offer-top-health-benefits

- **80%** (Separate the financing decision from the benefit decision). Employer pays 80%: $720,000 employer; $180,000 employees
- **100%** (Separate the financing decision from the benefit decision). Employer pays 100%: $900,000 employer; $0 employee premiums
- **27%** (The secret is self-funding). KFF's 2025 survey shows the gap clearly: 80% of covered workers at larger firms are in self-funded plans, compared with 27% at firms with 10–199 workers.
- **43%** (What large employers layer on top). KFF found 43% of firms with 5,000 or more workers cover GLP-1 drugs for weight loss.
- **10–20%** (Where Prescience fits for a startup). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## How much do employers pay for employee health insurance?

Source: https://www.getprescience.com/guides/how-much-do-employers-pay-for-health-insurance
Cite as: Aditya Jain, MD. "How much do employers pay for employee health insurance?." Prescience, October 28, 2026. https://www.getprescience.com/guides/how-much-do-employers-pay-for-health-insurance

- **50%** (Common carrier minimum). Often 50% of employee-only premium
- **16%** (What employers pay on average). KFF's 2025 survey found covered workers contribute 16% of the premium for single coverage and 26% for family coverage.
- **26%** (What employers pay on average). KFF's 2025 survey found covered workers contribute 16% of the premium for single coverage and 26% for family coverage.
- **84%** (What employers pay on average). That leaves employers paying 84% and 74%, or about $7,885 and $20,143 a year ($657 and $1,679 a month).
- **74%** (What employers pay on average). That leaves employers paying 84% and 74%, or about $7,885 and $20,143 a year ($657 and $1,679 a month).
- **29%** (What employers pay on average). At small firms, 29% of covered workers face more than half the family premium, versus 5% at large firms.
- **5%** (What employers pay on average). At small firms, 29% of covered workers face more than half the family premium, versus 5% at large firms.
- **9.96%** (Are there minimums?). For plan years beginning in 2026, the affordability percentage is 9.96%.
- **82%** (Six contribution policies, priced for a 10-person team). The company pays about 82% of total premiums.
- **100%** (Six contribution policies, priced for a 10-person team). Going to 100% for families adds $26,496 a year; dropping dependents to 0% saves the same amount.
- **0%** (Six contribution policies, priced for a 10-person team). Going to 100% for families adds $26,496 a year; dropping dependents to 0% saves the same amount.
- **75%** (Six contribution policies, priced for a 10-person team). 75% of employee-only: the company pays more, but families still owe $1,666.25 monthly in this example.
- **2%** (Tax treatment: why a premium dollar beats a salary dollar). More-than-2% S corporation shareholders: special W-2 income inclusion and possible self-employed health insurance deduction rules apply.
- **7.65%** (Tax treatment: why a premium dollar beats a salary dollar). Company adds $777 salary: company cost with 7.65% payroll tax: $836.44
- **29.65%** (Tax treatment: why a premium dollar beats a salary dollar). Employee's tax on the $777 (29.65%): $230.38
- **10–20%** (How to set your contribution). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## How do I get better health benefits as a startup?

Source: https://www.getprescience.com/guides/how-to-get-better-benefits-as-a-startup
Cite as: Aditya Jain, MD. "How do I get better health benefits as a startup?." Prescience, October 28, 2026. https://www.getprescience.com/guides/how-to-get-better-benefits-as-a-startup

- **80%** (A 12-person team can improve paycheck cost first). The employer currently pays 80%.
- **20%** (A 12-person team can improve paycheck cost first). Current employee contribution: 20% × $108,000: $21,600
- **100%** (A 12-person team can improve paycheck cost first). Extra annual employer budget to pay 100%: $21,600
- **$0** (What candidates actually notice). $0 employee premium.
- **10–20%** (How to pay for it). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## How do I get free health insurance for my business?

Source: https://www.getprescience.com/guides/how-to-get-free-health-insurance-for-my-business
Cite as: Aditya Jain, MD. "How do I get free health insurance for my business?." Prescience, October 28, 2026. https://www.getprescience.com/guides/how-to-get-free-health-insurance-for-my-business

- **50%** (The Small Business Health Care Tax Credit, with 2026 numbers). It covers up to 50% of the premiums you pay (35% for tax-exempt employers) for two consecutive tax years.
- **35%** (The Small Business Health Care Tax Credit, with 2026 numbers). It covers up to 50% of the premiums you pay (35% for tax-exempt employers) for two consecutive tax years.
- **2%** (The Small Business Health Care Tax Credit, with 2026 numbers). Specified owners and family members are excluded under the IRS rules, including sole proprietors, partners, more-than-2% S corporation shareholders and more-than-5% other owners.
- **5%** (The Small Business Health Care Tax Credit, with 2026 numbers). Specified owners and family members are excluded under the IRS rules, including sole proprietors, partners, more-than-2% S corporation shareholders and more-than-5% other owners.
- **41%** (The Small Business Health Care Tax Credit, with 2026 numbers). The estimated credit covers about 41% of these employer premiums before the required reduction in the premium deduction.
- **75%** (The Small Business Health Care Tax Credit, with 2026 numbers). Employer premiums: 6 × $9,211 × 75%: $41,450
- **17.302%** (The Small Business Health Care Tax Credit, with 2026 numbers). Wage reduction: ($40,000 − $34,100) ÷ $34,100: About 17.302%, or $3,586
- **7.65%** (Lower the cost for the business). Tax deductions: employer contributions are deductible, and employees can pay their share pre-tax under a Section 125 plan, which can also save applicable payroll taxes for eligible employees; 7.65% FICA applies below the Social Security wage base, not universally.
- **80%** (Lower the cost for the business). Compare against fully insured pricing: in a fully insured plan, the carrier keeps what it doesn't spend on claims (the federal small-group medical loss ratio standard generally requires 80% for claims and quality improvement, using the statutory calculation and rebates).
- **10–20%** (Lower the cost for the business). Prescience quotes are usually 10–20% below comparable fully insured coverage.
- **40%** (What not to do). A cheap first year that turns into a 40% renewal isn't free.

## How do I leave a PEO?

Source: https://www.getprescience.com/guides/how-to-leave-a-peo
Cite as: Aditya Jain, MD. "How do I leave a PEO?." Prescience, October 28, 2026. https://www.getprescience.com/guides/how-to-leave-a-peo

- **102%** (COBRA when you leave a PEO). Cost and length: up to 102% of the plan's cost, generally for 18 months after termination other than gross misconduct or a reduction in hours causing loss of coverage; disability and second-event extensions may apply.
- **6.2%** (Payroll, taxes and workers' comp). Employer Social Security if no restart: 6.2% × $64,500 left in the base = $3,999
- **0.6%** (Payroll, taxes and workers' comp). Extra federal unemployment tax: 0.6% × $7,000 = $42
- **10–20%** (Moving health benefits to Prescience). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## How do I recruit FAANG talent to my startup?

Source: https://www.getprescience.com/guides/how-to-recruit-faang-talent-to-a-startup
Cite as: Aditya Jain, MD. "How do I recruit FAANG talent to my startup?." Prescience, October 28, 2026. https://www.getprescience.com/guides/how-to-recruit-faang-talent-to-a-startup

- **24%** (What senior candidates actually compare). About the retained graphic: West Health-Gallup published the 24% finding in July 2026, compared with 16% in 2021. The newer survey was fielded October 27 through December 22, 2025; the employment analysis included 2,322 respondents relying primarily on employer coverage.
- **16%** (What senior candidates actually compare). About the retained graphic: West Health-Gallup published the 24% finding in July 2026, compared with 16% in 2021. The newer survey was fielded October 27 through December 22, 2025; the employment analysis included 2,322 respondents relying primarily on employer coverage.
- **2%** (The benefits gap in dollars). More-than-2% S corporation shareholders and some dependent coverage need separate review.
- **50%** (What a seed or Series A startup can realistically match). Extra 50% the company would pay: $8,834 per family
- **10–20%** (How to compete). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## How do I run open enrollment at a small company?

Source: https://www.getprescience.com/guides/how-to-run-open-enrollment
Cite as: Aditya Jain, MD. "How do I run open enrollment at a small company?." Prescience, October 28, 2026. https://www.getprescience.com/guides/how-to-run-open-enrollment

- **50%** (Setting contributions: a worked example). Employee pays: family, 50% of $1,400: $700 monthly; $350 per paycheck, if eligible for pre-tax treatment

## Is Gusto health insurance good quality?

Source: https://www.getprescience.com/guides/is-gusto-health-insurance-good
Cite as: Aditya Jain, MD. "Is Gusto health insurance good quality?." Prescience, October 28, 2026. https://www.getprescience.com/guides/is-gusto-health-insurance-good

- **80%** (So is the insurance good?). Carriers must spend at least 80% of small group premiums on care and quality improvement; the rest covers administration, commissions and profit.
- **20%** (What a 12-person team pays through Gusto). Employee share (20%): $154/month each
- **5%** (What happens at renewal). KFF's 2025 survey found average employer premiums rose about 5% for single coverage and 6% for family coverage in one year, and family premiums rose 26% over five years.
- **6%** (What happens at renewal). KFF's 2025 survey found average employer premiums rose about 5% for single coverage and 6% for family coverage in one year, and family premiums rose 26% over five years.
- **26%** (What happens at renewal). KFF's 2025 survey found average employer premiums rose about 5% for single coverage and 6% for family coverage in one year, and family premiums rose 26% over five years.
- **10–20%** (Keep Gusto payroll, upgrade the plan). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Is ICHRA a scam for your employees?

Source: https://www.getprescience.com/guides/is-ichra-a-scam
Cite as: Aditya Jain, MD. "Is ICHRA a scam for your employees?." Prescience, October 28, 2026. https://www.getprescience.com/guides/is-ichra-a-scam

- **46%** (The math employees face). The chart’s rounded 46% HMO, 33% EPO, 15% PPO and 7% POS shares match plan-county listings in CMS’s 2026 federal-platform Marketplace landscape file, not distinct nationwide plans or enrollment.
- **33%** (The math employees face). The chart’s rounded 46% HMO, 33% EPO, 15% PPO and 7% POS shares match plan-county listings in CMS’s 2026 federal-platform Marketplace landscape file, not distinct nationwide plans or enrollment.
- **15%** (The math employees face). The chart’s rounded 46% HMO, 33% EPO, 15% PPO and 7% POS shares match plan-county listings in CMS’s 2026 federal-platform Marketplace landscape file, not distinct nationwide plans or enrollment.
- **7%** (The math employees face). The chart’s rounded 46% HMO, 33% EPO, 15% PPO and 7% POS shares match plan-county listings in CMS’s 2026 federal-platform Marketplace landscape file, not distinct nationwide plans or enrollment.
- **52%** (The math employees face). Deduplicating that file by standard component plan ID gives about 52% HMO, 27% EPO, 10% PPO and 10% POS.
- **27%** (The math employees face). Deduplicating that file by standard component plan ID gives about 52% HMO, 27% EPO, 10% PPO and 10% POS.
- **10%** (The math employees face). Deduplicating that file by standard component plan ID gives about 52% HMO, 27% EPO, 10% PPO and 10% POS.
- **100%** (The math employees face). Rounding can prevent totals from equaling 100%.
- **9.96%** (The premium tax credit trap). The test: the ICHRA is affordable if the cost of the lowest-cost silver plan for self-only coverage, minus the monthly allowance, is no more than 9.96% of household income for 2026 plan years (9.02% in 2025).
- **9.02%** (The premium tax credit trap). The test: the ICHRA is affordable if the cost of the lowest-cost silver plan for self-only coverage, minus the monthly allowance, is no more than 9.96% of household income for 2026 plan years (9.02% in 2025).
- **26%** (Red flags in an ICHRA sales pitch). If premiums rise 26% and the allowance rises 3%, your team just took a pay cut.
- **3%** (Red flags in an ICHRA sales pitch). If premiums rise 26% and the allowance rises 3%, your team just took a pay cut.
- **10–20%** (A better way to cap your costs). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Is Justworks PEO worth it?

Source: https://www.getprescience.com/guides/is-justworks-peo-worth-it
Cite as: Aditya Jain, MD. "Is Justworks PEO worth it?." Prescience, October 28, 2026. https://www.getprescience.com/guides/is-justworks-peo-worth-it

- **$15,000** (What a 12-person team pays in fees). About $15,000 a year separates the PEO from Justworks' own non-PEO setup for this team.
- **10%** (What a 12-person team pays in fees). With PEO Plus fees, the total is about $129,700. A 10% premium renewal adds roughly $11,200 more the next year.
- **9.96%** (Situations that change the math). Affordability for plan years beginning in 2026 uses 9.96% of household income for the lowest-cost self-only minimum-value offer, with employer safe harbors available.
- **10–20%** (Keep Justworks payroll, get your own plan). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Is Rippling PEO worth it?

Source: https://www.getprescience.com/guides/is-rippling-peo-worth-it
Cite as: Aditya Jain, MD. "Is Rippling PEO worth it?." Prescience, October 28, 2026. https://www.getprescience.com/guides/is-rippling-peo-worth-it

- **$41,400** (What a 15-person team pays over two years). The same 15 people cost $41,400 more in year two, a 34% jump in the total bill.
- **34%** (What a 15-person team pays over two years). The same 15 people cost $41,400 more in year two, a 34% jump in the total bill.
- **40%** (What a 15-person team pays over two years). Year two medical after 40%: 15 × $805 × 12: $144,900
- **10–20%** (Keep Rippling, leave the PEO). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Is Thatch ICHRA worth it?

Source: https://www.getprescience.com/guides/is-thatch-ichra-worth-it
Cite as: Aditya Jain, MD. "Is Thatch ICHRA worth it?." Prescience, October 28, 2026. https://www.getprescience.com/guides/is-thatch-ichra-worth-it

- **9.96%** (The ICHRA rules every Thatch customer follows). In 2026, affordability uses 9.96% of household income against the lowest-cost silver plan.
- **10–20%** (The group plan alternative). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## What is the most affordable health insurance for a small business?

Source: https://www.getprescience.com/guides/most-affordable-health-insurance-for-small-business
Cite as: Aditya Jain, MD. "What is the most affordable health insurance for a small business?." Prescience, October 28, 2026. https://www.getprescience.com/guides/most-affordable-health-insurance-for-small-business

- **10–20%** (Typical Prescience savings). Usually 10–20% vs. fully insured, fixed in your quote
- **20%** (Cheap vs. affordable). Lean plan: $5,000 + 20% of $15,416, capped: $8,000 (employee)
- **50%** (The small business health care tax credit). The federal small business health care tax credit can reach 50% of qualifying employer premiums for taxable employers, or 35% for eligible tax-exempt employers.
- **35%** (The small business health care tax credit). The federal small business health care tax credit can reach 50% of qualifying employer premiums for taxable employers, or 35% for eligible tax-exempt employers.

## Should we switch from a group plan to ICHRA?

Source: https://www.getprescience.com/guides/should-we-switch-from-a-group-plan-to-ichra
Cite as: Aditya Jain, MD. "Should we switch from a group plan to ICHRA?." Prescience, October 28, 2026. https://www.getprescience.com/guides/should-we-switch-from-a-group-plan-to-ichra

- **9.96%** (The affordability test, with a worked example). An ICHRA is "affordable" if the employee's cost for the lowest-cost silver self-only plan in their area, minus the monthly allowance, is no more than 9.96% of household income in 2026 (up from 9.02% in 2025).
- **9.02%** (The affordability test, with a worked example). An ICHRA is "affordable" if the employee's cost for the lowest-cost silver self-only plan in their area, minus the monthly allowance, is no more than 9.96% of household income in 2026 (up from 9.02% in 2025).
- **383%** (The affordability test, with a worked example). $60,000 is about 383% of the poverty line: Potentially eligible if she opts out and meets all other credit requirements
- **80%** (Edge cases that catch teams mid-switch). "You get $600 to buy your own plan" reads differently from "PPO, we pay 80%".
- **10–20%** (Run the math both ways). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Startup deals for health insurance

Source: https://www.getprescience.com/guides/startup-health-insurance-deals
Cite as: Aditya Jain, MD. "Startup deals for health insurance." Prescience, October 28, 2026. https://www.getprescience.com/guides/startup-health-insurance-deals

- **50%** (3. The Small Business Health Care Tax Credit). If you have fewer than 25 full-time equivalent employees with average wages below an IRS limit that's adjusted each year, pay at least half of employee-only premiums and buy a plan through the SHOP marketplace, you may get a tax credit of up to 50% of what you pay in premiums (35% for tax-exempt employers), for two consecutive years.
- **35%** (3. The Small Business Health Care Tax Credit). If you have fewer than 25 full-time equivalent employees with average wages below an IRS limit that's adjusted each year, pay at least half of employee-only premiums and buy a plan through the SHOP marketplace, you may get a tax credit of up to 50% of what you pay in premiums (35% for tax-exempt employers), for two consecutive years.
- **2%** (4. Use the tax rules you already have). Note: more-than-2% owners of an S corporation can't pay premiums pre-tax through a Section 125 plan.
- **7.65%** (4. Use the tax rules you already have). Employer payroll tax saved (7.65%): $2,295/year
- **22%** (4. Use the tax rules you already have). Employee federal income tax saved (22%): $6,600/year
- **10–20%** (6. Stop paying admin fees). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Thatch alternatives: seven ways to do this, and what each one costs

Source: https://www.getprescience.com/guides/thatch-alternatives
Cite as: Rishab Jain. "Thatch alternatives: seven ways to do this, and what each one costs." Prescience, October 28, 2026. https://www.getprescience.com/guides/thatch-alternatives

- **26%** (Individual market trend). About 26% premium increase estimated for 2026
- **7%** (What Thatch actually charges, so the comparisons are honest). On a $600 monthly allowance for ten employees, the allowances are $72,000 a year and the platform fees are $6,000. The software is roughly 7% of the total, and the other 93% is money going to individual-market carriers.
- **93%** (What Thatch actually charges, so the comparisons are honest). On a $600 monthly allowance for ten employees, the allowances are $72,000 a year and the platform fees are $6,000. The software is roughly 7% of the total, and the other 93% is money going to individual-market carriers.

## What is a QSEHRA, and is it better than a group plan?

Source: https://www.getprescience.com/guides/what-is-a-qsehra
Cite as: Aditya Jain, MD. "What is a QSEHRA, and is it better than a group plan?." Prescience, October 28, 2026. https://www.getprescience.com/guides/what-is-a-qsehra

- **50%** (QSEHRA limits for 2026 and the monthly math). One permitted approach is the same percentage of each statutory limit, such as 50%: $3,225 self-only and $6,550 family for a full 2026 year.
- **2%** (Who must be offered a QSEHRA, and who can be left out). Sole proprietors, partners and more-than-2% S corporation shareholders are not employees for this purpose, so they can't be reimbursed through it.
- **9.96%** (How a QSEHRA changes an employee's premium tax credit). Compare the result with 1/12 of 9.96% of the employee's household income (the 2026 required contribution percentage).
- **6.60%** (How a QSEHRA changes an employee's premium tax credit). Expected contribution: 6.60% × $31,300 / 12: $172.15/month
- **400%** (How a QSEHRA changes an employee's premium tax credit). Since the enhanced credits expired at the end of 2025, households above 400% of the poverty line get no credit at all, so for them every QSEHRA dollar is new money.
- **10–20%** (My take). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## What is a health savings account (HSA)?

Source: https://www.getprescience.com/guides/what-is-an-hsa
Cite as: Aditya Jain, MD. "What is a health savings account (HSA)?." Prescience, October 28, 2026. https://www.getprescience.com/guides/what-is-an-hsa

- **20%** (How an HSA works). Withdrawals for non-medical spending are taxed as income but no longer carry the 20% penalty.
- **7.65%** (What an HSA saves you in real dollars). Contributions through payroll under your employer's cafeteria plan avoid federal income tax and applicable FICA, generally 7.65% below the Social Security wage base.
- **$1,613** (What an HSA saves you in real dollars). About $1,613 less tax in one year, a 37% discount on every dollar she spends on care.
- **37%** (What an HSA saves you in real dollars). About $1,613 less tax in one year, a 37% discount on every dollar she spends on care.
- **24%** (What an HSA saves you in real dollars). Federal income tax avoided (24%): $1,056
- **5%** (What an HSA saves you in real dollars). State income tax avoided (5%): $220
- **6%** (What an HSA saves you in real dollars). Balance at 6% a year: About $203,665
- **$2,700** (Eligibility edge cases that trip people up). His 2026 limit is $2,700, including anything his employer contributes.
- **10%** (Eligibility edge cases that trip people up). She'd owe income tax on about $8,021 plus a 10% additional tax.
- **35%** (How employers can make the deductible disappear). Breaking the rule triggers a 35% excise tax on what you contributed.
- **2%** (How employers can make the deductible disappear). More-than-2% S corporation shareholders and partners can't receive pre-tax employer HSA contributions the same way employees do.
- **44%** (How employers can make the deductible disappear). The $750 single deposit covers about 44% of a $1,700 deductible; the $1,500 family deposit covers about 44% of a $3,400 family deductible.
- **10–20%** (How employers can make the deductible disappear). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## What is self-funded health insurance?

Source: https://www.getprescience.com/guides/what-is-self-funded-health-insurance
Cite as: Aditya Jain, MD. "What is self-funded health insurance?." Prescience, October 28, 2026. https://www.getprescience.com/guides/what-is-self-funded-health-insurance

- **27%** (At firms with 10–199 workers). 27% self-funded, 37% level-funded
- **67%** (How self-funding works). KFF reports 67% of covered workers in self-funded plans in 2025. At firms with 10–199 workers, it separately reports 27% self-funded and 37% level-funded, with a combined share of 51%.
- **37%** (How self-funding works). KFF reports 67% of covered workers in self-funded plans in 2025. At firms with 10–199 workers, it separately reports 27% self-funded and 37% level-funded, with a combined share of 51%.
- **51%** (How self-funding works). KFF reports 67% of covered workers in self-funded plans in 2025. At firms with 10–199 workers, it separately reports 27% self-funded and 37% level-funded, with a combined share of 51%.
- **10–20%** (Compare the employee experience as well as the finances). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Why are insurers and investors pushing ICHRA?

Source: https://www.getprescience.com/guides/why-are-insurers-pushing-ichra
Cite as: Aditya Jain, MD. "Why are insurers and investors pushing ICHRA?." Prescience, October 28, 2026. https://www.getprescience.com/guides/why-are-insurers-pushing-ichra

- **10%** (Follow the money through a hypothetical renewal). The insurer premium rises 10%, but the employee’s premium payment rises 40%, from $200 to $280. Keeping the employer budget fixed shifts that increase to employees in this scenario.
- **40%** (Follow the money through a hypothetical renewal). The insurer premium rises 10%, but the employee’s premium payment rises 40%, from $200 to $280. Keeping the employer budget fixed shifts that increase to employees in this scenario.
- **9.96%** (Tax credits can change the employee result). For 2026 the applicable affordability percentage is 9.96%.
- **10–20%** (Where I would compare Prescience). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Why did our health insurance renewal go up so much?

Source: https://www.getprescience.com/guides/why-did-our-health-insurance-renewal-go-up
Cite as: Aditya Jain, MD. "Why did our health insurance renewal go up so much?." Prescience, October 28, 2026. https://www.getprescience.com/guides/why-did-our-health-insurance-renewal-go-up

- **8.5%** (Use market forecasts as context). PwC's 2027 report revised its earlier 2026 group estimate from 8.5% to 9.0%.
- **9.0%** (Use market forecasts as context). PwC's 2027 report revised its earlier 2026 group estimate from 8.5% to 9.0%.
- **11.616%** (Worked example: breaking a 16% renewal into its parts). The rate-and-aging component is 11.616%; with the assumed enrollment effect, the bill rises 16.081%.
- **16.081%** (Worked example: breaking a 16% renewal into its parts). The rate-and-aging component is 11.616%; with the assumed enrollment effect, the bill rises 16.081%.
- **2.4%** (Worked example: breaking a 16% renewal into its parts). Aging on the age curve, +2.4% ($11,445 × 1.024): $11,720
- **4.0%** (Worked example: breaking a 16% renewal into its parts). Coverage tier changes, +4.0% on $11,719.68: $12,188.47
- **16.08%** (Worked example: breaking a 16% renewal into its parts). Total increase: About $1,688.47 monthly (16.08%)
- **11.6%** (Worked example: breaking a 16% renewal into its parts). Like-for-like increase (trend and aging only): +11.6%
- **73.91%** (Worked example: breaking a 16% renewal into its parts). The assumed increase is $51,000 annually, or 73.91%.
- **74%** (Worked example: breaking a 16% renewal into its parts). Increase: +$51,000 a year (+74%)
- **10–20%** (Compare the next written quote). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Small business health insurance in Arizona

Source: https://www.getprescience.com/small-business-health-insurance/arizona
Cite as: Aditya Jain, MD. "Small business health insurance in Arizona." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/arizona

- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Phoenix benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Phoenix benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Phoenix benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in California

Source: https://www.getprescience.com/small-business-health-insurance/california
Cite as: Aditya Jain, MD. "Small business health insurance in California." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/california

- **2.5%** (Small group eligibility and the resident mandate are separate). For tax year 2025, the Franchise Tax Board identifies the flat amounts as $950 per adult and $475 per child, compared with the income-based calculation of 2.5% of gross income above the filing threshold, subject to the applicable rules and cap.
- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative San Francisco benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative San Francisco benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative San Francisco benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in Colorado

Source: https://www.getprescience.com/small-business-health-insurance/colorado
Cite as: Aditya Jain, MD. "Small business health insurance in Colorado." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/colorado

- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Denver benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Denver benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Denver benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in Florida

Source: https://www.getprescience.com/small-business-health-insurance/florida
Cite as: Aditya Jain, MD. "Small business health insurance in Florida." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/florida

- **150%** (Florida mini-COBRA has a beneficiary notice step). A qualifying Social Security disability can support an additional 11 months, with its own determination and notice conditions and a premium ceiling of 150% during that extension.
- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Miami benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Miami benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Miami benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in Georgia

Source: https://www.getprescience.com/small-business-health-insurance/georgia
Cite as: Aditya Jain, MD. "Small business health insurance in Georgia." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/georgia

- **2%** (A short continuation period still needs a deliberate handoff). Its guidance describes the remainder of the paid termination month followed by continued coverage paid in advance at the full employer-and-employee premium, without federal COBRA’s extra 2% charge.
- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Atlanta benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Atlanta benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Atlanta benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in Illinois

Source: https://www.getprescience.com/small-business-health-insurance/illinois
Cite as: Aditya Jain, MD. "Small business health insurance in Illinois." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/illinois

- **5%** (Read the 2026 infertility provision using the policy date). The earlier version and the new provision appear together in the Illinois Insurance Code (https://ilga.gov/legislation/ILCS/details?ActID=1249&ActName=Illinois+Insurance+Code.&ChapAct=215+ILCS+5%2F&Chapter=&ChapterID=22&MajorTopic=&Print=True&SeqEnd=121900000&SeqStart=101300000).
- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Chicago benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Chicago benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Chicago benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in Massachusetts

Source: https://www.getprescience.com/small-business-health-insurance/massachusetts
Cite as: Aditya Jain, MD. "Small business health insurance in Massachusetts." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/massachusetts

- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Boston benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Boston benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Boston benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in New York

Source: https://www.getprescience.com/small-business-health-insurance/new-york
Cite as: Aditya Jain, MD. "Small business health insurance in New York." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/new-york

- **102%** (Continuation can reach 36 months in an eligible insured plan). DFS describes state continuation for eligible small-employer insured coverage for up to 36 months, at up to 102% of the group premium.
- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative New York City benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative New York City benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative New York City benefits budget). Now test an assumed 10% premium increase with the same people and benefits.

## Small business health insurance in Texas

Source: https://www.getprescience.com/small-business-health-insurance/texas
Cite as: Aditya Jain, MD. "Small business health insurance in Texas." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/texas

- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Austin benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Austin benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Austin benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## Small business health insurance in Washington State

Source: https://www.getprescience.com/small-business-health-insurance/washington
Cite as: Aditya Jain, MD. "Small business health insurance in Washington State." Prescience, October 28, 2026. https://www.getprescience.com/small-business-health-insurance/washington

- **12.8%** (2026 approved increase). 12.8% market average; quotes vary
- **9.5%** (A statewide approved increase is not your renewal quote). It reported a 9.5% average requested increase and a 12.8% average approved increase, with new rates applying as plans renew after January 1, 2026. Those are market-level filing results, not a guaranteed increase for each employer or a premium per employee.
- **50%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **35%** (Choose the arrangement around the work you need done). The maximum is generally 50% of eligible premiums for taxable employers or 35% for eligible tax-exempt employers, over a two-consecutive-tax-year credit period.
- **80%** (An illustrative Seattle benefits budget). Employer contribution, 80%: $10,560 monthly; $126,720 annually
- **20%** (An illustrative Seattle benefits budget). Employees collectively pay, 20%: $2,640 monthly; $31,680 annually
- **10%** (An illustrative Seattle benefits budget). Now test an assumed 10% premium increase with the same people and benefits.
- **102%** (Handle departures, Medicare and family changes separately). The usual premium ceiling is 102% of total plan cost, not 102% of the employee’s former payroll deduction.

## ACA affordability calculator for 2026 and 2027

Source: https://www.getprescience.com/tools/aca-affordability-calculator
Cite as: Aditya Jain, MD. "ACA affordability calculator for 2026 and 2027." Prescience, October 28, 2026. https://www.getprescience.com/tools/aca-affordability-calculator

- **60%** (What the affordability test actually checks). Minimum value requires at least 60% of expected allowed costs for a standard population and substantial coverage of inpatient hospital and physician services.
- **9.96%** (What the affordability test actually checks). A July 1, 2026 plan year uses 9.96% through June 30, 2027. Employer penalty dollar amounts, by contrast, are indexed by calendar year and applied monthly.
- **95%** (The three safe harbors). Review the separate 95% offer threshold and its five-employee allowance when evaluating potential penalties.
- **83%** (Worked examples with 2026 figures). Employer share, rounded: 83%
- **10.22%** (What to do with your result). Recheck every year: The percentage changes each year: 9.96% in 2026, 10.22% in 2027. Recheck when renewal rates arrive.
- **10–20%** (Making coverage affordable without raising your cost). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## ALE calculator: are you an applicable large employer?

Source: https://www.getprescience.com/tools/ale-calculator
Cite as: Aditya Jain, MD. "ALE calculator: are you an applicable large employer?." Prescience, October 28, 2026. https://www.getprescience.com/tools/ale-calculator

- **2%** (Edge cases that change the answer). Sole proprietors, partners and more-than-2% shareholders of an S corporation aren't treated as employees, so they don't count.
- **95%** (What an ALE has to do). The section 4980H(a) test generally requires an offer of minimum essential coverage to at least 95% of full-time employees and their dependent children.
- **5%** (What an ALE has to do). The regulation also has a five-employee allowance when greater than 5%.
- **10–20%** (Growing past 50). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## COBRA cost calculator

Source: https://www.getprescience.com/tools/cobra-cost-calculator
Cite as: Aditya Jain, MD. "COBRA cost calculator." Prescience, October 28, 2026. https://www.getprescience.com/tools/cobra-cost-calculator

- **102%** (Usual federal premium cap). 102% of applicable plan cost
- **150%** (Disability premium exception). Up to 150%, subject to extension rules
- **10%** (How COBRA pricing and timing work). A small underpayment (no more than the lesser of $50 or 10% of the premium) counts as full payment unless the plan gives notice and time to pay the difference.
- **10–20%** (COBRA on a Prescience plan). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.

## Cost of an employee calculator

Source: https://www.getprescience.com/tools/cost-of-an-employee-calculator
Cite as: Rishab Jain. "Cost of an employee calculator." Prescience, October 28, 2026. https://www.getprescience.com/tools/cost-of-an-employee-calculator

- **0.6%** (FUTA). 0.6% of the first $7,000 ($42)
- **$116,181,** (Worked examples). $116,181, or 1.16× salary.
- **$72,921,** (Worked examples). $72,921, or 1.22× salary.
- **1.45%** (Is 1.25 to 1.4 times salary a good rule of thumb?). The multiplier falls as salary rises for two reasons: health premiums are a flat dollar amount, and Social Security stops at $184,500 of pay in 2026. Above that, only the 1.45% Medicare tax continues.
- **7.65%** (Ways to lower the cost without cutting pay). Premium contributions come out before tax, which saves the company 7.65% on those dollars.
- **10%** (Ways to lower the cost without cutting pay). A 10% lower premium on $7,800 a year saves $780 per employee.
- **6.2%** (Budgeting for a hire's first year). For salaries above $184,500, the 6.2% tax stops partway through the year, so later paychecks cost less.
- **15%** (Budgeting for a hire's first year). Recruiting fees are often 15% to 25% of first-year salary through an agency, plus a laptop, software seats and onboarding time.
- **25%** (Budgeting for a hire's first year). Recruiting fees are often 15% to 25% of first-year salary through an agency, plus a laptop, software seats and onboarding time.
- **8.2%** (Budgeting for a hire's first year). Plan for next year's salary increase and a health renewal; employers in Mercer's 2026 survey expected benefit costs to rise 8.2% for 2027.
- **4%** (Common mistakes when budgeting a hire). A 4% match on $100,000 is $4,000 a year, more than workers' comp and unemployment combined in most states.

## Employer health insurance cost calculator

Source: https://www.getprescience.com/tools/employer-health-insurance-cost-calculator
Cite as: Rishab Jain. "Employer health insurance cost calculator." Prescience, October 28, 2026. https://www.getprescience.com/tools/employer-health-insurance-cost-calculator

- **100%** (What employers pay on average). Many startups pay 100% for employees and 50% or more for dependents, which puts them above the average on single coverage and close to it on family.
- **50%** (What employers pay on average). Many startups pay 100% for employees and 50% or more for dependents, which puts them above the average on single coverage and close to it on family.
- **10–20%** (Worked example: a 12-person startup). A plan priced 10–20% lower on the same premiums would save roughly $18,300 to $36,500 a year, before any change in how the cost is split.
- **67%** (Worked example: a 12-person startup). Enter 100% single and about 67% family in the calculator to model it.
- **0%** (How company size changes the picture). 100% for employees, 0% to 50% for dependents.
- **84%** (How company size changes the picture). The KFF average split, about 84% and 74%.
- **74%** (How company size changes the picture). The KFF average split, about 84% and 74%.
- **90%** (How company size changes the picture). A $700 contribution toward a $777 single premium is about 90%.
- **7.65%** (Ways to lower the cost without cutting benefits). Pay premiums pre-tax: A Section 125 plan saves the company 7.65% payroll tax on every dollar employees contribute.

## Employer mandate penalty calculator for 2026 and 2027

Source: https://www.getprescience.com/tools/employer-mandate-penalty-calculator
Cite as: Rishab Jain. "Employer mandate penalty calculator for 2026 and 2027." Prescience, October 28, 2026. https://www.getprescience.com/tools/employer-mandate-penalty-calculator

- **95%** (The two employer mandate penalties). The A penalty applies when you don't offer coverage to at least 95% of full-time employees and their children up to age 26, and at least one full-time employee buys a marketplace plan with a premium tax credit.
- **$113,400** (Worked examples). $113,400 a year, triggered by a single subsidized employee.
- **60%** (How to avoid the penalty). Make sure the plan provides minimum value: The plan has to pay at least 60% of covered costs and include substantial hospital and physician coverage.
- **10.22%** (How to avoid the penalty). Keep the cheapest self-only option affordable: In 2027 the employee's share can't exceed 10.22% of pay under one of the three IRS safe harbors (9.96% in 2026).
- **9.96%** (How to avoid the penalty). Keep the cheapest self-only option affordable: In 2027 the employee's share can't exceed 10.22% of pay under one of the three IRS safe harbors (9.96% in 2026).
- **$28,350** (How the IRS works it out month by month). $28,350 instead of $113,400. Starting coverage mid-year still cuts the exposure by three quarters.

## How much health insurance takes out of your paycheck

Source: https://www.getprescience.com/tools/health-insurance-paycheck-calculator
Cite as: Rishab Jain. "How much health insurance takes out of your paycheck." Prescience, October 28, 2026. https://www.getprescience.com/tools/health-insurance-paycheck-calculator

- **7.65%** (Why pre-tax deductions cost you less). Your share comes out before federal income tax, Social Security and Medicare (7.65% together), and usually state income tax.
- **22%** (Why pre-tax deductions cost you less). Tax rate avoided: 22% + 5% + 7.65% = 34.65%
- **5%** (Why pre-tax deductions cost you less). Tax rate avoided: 22% + 5% + 7.65% = 34.65%
- **34.65%** (Why pre-tax deductions cost you less). Tax rate avoided: 22% + 5% + 7.65% = 34.65%
- **100%** (Is my deduction normal?). Many startups pay 100%, so $0 is common at venture-backed companies.
- **9.96%** (Is my deduction normal?). Above about 9.96% of pay for single coverage (10.22% in 2027) may mean the plan isn't "affordable" under the ACA.
- **10.22%** (Is my deduction normal?). Above about 9.96% of pay for single coverage (10.22% in 2027) may mean the plan isn't "affordable" under the ACA.
- **12%** (Reading health insurance on your pay stub). Tax rate avoided: 12% + 7.65% = 19.65%
- **19.65%** (Reading health insurance on your pay stub). Tax rate avoided: 12% + 7.65% = 19.65%

## HSA contribution calculator for 2026 and 2027

Source: https://www.getprescience.com/tools/hsa-contribution-calculator
Cite as: Rishab Jain. "HSA contribution calculator for 2026 and 2027." Prescience, October 28, 2026. https://www.getprescience.com/tools/hsa-contribution-calculator

- **10%** (Partial years and the last-month rule). If you don't, the extra you contributed becomes taxable income plus a 10% additional tax.
- **6%** (If you contribute too much). Excess contributions are subject to a 6% excise tax for every year they stay in the account.
- **22%** (What an HSA contribution is worth in taxes). Federal income tax avoided (22%): $990
- **5%** (What an HSA contribution is worth in taxes). State income tax avoided (5%): $225
- **7.65%** (What an HSA contribution is worth in taxes). Social Security and Medicare avoided (7.65%): $344
- **20%** (What an HSA contribution is worth in taxes). Before 65, non-medical withdrawals are taxed plus a 20% penalty.
- **35%** (For employers: contributing to employee HSAs). Contributions made outside a cafeteria plan must be comparable for all employees with the same coverage tier, or a 35% excise tax applies.

## ICHRA affordability calculator for 2026 and 2027

Source: https://www.getprescience.com/tools/ichra-affordability-calculator
Cite as: Rishab Jain. "ICHRA affordability calculator for 2026 and 2027." Prescience, October 28, 2026. https://www.getprescience.com/tools/ichra-affordability-calculator

- **9.96%** (How the ICHRA affordability test works). If that required contribution is at or below the affordability percentage of income (9.96% in 2026, 10.22% in 2027), the ICHRA is affordable.
- **10.22%** (How the ICHRA affordability test works). If that required contribution is at or below the affordability percentage of income (9.96% in 2026, 10.22% in 2027), the ICHRA is affordable.

## QSEHRA calculator and 2026 limits

Source: https://www.getprescience.com/tools/qsehra-calculator
Cite as: Rishab Jain. "QSEHRA calculator and 2026 limits." Prescience, October 28, 2026. https://www.getprescience.com/tools/qsehra-calculator

- **9.96%** (How a QSEHRA interacts with premium tax credits). A QSEHRA is affordable if the second-lowest-cost silver plan's self-only premium, minus one-twelfth of the annual self-only allowance, is no more than 9.96% of household income in 2026. Employees have to report the allowance when they apply for a credit, so tell them the amount in writing.

## Section 125 tax savings calculator

Source: https://www.getprescience.com/tools/section-125-tax-savings-calculator
Cite as: Rishab Jain. "Section 125 tax savings calculator." Prescience, October 28, 2026. https://www.getprescience.com/tools/section-125-tax-savings-calculator

- **7.65%** (How a Section 125 plan saves taxes). When in doubt, model only the 7.65% federal payroll tax, which applies everywhere and is the number this calculator uses for the company.
- **12%** (Worked example: a 20-person company). Each employee saves (12% + 5% + 7.65%): $354.96
- **5%** (Worked example: a 20-person company). Each employee saves (12% + 5% + 7.65%): $354.96
- **100%** (Who benefits most). If you pay 100% of every premium, a premium only plan saves nothing on medical coverage, because there are no employee contributions to run through it, though it still matters for dental, vision and FSAs.
- **2%** (Common Section 125 mistakes I see). More-than-2% S corporation shareholders get their premiums added to W-2 wages instead.
- **1.45%** (Limits and exceptions). Above the Social Security wage base ($184,500 in 2026), only the 1.45% Medicare portion is saved on the extra dollars.
- **34.65%** (What else a cafeteria plan can cover). Each parent saves (34.65%): $2,598.75
- **25%** (What else a cafeteria plan can cover). Cafeteria plans must pass nondiscrimination tests, and "key employees" can't receive more than 25% of the plan's total tax benefits.

## Level-funded vs. self-funded vs. fully insured: which is best?

Source: https://www.getprescience.com/guides/level-funded-vs-self-funded-vs-fully-insured
Cite as: Aditya Jain, MD. "Level-funded vs. self-funded vs. fully insured: which is best?." Prescience, October 28, 2026. https://www.getprescience.com/guides/level-funded-vs-self-funded-vs-fully-insured

- **37%** (The short version). KFF’s 2025 survey reports 37% of covered workers at firms with 10–199 workers in level-funded plans and 27% reported in self-funded plans.
- **27%** (The short version). KFF’s 2025 survey reports 37% of covered workers at firms with 10–199 workers in level-funded plans and 27% reported in self-funded plans.
- **51%** (The short version). These categories overlap and must not be added: the combined measure is 51%.
- **67%** (The short version). Across all surveyed firms, 67% of covered workers were reported in self-funded plans.
- **80%** (Fully insured). Carriers must spend at least 80% of small group premiums on care and quality; the rest covers administration, commissions and profit.
- **10–20%** (Where Prescience fits). What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees.