Pricing with you in mind
One price covers the whole determination: reading the plan document, the actuarial value, the CMS notice, and the record behind it.
Plans
Core
Billed as you run determinations. Re-running a plan after a design change is included.
Request a demoWhat’s included
- Full creditable coverage determination
- Actuarial value against the CMS defined standard benefit
- CMS disclosure notices generated for you
- Stored determination record with the parameters used
- SBC document reading included, no re-keying
- Unlimited team members at no extra cost
Custom
For TPAs and brokerages running determinations across a large client base.
Talk to usEverything in Core, plus
- Volume pricing across every client you serve
- Implementation support and onboarding
- A named point of contact
- Early access to new compliance modules
For firms of all sizes
We work with small brokerages to national TPAs, ensuring everyone has access to standardized creditability testing
What the price actually covers
A determination is not just a number. The work around it is what a client asks about.
The document work
Plan design is read out of the SBC and shown for your review. No re-keying tier structures into a spreadsheet by hand.
The determination
Actuarial value calculated against the CMS parameters for that plan year and compared to the defined standard benefit.
The record
Inputs, method, parameter set, and outcome stored together. The disclosure notice generates from that same record.
Common questions
Is $250 per plan or per determination?
Per plan, per plan year. In practice these are the same thing, since a plan is normally determined once per plan year. A re-run after a design change inside the same plan year is included at no extra charge.
What counts as one plan?
One prescription drug plan design for one employer client for one plan year. An employer offering three separate plan designs counts as three.
Do you charge per user?
No. Add as many people from your team as you like at no extra cost. You pay for determinations, not seats.
What happens above 99 plans?
Volume pricing takes over and the per-plan rate comes down. Get in touch and we’ll work out what makes sense for the number of clients you serve.
Is there a contract or a minimum?
No annual minimum and no platform fee on Core. You pay for the determinations you run.
What if a determination comes back non-creditable?
The full result, notice, and record are still produced. An unfavourable answer is still the answer, and often the more useful one.
Try it on a plan you already know.
Pick one you've already run yourself. We'll go through it together, and you can see how the numbers line up.