Editing Openai/695d4253-5060-8005-95db-586e777927f4 (section)

==== - Standardized actuarial value / richness metrics: estimate AV or expected paid-to-allowed using a common claim model. ====
* Benchmarking to a reference plan: normalize to a common plan design and price using the same allowed-cost basis.
* Scenario-based employee cost modeling: compare total cost (premium contribution + expected OOP) for standardized utilization profiles (low/medium/high, chronic condition scenarios) and by coverage tier (single/family).
* Total cost of coverage metrics: employer + employee spend, PEPM allowed and paid, admin load, and trend—adjusted for geography and demographics.
* Benefit scorecards: incorporate non-benefit features (network disruption, Rx coverage, UM rigor, care management, quality/service metrics) with weighted scoring.
* Peer surveys and broker benchmarks: use credible market surveys for prevalence of plan types and contribution strategies, adjusted for industry/region.