Assumed participation
The model applies this rate to full-time employees and rounds participating employees down.
Three inputs. A first look at potential annual impact. Then a real conversation about the details behind your numbers.
Combined potential value across the three categories below. This is a scenario estimate, not a guaranteed return or a cash payment.
Modeled payroll-tax benefit at 75% participation.
Risk exposure that might be avoided, not direct cash savings.
Modeled for self-funded or level-funded coverage.
This reproduces the assumptions in the current Overlay ROI estimator for an initial conversation. A proposal would use your actual census, plan, state, participation, and implementation details.
The model applies this rate to full-time employees and rounds participating employees down.
Adjusted by average income ÷ $60,000, with a floor of 0.8 and a cap of 1.2.
Potential incidents multiplied by assumed average cost. Actual avoided incidents and costs are uncertain.
Per participant for self/level-funded plans; half for “other/not sure”; zero for fully insured.
The total combines modeled FICA savings, potential incident cost avoidance, and potential claim savings. Incident avoidance is not realized cash savings. The model assumes implementation of a qualifying Section 125 structure; actual payroll treatment, plan participation, claims, and incident experience may differ. Fully insured employers generally do not capture direct variable claim savings. Figures are for illustration only and are not a guarantee, quote, tax advice, or legal advice.