Plan tiers

Tier 1 National PPO Health Plans

You are here because health coverage is taking too much money, and you need to know whether USA OPS can put you on a better path after every premium, fee, and tax assumption is counted.

A lower monthly figure comes with a higher deductible. The calculator puts each tier next to your current path so you can see which one actually works.

Plan ALowest deductible
$880per month
Deductible
$1,000
Out-of-pocket max
$5,000
Coinsurance
20%
PC copay
$20 Copay
Specialist copay
$40 Copay
Plan BBalanced
$723per month
Deductible
$3,500
Out-of-pocket max
$7,350
Coinsurance
20%
PC copay
$45 Copay
Specialist copay
$90 Copay
Plan CHighest deductible
$589per month
Deductible
$7,350
Out-of-pocket max
$7,350
Coinsurance
0%
PC copay
$50 Copay
Specialist copay
$100 Copay

See the plan documents and coverage details.

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HOW PEOs CHARGE

Fixed fee or a percentage of payroll.

Charge model

FIXED

Flat monthly fee per person

One rate for employees with benefits, and a lower rate for employees without.

  • Easy to forecast month to month
  • Does not rise just because payroll rises
  • Cleaner for owners who want cost clarity

Charge model

PERCENTAGE

0.5 to 6 percent of total payroll

The rate depends on your headcount, payroll frequency, and workers comp profile.

  • Cost scales with total payroll
  • Can feel small at first and grow quietly
  • Needs a cleaner apples-to-apples comparison

The real question

Does getting inside the group beat what you pay now?

Business of one

Solo owners tend to fit at about $80,000 or more in net income and about $700 or more a month for current coverage.

The answer still depends on entity, state, current premium, and tier. The calculator owns the exact number.

Already S-corp

Access and predictability may be the motive.

The path may be near break-even. That can still be worth knowing when renewal pressure is the problem.

Team

Teams tend to fit when the business nets about $90,000 or more and renewal pressure, retention cost, or payroll load is part of the decision.

The comparison is payroll, HR, workers' comp, compliance, and renewals in one operating lane.