Where you are today
Blue Cross wants $27,508 more next year
You offer four Blue Cross HSA plans. Every one of them goes up 23% to 25% on December 1, with no change to the plans or the people on them.
Medical premium per year
+24.2% and Blue Cross is already projecting double digits again for 2027.
- Medical
- Blue Cross NC, four HSA plans. +24.2% on 12/1.
- Vision
- UnitedHealthcare, employee-paid. 7 enrolled, rates flat through 11/30/2028.
- Who’s on the plan
- 9 of 17 employees. 8 waive. Plus a couple on COBRA through 3/31/2028.
- Rating
- Blue Cross prices each person by age, so older members cost much more.
Yes, four plans: two designs, each on two networks
All four have 30% coinsurance and an $8,300 out-of-pocket max. The two BlueHPN plans use Atrium’s network only and don’t cover out-of-network care except emergencies.
| Blue Cross plan | Network | Who’s on it | 12/1, a month | 12/1, a year | Increase |
|---|---|---|---|---|---|
| BlueHPN Bronze HSA 6000$6,000 deductible | BlueHPN, AtriumNo out-of-network coverage | 5 employeesAll employee only | $2,967.53 | $35,610 | +23.2% |
| BlueHPN Silver HSA 3500$3,500 deductible | BlueHPN, AtriumNo out-of-network coverage | 1 employeeEmployee only | $528.20 | $6,338 | +23.3% |
| Blue Options Bronze HSA 6000$6,000 deductible | Blue Options PPOOut-of-network covered | 2 employees + COBRA couple2 employee only, 1 employee + spouse | $5,165.01 | $61,980 | +24.6% |
| Blue Options Silver HSA 3500$3,500 deductible | Blue Options PPOOut-of-network covered | 1 employeeFamily | $3,095.84 | $37,150 | +24.7% |
| All four plans | 10 on the plan | $11,756.58 | $141,079 | +$27,508+24.2% | |
How a PEO works
You run the practice. LBMC handles the paperwork.
LBMC becomes the employer on paper for payroll, taxes and benefits. That lets the practice buy benefits as part of one large group, at large-group prices. You keep running the practice.
Stays the same
Yours- You run the practice: hiring, firing, pay, schedules and culture.
- Your patients, your systems, and how your office runs day to day.
- Your team keeps HSA-eligible plans, so their HSAs carry on.
Changes
LBMC- Payroll moves to LBMC, with a dedicated payroll specialist. W-2s show LBMC.
- One invoice a month for payroll and benefits.
- Medical moves to BlueCross BlueShield of Tennessee.
- A dedicated HR business partner for policies, handbook and employee questions.
We’re getting all of this from LBMC in writing. CBA stays your team and holds LBMC accountable.
Side by side · Medical
Each LBMC plan next to the plan it replaces
Today you have two plan designs, Bronze 6000 and Silver 3500, each on two networks. Bronze members move to Plan 4. Silver members move to Plan 3. Plan 5 is the lowest-cost option for anyone.
| In network | TodayBronze 60005 on BlueHPN, 3 on Blue Options | Replaces BronzeLBMC Plan 4BCBS of Tennessee | TodaySilver 35001 on BlueHPN, 1 on Blue Options | Replaces SilverLBMC Plan 3BCBS of Tennessee | Lowest costLBMC Plan 5BCBS of Tennessee |
|---|---|---|---|---|---|
| Network | BlueHPN (Atrium) or Blue Options | BCBS of Tennessee | BlueHPN (Atrium) or Blue Options | BCBS of Tennessee | BCBS of Tennessee |
| Out-of-network | Blue Options only | Covered | Blue Options only | Covered | Covered |
| DeductibleSingle / family | $6,000 / $12,000 | $5,500 / $11,000 | $3,500 / $7,000 | $4,000 / $8,000 | $7,400 / $14,800 |
| Coinsurance | 30% | 20% | 30% | 30% | 0% |
| Out-of-pocket maxSingle / family | $8,300 / $16,600 | $8,000 / $16,000 | $8,300 / $16,600 | $6,500 / $13,000 | $7,400 / $14,800 |
| PrescriptionsGeneric / brand | 30% after deductible | 40% / 50% | 30% after deductible | 30% / 30% | 0% after deductible |
| HSA eligible | Yes | Yes | Yes | Yes | Yes |
| Monthly premium | |||||
| Employee only | Priced by age$455.54 to $1,331.76 | $626.54 | Priced by age$528.20 today | $705.59 | $542.26 |
| Employee + spouse | Priced by age$2,522.80 for the COBRA couple | $1,226.10 | None today | $1,381.03 | $1,060.90 |
| Family | None today | $1,769.46 | Priced by age$3,095.84 today | $1,993.16 | $1,530.93 |
| Group, a month | $8,132.54 | $5,611.88$2,520.66 less | $3,624.04 | $2,698.75$925.29 less | $6,929.91All 10 members |
How we matched: by coverage, not network. Both Bronze versions have the same $6,000 deductible, 30% coinsurance and $8,300 max, so all of them go to Plan 4, the closest LBMC plan. Both Silver versions go to Plan 3 for the same reason. Everyone stays on an HSA plan, and nobody’s out-of-pocket max goes up.
Each person
Who saves and who pays more, per month
Blue Cross prices each person by age; LBMC charges one rate per coverage level. The five oldest members and the family plan save a lot. Five younger employees cost a little more, for a plan with a lower deductible, 20% coinsurance and out-of-network coverage.
| Person | Plan today | RenewalBlue Cross | LBMCAs quoted | ChangeA month | Plan 5Instead |
|---|---|---|---|---|---|
| Karin BakerAge 56 · Employee | BlueHPN Bronze | $842.14 | $626.54Plan 4 | $215.60 less | $542.26$299.88 less |
| Cassidy BrazeltonAge 43 · Employee | BlueHPN Bronze | $489.84 | $626.54Plan 4 | $136.70 more | $542.26$52.42 more |
| Alesha GriffinAge 47 · Employee | BlueHPN Bronze | $564.20 | $626.54Plan 4 | $62.34 more | $542.26$21.94 less |
| Andrea LammAge 49 · Employee | BlueHPN Bronze | $615.81 | $626.54Plan 4 | $10.73 more | $542.26$73.55 less |
| Angeles MelchorAge 39 · Employee | BlueHPN Bronze | $455.54 | $626.54Plan 4 | $171.00 more | $542.26$86.72 more |
| Meredith RogersAge 43 · Employee | BlueHPN Silver | $528.20 | $705.59Plan 3 | $177.39 more | $542.26$14.06 more |
| Marsha MontgomeryAge 64 · Employee | Blue Options Bronze | $1,331.76 | $626.54Plan 4 | $705.22 less | $542.26$789.50 less |
| Andrea StarnesAge 63 · Employee | Blue Options Bronze | $1,310.45 | $626.54Plan 4 | $683.91 less | $542.26$768.19 less |
| John and Sandra RuoccoAge 62, 61 · Employee + spouse, COBRA | Blue Options Bronze | $2,522.80 | $1,226.10Plan 4 | $1,296.70 less | $1,060.90$1,461.90 less |
| Dean GicklingAge 50 · Family (Molly, Kayla, Luke, Lauren) | Blue Options Silver | $3,095.84 | $1,993.16Plan 3 | $1,102.68 less | $1,530.93$1,564.91 less |
| Whole plan10 members | $11,756.58 | $8,310.63 | $3,445.95 less | $6,929.91$4,826.67 less |
Full monthly premium for each person’s coverage, before any employee contribution. Waive medical today (8): Danielle Hartsell, Sandra Helms, Monica Howard, Hilary Huguelet, Jeremy Hyder, Jennifer Jones, Michelle Privett, Angie Wallace. The Ruoccos are on COBRA; if they pay their own premium, their savings go to them.
Contribution strategy
Who saves: the practice or your employees
9 of your 17 employees are on the plan (53%). We don’t have your current split yet, so this starts at 50% / 50%. Set it to what you pay today, then try other splits to see where the savings land and what each person pays per paycheck.
LBMC option
Paychecks
Total savings vs. renewing, per year
$0
Practice savings count LBMC’s $21,891 fee and any payroll and HR cost entered under What it costs.
| Employee pays, per paycheck | RenewBlue Cross | LBMCAs quoted | ChangePer paycheck |
|---|
Medical only, the 9 active employees. The Ruoccos are on COBRA and aren’t counted here.
What it costs
All in, per year
Each column adds up the same way: medical, plus LBMC’s fee, which replaces what you pay today for payroll and HR. Type in your payroll and HR cost and the savings update.
| Per year | Renewal 12/1/26Renew Blue CrossYour four plans | RecommendedLBMC as quotedPlans 4 and 3 | Lowest costLBMC Plan 5Everyone |
|---|---|---|---|
| Medical premiumAll 10 enrollments | $141,079 | $99,728 | $83,159 |
| Payroll and HRWhat you pay a payroll or HR company today | Included in LBMC’s fee | Included in LBMC’s fee | |
| LBMC’s fee$105.25 per employee a month, 17 employees, plus cyber | None | $21,891 | $21,891 |
| Total per year | $141,079 | $121,619 | $105,050 |
| Saves vs. renewing | Starting point | $19,460 | $36,029 |
LBMC’s fee also includes company-paid life, employment practices liability and cyber coverage, shown below. Year one adds a one-time $2,000 setup.
Vision and what the fee includes
The rest of the package
Your vision plan is employee-paid through UnitedHealthcare. LBMC’s Low vision plan costs employees less at every level, and LBMC’s fee adds coverage you don’t carry today.
Vision Employee-paid
7 enrolled today: 6 employee only, 1 employee + spouse. UHC’s rates are locked through 11/30/2028. LBMC’s plans use the VSP or Superior networks.
| In network | TodayUHCPlan S1006 | Costs lessLBMC LowVSP or Superior | RicherLBMC HighVSP or Superior |
|---|---|---|---|
| Exam / lenses copay | $10 / $25 | $10 / $10 | $10 / $10 |
| Frames | $130, every 12 months | $150, every 24 months | $225, every 12 months |
| Contacts instead | $105 | Up to $150 | Up to $225 |
| Monthly premium, paid by the employee | |||
| Employee only | $8.19 | $6.96 | $9.30 |
| Employee + spouse | $15.53 | $13.90 | $18.35 |
| Employee + children | $18.22 | $13.26 | $17.72 |
| Family | $25.62 | $21.00 | $28.10 |
Included in LBMC’s fee No extra cost
These come with the $21,891 a year, for all 17 employees.
$10,000 per employee, company-paid, with an employee assistance program.
$1,000,000 per claim, $50,000 retention.
A cyber policy for the practice.
A dedicated payroll specialist, tax filings and W-2s, on UKG.
A dedicated HR business partner, handbook and compliance updates.
COBRA, HSA and FSA administration, and open enrollment.
Questions about any of this? Call either of us.
We’ll close the open items this week and send you the updated numbers.