Benchmark Plan A and Plan B coverage. Adjust weights to match your workforce priorities today. See the better network fit in seconds, confidently now.
This chart visualizes component scores and final scores on a 0–100 scale.
Use this format when collecting values from carrier directories.
| Metric | Plan A | Plan B |
|---|---|---|
| Total providers | 5,500 | 7,200 |
| Nearby providers | 110 | 95 |
| In-network hospitals | 14 | 16 |
| Specialists | 42 | 35 |
| Urgent care | 5 | 7 |
| Telehealth | Yes | Yes |
| Out-of-network coverage | 60% | 50% |
| Preferred providers in-network | 2 | 3 |
| Referral required | No | Yes |
| Tiered network | No | Yes |
This calculator creates a single coverage score per plan.
For large workforces, network breadth reduces friction. A plan that delivers 100 nearby clinicians against a 120 target scores 83.33 points. If another plan offers 140, the score caps at 100. This ceiling prevents a single metric from dominating decisions.
Hospital access matters most during high-cost events. In the example table, Plan B lists 16 hospitals versus a target of 15, earning 100 points, while Plan A lists 14, earning 93.33. Pair this with urgent care counts, where 7 sites versus a 6 target earns 100, and 5 earns 83.33. When hospital and urgent weights total 28%, acute readiness can shift final scores by 5–10 points.
Specialist depth supports chronic care and complex diagnoses. With a 40 specialist target, 42 specialists score 100, and 35 score 87.50. If a plan requires referrals, the calculator subtracts a configurable penalty, such as 6 points, reflecting extra steps that can delay appointments. In tight markets, increasing the specialist weight from 18% to 25% highlights access gaps sooner.
Telehealth is scored as 0 or 100 to reflect availability. When enabled, it can offset limited local supply for behavioral health or follow-ups. For distributed teams, a telehealth weight of 8% stabilizes scores across cities. If telehealth is mandatory, set the weight higher and keep penalties modest.
Out-of-network reimbursement is entered as a percent and used directly. A plan at 60% scores 60 points; at 50% scores 50. Weighting this metric at 10% lets HR reflect risk tolerance, especially when employees travel or rely on cross-border providers. If your policy includes strong protections, keep this weight modest and prioritize in-network breadth.
The final score is a weighted sum of normalized components minus penalties, clamped to 0–100. Because weights are automatically normalized, setting weights as 28, 18, 18, 10, 8, 10, and 8 yields an even 100% distribution. This creates a repeatable baseline for renewals. Exporting CSV supports audit trails, while the PDF snapshot communicates outcomes clearly today for stakeholders.
It means the plan meets most of your targets after weights and any penalties. A 90 typically reflects strong facility access, solid local providers, and minimal friction rules.
Set targets first to define “excellent” coverage for your geography. Then adjust weights to match employee priorities, such as specialists for chronic care or urgent care for families.
Those features can add steps or limit choices. Penalties convert operational friction into a small score reduction so comparisons reflect both access and usability.
Yes. One plan may excel in hospitals while the other leads in specialists or out-of-network coverage. Use the component table and chart to see where trade-offs occur.
Treat it as financial backstop strength. Higher percentages improve the score, but you can keep the weight modest if your strategy is to maximize in-network access.
Use carrier provider directories, third-party network audits, and your own claims or utilization reports. Keep the same service area definition for both plans to avoid bias.
Important Note: All the Calculators listed in this site are for educational purpose only and we do not guarentee the accuracy of results. Please do consult with other sources as well.