Platform Features

Insurance optimization built on
actuarial-grade analysis

Verd combines federal healthcare expenditure data, Monte Carlo cost simulation, and pharmacy benefit analysis to identify the plan that minimizes your total annual cost of coverage — across every major insurance program in the United States.

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Built on federal data — MEPS · CMS · IRS · USPSTFFounded by healthcare policy expertsNo commissions, no carrier partnerships

Our Methodology

Every recommendation follows a five-stage analytical pipeline. We do not use heuristics or simplified rule sets. Each stage processes real data to produce a statistically grounded cost projection for every eligible plan.

User ProfileMEPS DataCost Simulation1234Plan RankingRecommendation
01

Profile Ingestion

We collect your age, household size, income, prescriptions, chronic conditions, preferred providers, and anticipated procedures. No account required for the initial analysis.

02

MEPS Data Matching

Your profile is matched against 412,000+ person-level records from the Medical Expenditure Panel Survey to build a utilization distribution. We identify spending patterns among demographically and clinically similar cohorts — not national averages.

03

Monte Carlo Cost Simulation

For each eligible plan, we run stochastic simulations sampling from your matched utilization distribution. Each simulation applies the plan's actual benefit design: deductible, copay schedule, coinsurance tiers, out-of-pocket maximum, and pharmacy formulary placement.

04

Plan Ranking

Plans are ranked by expected total annual cost at the median, 75th, and 95th percentiles. We also score pharmacy benefit coverage, network adequacy, and provider access. The result is a composite ranking weighted to your risk tolerance.

05

Recommendation

Your top-ranked plan is presented with a full cost breakdown: premiums, expected out-of-pocket, tax-advantaged account contributions, and net annual cost. We show best-case, likely, and worst-case scenarios with confidence intervals.

Our Data Sources

Every recommendation is grounded in peer-reviewed federal datasets — the same sources used by CBO, HHS, and academic health economists. We do not rely on self-reported surveys or proprietary insurance industry data.

MEPS

Medical Expenditure Panel Survey

Agency for Healthcare Research and Quality (AHRQ)

  • 412,000+ person-level records across the Household Component
  • Detailed service-level expenditure data: inpatient, outpatient, Rx, dental, vision
  • Linked to NHIS for clinical condition validation
  • Enables utilization distribution modeling by age, sex, income, insurance type, and chronic condition burden
  • Updated annually; current model uses consolidated 2018-2022 panels
CMS

Centers for Medicare & Medicaid Services

U.S. Department of Health and Human Services

  • Plan Finder and Landscape files for all ACA Marketplace metal-tier plans
  • Medicare Part D formulary files with tier placement and prior authorization flags
  • Medicare Advantage plan benefit packages including SNP and D-SNP variants
  • FEHB plan brochures parsed for benefit design extraction
  • Includes actuarial value calculations from the AV Calculator methodology
IRS

Internal Revenue Service

U.S. Department of the Treasury

  • Publication 502: eligible medical and dental expenses for tax deduction
  • HSA contribution limits, catch-up provisions, and HDHP qualification thresholds
  • FSA carryover and grace period rules updated annually
  • Premium Tax Credit (PTC) calculation parameters and FPL benchmarks
  • ACA affordability threshold and employer mandate safe harbor percentages
USPSTF

U.S. Preventive Services Task Force

Agency for Healthcare Research and Quality (AHRQ)

  • A and B grade preventive service recommendations — mandated as first-dollar coverage under ACA
  • Age- and sex-specific screening schedules integrated into benefit utilization modeling
  • Used to flag underutilized zero-cost-sharing benefits in coverage analysis
  • Immunization schedules cross-referenced with ACIP recommendations
  • Statin, aspirin, and behavioral counseling recommendations factored into Rx modeling

Intelligent Plan Matching

Our matching engine evaluates every eligible plan across ACA Marketplace, FEHB, Medicare and Medicare Advantage (including Special Needs Plans), Medigap, Medicaid, employer-sponsored coverage, TRICARE, VA/CHAMPVA, and COBRA. Instead of filtering by premium alone, we compute actuarial value against your specific utilization profile — factoring in formulary placement for each of your prescriptions, provider network inclusion, and the interaction between deductible structure and your projected service mix.

✓ Cross-program eligibility analysis spanning every major federal and private insurance category, plus assistance programs like Medicare Savings Programs and Extra Help
✓ Prescription-level formulary matching with tier placement and prior authorization detection
✓ Network adequacy scoring based on your providers, specialists, and facility preferences
✓ True total cost projection — not just premiums, but deductibles, copays, coinsurance, and Rx costs

Monte Carlo Cost Projection

Traditional plan comparisons use a single “expected” cost figure. That approach fails because healthcare spending is stochastic — a single ER visit or unexpected diagnosis can shift your annual costs by thousands. Verd runs Monte Carlo simulations for each plan, sampling from your matched MEPS utilization distribution to produce a full probability distribution of annual costs. You see the 25th, 50th, 75th, and 95th percentile outcomes for every plan under consideration.

✓ Stochastic simulation using MEPS-derived utilization distributions, not point estimates
✓ Applies actual plan benefit design: deductible accumulators, copay/coinsurance split, OOP max
✓ Incorporates HSA/FSA tax impact and premium tax credit eligibility into net cost
✓ Confidence intervals at multiple percentiles — understand your tail risk, not just the average

Comprehensive Dashboard

After enrollment, Verd tracks your real-world utilization against projections. The dashboard monitors deductible accumulation, out-of-pocket progress toward your maximum, and prescription refill timing. Smart alerts notify you when elective procedures should be scheduled to minimize cost — for example, consolidating services in a year when you have already met your deductible, or deferring when you are close to a plan year boundary.

✓ Real-time deductible and OOP maximum accumulator tracking
✓ Elective procedure timing optimization based on accumulator status
✓ Preventive care reminders tied to USPSTF A/B grade recommendations
✓ FSA deadline and HSA contribution pacing alerts
Pro Feature

HSA & FSA Optimization

Tax-advantaged accounts are the most powerful — and most misunderstood — tool in health insurance. An HDHP with an HSA can outperform a low-deductible PPO by $1,500+ annually for the right profile, but only with correct contribution sizing. Verd calculates the optimal contribution based on your projected utilization, marginal tax rate, and state tax treatment. For FSAs, we model the use-it-or-lose-it constraint and carryover limits to prevent forfeiture.

✓ Optimal HSA contribution calculated against projected out-of-pocket and marginal tax rate
✓ HDHP qualification validation with current IRS thresholds ($1,650/$3,300 individual/family for 2025)
✓ FSA election modeling with $640 carryover optimization to prevent forfeiture
✓ Long-term HSA investment growth projections for triple-tax-advantage maximization
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Life Event Re-Optimization

Qualifying life events — marriage, birth/adoption, job loss, relocation, aging off a parent’s plan at 26, Medicare eligibility at 65 — trigger Special Enrollment Periods that allow mid-year plan changes. Verd monitors for these events and automatically re-runs the full optimization pipeline with your updated profile. This is critical because the optimal plan often changes dramatically after a life event: a birth adds pediatric utilization, a job change may eliminate employer coverage, and turning 65 introduces Medicare Parts A/B/C/D and Medigap into the analysis.

✓ SEP detection with 60-day deadline tracking for all qualifying events
✓ Automatic re-optimization when income, household, or employment status changes
✓ Age milestone tracking: aging off parent plan (26), Medicare IEP (65), late enrollment penalty windows
✓ COBRA continuation analysis — 18/36 month cost comparison vs. ACA Marketplace alternatives

Family & Multi-Member Optimization

Family coverage is a combinatorial problem. A family of four with two employer plans available may have dozens of viable configurations: all on one plan, adults split across employers, children on CHIP, a spouse on a Marketplace plan for PTC eligibility. Verd evaluates every permutation, including the “family glitch” fix that expanded Marketplace subsidy eligibility for family members when employer coverage is unaffordable at the family tier.

✓ Exhaustive combination analysis: family plan vs. individual plans vs. cross-employer splits
✓ Spousal employer plan comparison with affordability threshold testing
✓ Pediatric dental and vision mandate compliance for dependent-only configurations
✓ CHIP income threshold detection when Marketplace family coverage is suboptimal

Verd Assistant

Insurance documents are written for lawyers, not patients. The Verd Assistant is an AI advisor that explains your specific plan in plain language — your deductible, your coinsurance, your prior authorization requirements, your formulary tiers — and answers any healthcare or insurance question you have, any time. Because it is connected to your dashboard, it knows your deductible progress, projected spending, and subsidy eligibility, so answers come back with your actual dollar figures instead of generic guidance.

✓ Plain-language explanations of your plan’s deductible, coinsurance, prior auth rules, and formulary tier placement
✓ Answers any healthcare or insurance question — from “Is this procedure covered?” to Medicare enrollment windows
✓ Knows your numbers: deductible progress, projected annual spending, and subsidies — answers include dollar figures
✓ Available year-round from your dashboard, not just during open enrollment
Pro Feature
$ figures

Every Major Insurance Program

Most comparison tools only handle ACA Marketplace plans. Verd analyzes every major federal and private insurance program — including Special Needs Plans and the assistance programs most tools ignore entirely — because the optimal coverage for a given individual may exist in any of them, and eligibility often spans multiple programs simultaneously.

ACA Marketplace

Individual and family plans across Bronze, Silver, Gold, and Platinum metal tiers. We model Cost-Sharing Reductions (CSR) on Silver plans for eligible households, Premium Tax Credit amounts, and the interaction between metal tier and utilization profile. Includes on- and off-exchange plan comparison.

Federal Employee Health Benefits (FEHB)

Over 250 plan options available to federal employees, retirees, and eligible family members. We parse FEHB brochures to extract benefit design details not available in structured data, including dental/vision riders and plan-specific formulary rules.

Medicare Parts A & B

Original Medicare with Part A hospital insurance and Part B medical insurance. We model Part B premium surcharges (IRMAA) based on MAGI, Part A late enrollment penalties, and the coverage gap between Original Medicare and supplemental options.

Medicare Advantage (Part C)

MA plans from private insurers that bundle Parts A, B, and often D. We analyze MA-PD plan benefit packages including maximum out-of-pocket limits, supplemental benefits (dental, vision, hearing, fitness), and SNP/D-SNP eligibility for dual-eligible beneficiaries.

Medicare Part D & Medigap

Standalone Part D prescription drug plans with formulary-level analysis: tier placement, prior authorization requirements, step therapy protocols, and the coverage gap (donut hole). Medigap plans A through N compared against MA alternatives.

Medicaid & CHIP

Income-based eligibility determination using Modified Adjusted Gross Income (MAGI) methodology. State-specific expansion status, medically needy pathways, and CHIP income thresholds. Critical for families near the Medicaid/Marketplace eligibility boundary.

Employer-Sponsored Insurance

Analysis of employer plan options including HDHP/HSA, PPO, HMO, and POS configurations. We model employer premium contributions, HDHP qualification for HSA eligibility, and affordability testing under the ACA employer mandate.

TRICARE

Military health coverage including TRICARE Prime, Select, For Life, and Young Adult. Eligibility based on uniformed service status, retirement category, and dependent relationships. Cost comparison against civilian alternatives when dual eligibility exists.

VA Health Care & CHAMPVA

VA enrollment priority groups for veterans and CHAMPVA coverage for eligible spouses and dependents. We model how VA care coordinates with Medicare, employer coverage, and Marketplace plans — and when carrying secondary coverage alongside VA care pays off.

COBRA Continuation

Temporary continuation of employer group coverage for 18 or 36 months after qualifying events. We calculate the full unsubsidized premium cost and compare against ACA Marketplace plans with potential PTC eligibility — COBRA is often not the best option.

Special Needs Plans (D-SNP / C-SNP)

Medicare Advantage Special Needs Plans for dual-eligible beneficiaries (D-SNP) and people with qualifying chronic conditions (C-SNP). We screen for eligibility, compare SNP benefit packages against standard MA and Original Medicare options, and flag care coordination benefits.

Assistance Programs (MSP, Extra Help, CHIP)

Medicare Savings Programs (QMB, SLMB, QI) that pay Part B premiums and cost sharing, Extra Help/LIS for Part D drug costs, and CHIP advisories for children in households near eligibility thresholds. These programs are chronically under-enrolled — we check every profile for them.

Why Verd vs. Traditional Approaches

Insurance brokers earn commissions from the plans they sell. Manual research takes dozens of hours and still misses critical variables. Verd is the first approach that combines comprehensive data, actuarial methods, and zero financial conflicts of interest.

DimensionVerdInsurance BrokerManual Research
Data SourcesMEPS, CMS, IRS, USPSTF — 412K+ person-level recordsCarrier-provided rate sheets and personal experienceHealthcare.gov or individual carrier websites
Plan CoverageACA, FEHB, Medicare A/B/C/D, Medigap, SNPs, Medicaid, employer, TRICARE, VA/CHAMPVA, COBRA, plus MSP and Extra Help screeningTypically 1-2 programs; limited by carrier appointmentsWhatever programs you know to search for
Cost AnalysisMonte Carlo simulation with percentile-based projectionsRough estimates based on premium and deductiblePremium comparison; OOP costs estimated or ignored
Rx AnalysisFormulary-level tier placement, PA flags, step therapy, quantity limitsBasic formulary check if requestedManual lookup per drug per plan
Network AnalysisProvider-level network matching with adequacy scoringGeneral network type (HMO/PPO) guidanceManual provider directory search per plan
Tax OptimizationHSA/FSA contribution optimization, PTC modeling, IRMAA projectionGeneric HSA/FSA awareness; no modelingRequires separate tax advisor
Time RequiredUnder 5 minutes1-3 appointments over 1-2 weeks10-40+ hours of research
CostFree core analysis; Pro for ongoing monitoringFree to you — broker earns 3-8% commission from carrierFree, but high opportunity cost
BiasNo carrier affiliations, no commissions, no conflictsCommission-driven; limited to appointed carriersSubject to plan marketing and anchoring effects

Additional Capabilities

Standardized Plan Summaries

Every plan rendered in a consistent format: deductible structure, copay schedule, coinsurance rates, OOP max, and embedded vs. non-embedded deductible status. No more parsing 40-page plan brochures.

Scenario Modeling

Adjust health assumptions — add a planned surgery, pregnancy, or new chronic condition — and instantly see re-ranked results. Each scenario re-runs the full simulation pipeline, not a simplified estimate.

Provider Network Scoring

Network adequacy analysis beyond simple in/out-of-network checks. We score breadth of specialty coverage, geographic accessibility, and whether your specific providers participate in each plan's network.

Educational Resources

Expert-authored guides covering metal tier selection, HDHP vs. PPO tradeoffs, Medicare enrollment windows, and common costly mistakes. Written for clarity, not to push a particular plan type.

Multi-Member Profiles

Separate profiles for each household member with individual health histories, prescription lists, and provider preferences. The optimizer evaluates coverage combinations across all members simultaneously.

Annual Re-Optimization

During open enrollment, Verd re-evaluates every plan with updated rates, formulary changes, and your current year's utilization data. Plans that were optimal last year may not be this year — we catch the difference.

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