When a benefits leader gets to pricing, the question is usually some version of the same thing: how do you charge, and what am I on the hook for? My answer is that it depends on what you want. That's a feature, not a dodge.
We designed two models on purpose, because the right one depends on your workforce: how much it's going to change this year, and how much of that change you can predict.
PEPM: one number you can defend
PEPM means per employee, per month. You pay a set rate across your covered population, and that produces a single number you can take to finance and stand behind for the whole year. No reconciliation. No surprise line item. No meeting where you explain why you went over. (You'll also hear PMPM, per member per month, which counts covered members instead of employees. The logic is the same: pay a flat rate, get predictability.)
If cost predictability is your primary objective, PEPM is your best bet. It fits a specific kind of employer, one with steady workforce transitions, where headcount and departures don't swing much from year to year.
And I’m going to be honest as I say this aloud: that employer is getting harder to find. We're in an unusual stretch for workforce transitions. Layoffs keep coming with no clear end. Medicare-eligible populations are at record highs and climbing. And tenure isn't what it used to be. Our grandparents stayed at one company for decades. Today, close to a third of American workers leave a job within six months. A steady-state workforce is the exception now, not the rule.
Utilization: you pay when there's something to pay for
So we built a second model. Utilization-based pricing pairs an annual subscription that covers setup and platform maintenance with engagement fees that only apply when an employee actually uses our service. If actual cost tracking is your primary objective, this is the one. You're paying for a service that gets delivered, not for a year that might not happen.
To wrap your head around it, I like the analogy of PEPM as being fully insured, and utilization-based pricing as being self-insured. Fully insured gives you a fixed premium and full coverage when a catastrophic event hits. Self-insured means you hold more of the timing yourself and pay as things come in. Neither is right or wrong. It comes down to how much of the uncertainty you want to carry.
Most people don't love paying for coverage they might never use. You've probably felt it with your own car or home insurance. Twenty years in the same house, never a claim, and you still write the check. Utilization pricing answers that instinct. Every dollar maps to a service rendered.
Who carries the risk under each model
This is the question most buyers are really asking, so let's be direct about it.
Under PEPM, the employer carries the risk. You pay the annual rate up front. If the year turns out quiet and few people elect COBRA or need guidance, you've paid for capacity you didn't use. If you run a large layoff, the math tips the other way and the fixed rate works in your favor.
Under utilization, the risk is shared. The subscription covers our cost to stand the program up, so we're not exposed on setup, and we get paid as your employees engage with us. But once the program is live, we're carrying the ongoing cost of being ready. Licensed advisors on staff, educational content updated, the integration maintained, all of it built to handle your volume whether or not the volume shows up. If your year stays quiet, we’re still staffed and earned little beyond the subscription.
That's what makes it the more aligned of the two models. Both sides have something on the line, which tends to make both sides comfortable. When our fee moves with your usage, we have real skin in the game to deliver quality at every single event, not just at signing.
How to choose
If you're genuinely torn, start with one question: what matters more to you, actual cost tracking or predictability?
After that, a few more worth answering:
Are you protecting against a volume spike, like a planned RIF? That points toward utilization.
How does procurement want to see it: one clean line item, or usage you reconcile month to month?
Where is the budget coming from? A subscription can sometimes sit in a different bucket on the books than a recurring per-employee charge, which matters for some finance teams.
What do your demographics and recent history actually look like? Your COBRA election rate, your Medicare-eligible share, the events you've had and the ones you're forecasting.
Tell me what you're trying to protect, and I can tell you which model fits and why.
Offering both isn't a pricing gimmick. It's what happens when you start from the employer's situation instead of your own convenience. You get cost you can control. Your departing employees get guided to coverage that often fits them better. We price to that.
Want to walk through which model fits your workforce?
