> ## Documentation Index
> Fetch the complete documentation index at: https://docs.benefitflow.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Modeled Commissions and Premiums

> How BenefitFlow estimates per-benefit premiums and commissions when a Form 5500 filing reports only a combined total, and medical spend when a self-funded employer files none at all.

BenefitFlow's premium and commission numbers come from what employers file on Form 5500. Usually the filing shows exactly what was paid for each benefit. Two things make that harder:

* **Several benefits bundled on one contract.** The filing shows one combined premium, not the split.
* **A self-funded employer with no medical policy.** There's nothing filed for medical. No premium, no commission.

When that happens, BenefitFlow estimates the missing number instead of leaving it blank, and always marks it as an estimate.

## Benefits bundled on one contract

Sometimes multiple benefits are bundled into a single policy, making it unclear what commissions or premiums are attributable to each specific benefit. For example, a contract might bundle life insurance, long-term disability, and temporary disability under one reported premium, without showing how much of that premium went to each benefit.

To estimate the split, we look at employers who file those same benefits as separate policies. Their filings show the actual split, which we apply to the bundled contract.

<Frame>
  <img src="https://mintcdn.com/benefitflow/nB7hjzlN5Qs5GDns/images/modeled-commissions-and-premiums-bundled-split.png?fit=max&auto=format&n=nB7hjzlN5Qs5GDns&q=85&s=2778a7cda2f4281ee82cea76ca904eca" alt="A bundled contract's single reported premium of $3.6M split into modeled premiums for life insurance, long term disability and temporary disability, with the modeled parts adding back to the same $3.6M total" width="2120" height="960" data-path="images/modeled-commissions-and-premiums-bundled-split.png" />
</Frame>

## Self-funded medical

A self-funded employer pays medical claims out of pocket instead of buying a policy, so there's no medical premium or commission to file. About seven in ten have no medical figure on file at all. Because medical's usually the biggest line in a benefits program, the employer's spend and the broker's commission both look much smaller than they really are.

To fill that gap, we look at what similar fully insured employers pay per person per month on medical, and what their brokers earn, then apply that rate to the people covered by the plan over a year.

<Frame>
  <img src="https://mintcdn.com/benefitflow/nB7hjzlN5Qs5GDns/images/modeled-commissions-and-premiums-self-funded.png?fit=max&auto=format&n=nB7hjzlN5Qs5GDns&q=85&s=c888180cbf6b1d3af1651db6a8a65af5" alt="A self-funded employer's filing showing dental, life and vision premiums but no medical policy, with a per person per month benchmark from comparable fully insured employers used to add a modeled $1.56M medical premium on top of the $520K reported" width="2120" height="1012" data-path="images/modeled-commissions-and-premiums-self-funded.png" />
</Frame>

## FAQs

<AccordionGroup>
  <Accordion title="Does an estimate change or replace what the employer reported?">
    No. On a bundled contract the pieces add up to the filed total. We're just showing the breakdown. For self-funded medical there's nothing filed to change; the estimate sits next to whatever was reported.
  </Accordion>

  <Accordion title="Why isn't there an estimate for this benefit or this employer?">
    Usually there isn't enough filed data. Either too few separate filings exist to measure a reliable split, or the employer's below the Form 5500 filing threshold with no Schedule A at all.
  </Accordion>

  <Accordion title="Can I search or filter on estimated figures?">
    No. Search and filters only look at what was actually filed, so an estimate alone can't be why an employer shows up in a search.
  </Accordion>
</AccordionGroup>

***

## Related

<CardGroup cols={2}>
  <Card title="Data Glossary" icon="book" href="/knowledge-base/data-glossary">
    What every field on an employer or broker profile means
  </Card>

  <Card title="Form 5500 Overview" icon="file-lines" href="/knowledge-base/data-source-5500-overview">
    What the filing includes, and what BenefitFlow adds
  </Card>

  <Card title="What is the Primary Broker?" icon="handshake" href="/knowledge-base/primary-broker">
    How reported commissions decide the lead broker relationship
  </Card>

  <Card title="Filtering Guide" icon="filter" href="/knowledge-base/filtering-guide">
    Which fields you can search and filter on
  </Card>
</CardGroup>
