For years, benefits consultants have relied on headline discount rates that often obscure the true cost of care. Serif Health’s new tool shifts this dynamic by integrating Transparency in Coverage files, hospital rate disclosures, and national claims data to model real-world performance. By benchmarking against CMS Medicare rates, the platform allows advisors to weigh negotiated reimbursement levels against provider participation and out-of-network utilization.

CEO Rafiq Ahmed argues that traditional methods offer a backward-looking view of a carrier’s entire book of business rather than the specific reality for an individual client. The module enables brokers to generate side-by-side comparisons, analyze provider disruption, and model costs based on actual employee census data. CTO Matt Robben notes that the platform achieves match rates of 80-90% between claims and negotiated rates, providing a level of precision that raw transparency files cannot deliver alone. The tool is available immediately for brokers, TPAs, and self-funded employers.