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Sherlock Benchmarks


Sherlock Benchmark Calculator

We invite you to compare your health plan to the Sherlock Expense Evaluation Report (SEER) benchmarks by applying your values to this calculator.

  1. Insert the number of members for each product that you offer into the appropriate box. The National Association of Insurance Commissioners (NAIC) schedule, the Exhibit of Premiums, Enrollment, and Utilization can be adapted for this purpose.
  2. Select the universe that is most comparable to yours with respect to the product offered by your organization. You may select products of universes individually or you may select only those products in a particular universe. If you do not locate your universe here, choose the closest one. For instance, we have found that commercial plans may closely resemble Blue Cross Blue Shield plans. The universes are Blue Cross Blue Shield Plans, Independent/Provider-Sponsored plans, Medicaid plans, and Medicare plans.
  3. If you are only interested in what the benchmark is, this value is now shown.
  4. If you are interested in comparisons, please insert your administrative expenses for your organization into the appropriate box. The NAIC schedule, The Statement of Revenues and Expenses, are a possible source. Use the sum of "Claims Adjustment Expenses" and "General Administrative Expenses." This will provide you with PMPM and percent variances.

The source of the values that populate this calculator are past editions of Plan Management Navigator, linked here. Other information concerning our SEER benchmarks can be found here.

Benchmark Value: N/A
Your Total Annual Administrative Expenses $ Optional
Total Average Members
Your PMPM Administrative Expenses
Variance from Benchmark
Percent Variance from Benchmark
Products Average Members Universe
Commercial HMO Insured
Commercial HMO ASO/ASC
Commercial POS Insured
Commercial POS ASO/ASC
Indemnity & PPO Insured
Indemnity & PPO ASO/ASC
Commercial ASO
Medicare Advantage
Medicare SNP
Medicare Cost IPS Only
Medicare Supplement
Medicaid HMO
Medicaid CHIP
Stand-Alone Part D
Stand-Alone Dental

Data is from calendar year 2015. Updated 10-10-2016.

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