The Opportunity
Companies on the Aetna PEO plan (a popular option through Rippling, Justworks, TriNet, and other PEOs) are overpaying for medical insurance. The low-deductible plan (LDHP 300/90) costs 39% more in premiums than the high-deductible alternative (HDHP 3300/90) while providing nearly identical actuarial value when out-of-pocket costs are factored in.
By switching to the HDHP and pairing it with Gimble Card, employers can give employees free healthcare (zero out-of-pocket costs) and still save hundreds of thousands of dollars per year.
Plan Comparison
Current Plan (Low Deductible)
Proposed Plan (High Deductible)
Rates from Aetna CA OA Managed Choice POS (common PEO plan). Your rates may vary slightly by PEO.
What is Gimble Card?
Gimble Card is like Ramp for medical expenses. It provides employees first-dollar liquidity so they never face large, unexpected medical bills, even on a high-deductible plan.
The result: employees experience $0 out-of-pocket costs at point of care. No surprise bills. No financial stress. Just swipe the Gimble Card.
Customize Your Numbers
Enter Your Employee Count by Tier
Employer Premium Contribution
Premium Savings: 39% Across All Tiers
| Coverage Tier | Employees | LDHP (Employer) | HDHP (Employer) | Savings |
|---|
The Employee Experience: Same Surgery, Three Plans
An employee needs a surgery in April that costs $4,800 after insurance. Here's the total monthly cost (premiums + out-of-pocket) under each approach:
Splitting the Savings
Switching to the HDHP generates significant premium savings. The question is: how do you and your employees share the benefit?
There are two paths, depending on whether you want a variable or fixed cost structure.
Path A: Variable Cost — Fund Employee OOP via Gimble Card
The employer funds some or all employee out-of-pocket costs through Gimble Card. This means employees pay $0 at the doctor, but the employer's total cost varies depending on how much healthcare employees actually use. The premium savings are so large that the employer saves money even in catastrophic scenarios.
The two scenarios below aren't choices — they're possible outcomes of the same approach:
Likely Outcome
Worst Case Outcome
In the worst case, the employer caps its OOP funding at the gap between HDHP and LDHP out-of-pocket maximums ($2,500/single, $5,000/family). The employee never pays more than they would have on the LDHP. Even in this catastrophic scenario — every employee maxing out — the employer still saves money because the premium gap exceeds the coverage gap at every tier.
Path B: Fixed Cost — HSA Seeding
If you prefer predictable budgeting, seed employee HSAs with a fixed amount ($2,000 single / $4,000 family). This gives employees tax-advantaged dollars to cover their out-of-pocket costs, and the employer's cost is known on day one.
Fixed Cost (HSA Seeding)
HSA funds are the employee's property — they roll over year to year, earn investment returns, and follow the employee if they leave. Unlike premium dollars that go to Aetna, this is real wealth employees keep. Healthy employees accumulate savings; those with medical needs use it for expenses.
Side-by-Side Comparison
| Line Item | Baseline | Path A (Likely) | Path A (Worst) | Path B (Fixed) |
|---|
Why This Works at Every Level
The math is straightforward: the premium gap between LDHP and HDHP is larger than the coverage gap.
| Comparison | Single (EE) | Family (EF) |
|---|---|---|
| Annual premium savings (LDHP → HDHP) | $4,353 | $13,496 |
| Max additional OOP exposure | $2,500 | $5,000 |
| Net savings (even at max OOP) | $1,853 | $8,496 |
For every coverage tier, the premium savings exceed the maximum possible out-of-pocket costs. This is why the employer saves money in every scenario — even the catastrophic one where every employee maxes out. The HDHP is simply a better-priced product for the same underlying coverage.
Summary
| Approach | Employer Spend | Employer Savings | Per Employee OOP |
|---|
All scenarios include Gimble fee of $40/employee/month.