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Track A · MGU · TPA · Stop-Loss

Every rate. Every network. Every carrier. One data layer.

Milliman gives you actuarial workflow. Gradient AI gives you underwriting ML. Neither gives you the underlying rate data. We do — so your pricing holds up when claims land.

Sample · Network Rate DNA · 6 carriers × 7 specialties
The problem you face today

Three failures that quietly cost every stop-loss book money.

These aren't edge cases. They're structural gaps in the data you're handed — by the carrier you're underwriting, by the TPA who manages the plan, by the broker who wants a placement.

RATE SHEET9921399213992139921399213$142.08ACTUAL
Problem 01

Carriers don't show you rate depth.

Quote sheets list percentiles, not contracted rates. The deep-discount story a carrier sells may be true for primary care and false for orthopedics — exactly where claims concentrate. You underwrite blind.

LASERCOSTTIME
Problem 02

Laser risk hides in network shape.

A specialty where this carrier negotiates weakly is where a $300K claimant will land. Rate-depth variance by specialty is the laser-risk early-warning — and no traditional UW tool surfaces it.

QUOTE?MRF DATAbroken
Problem 03

Stop-loss quoting is disconnected from MRF reality.

Actuarial tables forecast claims; they don't see the negotiated rates those claims will actually pay at. Your spec attachment is priced against a Milliman average, not the carrier's real rate book.

The four products for this track

Four pieces of evidence. Built on one indexed rate warehouse.

Every product below is live on the platform today. They draw from the same MRF-ingested rate data and translate it into underwriting-specific artifacts.

Underwriting evidence

Network Rate DNA

A full rate-depth profile for every carrier × specialty × state you price against.

For each carrier you're underwriting, we compute the percentile rate-depth vs Medicare at the specialty level, across the states where that carrier has real MRF coverage. The output reads like a credit bureau report — not a marketing one-sheet.

The visible highlight: cells where a carrier is thinly discounted relative to peers are flagged automatically. Those flags are your laser-risk early warning.

See the product
Replaces: Milliman benchmark tables
Scenario modeling

Claims Replay

Reprice any claims file through any carrier, any network, in seconds.

Drop a historical claims CSV. Pick a target carrier. We reprice every line through that carrier's MRF-published rates and return the dollar delta — per claim, per CPT, per member.

The answer you get is rooted in negotiated rates, not the carrier's self-reported allowed amounts. For stop-loss renewal modeling, this replaces the "estimated savings" spreadsheet with audited evidence.

See the product
Replaces: Carrier-supplied savings spreadsheets
CLAIMS.CSVREPRICESAVINGS$214Kannual projectedvs current carrierPROVENANCE
Attachment projection

Stop-Loss Modeler

Project spec and aggregate attachment exposure forward using real rate data.

Model spec attachment and aggregate corridor across network options, using the same MRF-indexed rates that drive the rest of the platform. The modeler is deliberately simplified (documented in-product) — the value is rate-grounded forward projection, not a full actuarial replacement.

Currently in beta. See the product for methodology transparency.

See the product
Replaces: Excel model built from industry tables
COSTCLAIMANTS (RANKED)SPEC $75KPROJECTED EOY$1.42M
ERISA / plan-integrity

Fiduciary Scorecard

PBM spread, leakage, allowed-rate divergence — graded A through F, with provenance.

For any plan you oversee or underwrite, we score the fiduciary health of the downstream vendors: PBM spread vs NADAC, leakage (OON claims that should be in-network), and carrier-allowed rate vs MRF-published rate divergence.

Every grade is backed by a provenance block — source, sample size, methodology. Defend the grade in audit or in court.

See the product
Replaces: PBM self-reports, leakage suspicion
FIDUCIARY GRADEBPBM spread above peersample group · 2026-Q1PBM SPREAD62 / 100LEAKAGE RATE78 / 100ALLOWED VS MRF85 / 100ADMIN RATIO92 / 100
Live warehouse · sample output

Your network-DNA report, the morning of renewal.

Every cell traced back to a specific MRF file and publication date. Every flag re-computed against fresh rates. Download as PDF, share to your audit trail, or query programmatically.

PrimaryCardioOrthoImagingOncMentalSurgeryBCBSAetnaCignaUHCHumanaAnthemvelora://warehouse/network-dna?carrier=all&state=MA · 2026-04-23T09:12:00Z
Rate depth vs Medicare · sample group · provenance attached per cell
Data handling

Pick your PHI posture. We support three.

Your counsel decides the floor; we don't. Server-mode for the one-throat-to-choke integration, client-mode for a smaller breach radius, sidecar-mode for "PHI never leaves our infrastructure." Same analytics output across all three.

01 · Server-mode

Encrypted at rest in customer-isolated vaults.

We hold the HMAC key (AES-256-GCM at rest) and the {token → original} mapping. Customer integration is a single header. Outbound rehydration middleware swaps tokens back to originals on responses, so your portal users see plaintext without managing a local map.

BAA-covered · audit-logged · 90-day vault TTL
02 · Client-mode

PHI not persisted on Velora.

You generate the HMAC secret and send it on the request. Velora tokenizes in process memory and immediately drops the originals — no PHI is written to our storage, DB, backups, or logs. Your application keeps the local rehydration map; we never touch it.

BAA-covered · in-transit + in-memory only · smaller breach radius
03 · Sidecar-mode live

PHI never leaves your infrastructure.

Run the velora-vault tokenizer inside your VPC — Docker, Python, or TypeScript. CSVs tokenize locally before upload; only tokens cross our wire. Velora literally cannot see plaintext. Tokens are byte-equivalent to server-side, so analytics joins work identically.

Zero PHI on Velora · auditor-friendly · for the strictest counsel
Next step

Send a sample group. We'll return a full DNA report in 48 hours.

De-identified claims file or a census + current carrier — either works. The output becomes your first reference point for the next 12 months of renewal conversations.