Documentation
Understand how Pelandri optimizes health insurance plan selection, or integrate our optimization engine into your own application via the REST API.
Quickstart
Enter your health profile and get optimized plan rankings in under 5 minutes.
Read moreCost Model
How we calculate expected annual out-of-pocket costs across premiums, deductibles, copays, and drugs.
Read moreMonte Carlo Simulation
10,000 health expenditure scenarios using MEPS distributions calibrated to your age and conditions.
Read moreFormulary Matching
How we match your medications against plan formularies and compute tier-adjusted drug costs.
Read moreNetwork Verification
Provider network checks to ensure your doctors are in-network for each plan we evaluate.
Read moreHSA/FSA Tax Optimization
Tax savings modeling for HSA-eligible HDHP plans vs. traditional plans based on your income and filing status.
Read moreAPI Endpoints
/v1/optimize/v1/plans/:zip/v1/drugs/search/v1/signup/v1/login/v1/account/v1/checkoutAuthentication
All API requests require an API key passed via the X-API-Key header.
curl https://api.pelandri.com/v1/plans/90210 \ -H "X-API-Key: pel_your_api_key_here"
Expected Annual Cost Model
For each plan, we compute the total expected annual cost as:
Expected medical out-of-pocket costs are derived from MEPS expenditure distributions, adjusted by age group and health condition multipliers. Drug costs are computed by matching each medication against the plan's formulary tiers and applying tier-specific cost-sharing.
The CMS Actuarial Value Calculator methodology ensures our cost estimates are consistent with the same framework insurers use to classify plans into metal levels.
Monte Carlo Simulation
Rather than a single point estimate, Pelandri runs 10,000 simulated health expenditure scenarios for each plan using Latin Hypercube Sampling. Each scenario draws from MEPS-calibrated log-normal distributions adjusted by your age group and health conditions.
The simulation produces a complete cost distribution, giving you:
- Expected (mean) cost -- the average across all scenarios
- Median cost -- the 50th percentile, less sensitive to outliers
- 95th percentile cost -- your worst-case planning number
- Full histogram -- see the entire distribution of possible costs
This lets you choose between plans based on your risk tolerance: a conservative user might optimize for worst-case cost, while an aggressive optimizer focuses on expected cost.
Formulary Matching
Each health plan has a formulary -- a list of covered drugs organized into tiers. Tier 1 (generic) drugs have the lowest copays, while Tier 4 (specialty) drugs can cost hundreds per fill. The same drug can be on different tiers across different plans.
Pelandri matches each of your medications against every plan's formulary using CMS Plan Finder data. We compute a coverage score (0-100) based on tier placement and a total annual drug cost by multiplying tier-specific copays by your fill frequency.
Provider Network Verification
Using CMS Provider Data, we check whether each of your preferred doctors and specialists is in-network for each plan. Out-of-network providers can increase your costs by 2-5x, so network coverage is a critical factor in plan ranking.
Each plan receives a network score (0-100) based on the percentage of your preferred providers that are in-network.
HSA/FSA Tax Optimization
High Deductible Health Plans (HDHPs) are eligible for Health Savings Accounts (HSAs), which provide a triple tax advantage: contributions are tax-deductible, growth is tax-free, and qualified withdrawals are tax-free.
Pelandri models the tax benefit of HSA contributions based on your income, filing status, and applicable federal tax brackets. This benefit is subtracted from the HDHP's total cost, often making HDHPs competitive with lower-deductible plans for healthy individuals.