UNDERWRITECoverage Estimator
Three questions.
One honest number.
Before we discuss placement strategy, we model your exposure. Answer three questions and receive a calibrated premium range — the same analysis we prepare before a first conversation.
Estimates are illustrative and based on aggregate placement data from Q4 2024 – Q1 2026. Final premiums depend on medical underwriting, carrier appetite, and coverage structure. Not a binding quote.
340+
HNWI placements, 2024–2026
$21.5B
Global HNWI insurance market
8 days
Median placement timeline
50 states
Licensed jurisdiction coverage
Coverage Architecture
Four tiers. Twelve variables.
No ambiguity.
Every placement decision begins here. Most clients find their architecture within Global Access or Family Office.
| Coverage Dimension | Domestic Premier Nationwide elite access | Most Placed Global Access Borderless coverage | Family Office Multi-member architecture | Legacy / Multi-Gen Generational health architecture |
|---|---|---|---|---|
| Annual Premium Range | $18K – $36K / yr | $44K – $86K / yr | $72K – $140K / yr | $120K – $240K+ / yr |
| Network Type | PPO + Select Private | Private + International | Closed physician network | Proprietary closed network |
| Executive Physical | Annual screening | Cleveland Clinic / Mayo | Quarterly executive suite | Bi-annual full-body protocol |
| Specialist Access Speed | 48 – 72 hrs | 24 – 48 hrs | Same-day | Direct physician line |
| Mental Health Concierge | Standard EAP | Dedicated therapist | Full behavioral suite | Embedded psychiatrist |
| Global Evacuation | Domestic only | Worldwide medevac | Air ambulance + repatriation | Global + charter coordination |
| Second-Opinion Coordination | On-request | Proactive coordination | Standing second-opinion panel | Retained specialist panel |
| Prescription Formulary | Tier 1 – 3 formulary | Open formulary | Custom formulary | Bespoke compound access |
| Multi-State Portability | 50 states | All jurisdictions | All jurisdictions + abroad | Global, multi-residency |
| Pre-Existing Condition Handling | Underwritten placement | E&S carrier placement | Guaranteed issue structure | Pre-existing: full coverage |
| Annual Out-of-Pocket Max | $4,500 individual | $2,500 individual | $1,500 family | No out-of-pocket maximum |
| Dedicated Advisor | Shared advisor | Named advisor | Dedicated team (2) | Dedicated advisor + liaison |
All figures reflect 2025–2026 placement data across E&S and admitted carriers. Premiums vary by underwriting outcome, coverage jurisdiction, and medical history. Global Access column reflects our most common placement architecture.
Download the 2025 Full Benchmark →Placement Dossiers
Three placements.
Three distinct architectures.
All profiles are anonymized composites drawn from actual placement engagements. Financial figures reflect 2024–2025 outcomes.
Profile
58-year-old retired CEO. Dual residency (Connecticut, Scottsdale). Cardiac history — two stents placed 2019. COBRA expiring in 11 weeks. Previous employer plan: self-funded Fortune 500 with no-cost executive suite access.
Gap Analysis
Standard market carriers declined or excluded cardiac history entirely. Open-market PPO options would have required 24-month pre-existing exclusion windows. Spouse required specialist continuity at a specific Phoenix-area practice not on any admitted carrier directory.
Placement Strategy
Placed through an E&S carrier with guaranteed-issue structure. Negotiated cardiac monitoring coverage as a named benefit. Secured secondary medevac rider for international travel. Maintained specialist continuity via closed network agreement.
Outcome
Full coverage placed 8 days before COBRA expiration.
vs. comparable COBRA continuation
Profile
44-year-old founder, recently closed $180M Series B liquidity event. Lost group coverage at close. Family of four. No significant medical history but requires global coverage — operates across Singapore, London, and New York on a 6-week rotation.
Gap Analysis
Domestic plans offered no meaningful international coverage. International plans excluded US-based care or imposed 90-day waiting periods. No single carrier offered seamless global coverage with US anchor.
Placement Strategy
Structured a hybrid architecture: US-anchor PPO for domestic care plus international overlay for global access. Added global medevac rider with charter coordination. Placed with two carriers in a coordinated benefit structure to eliminate coverage gaps across all three residency jurisdictions.
Outcome
Continuous global coverage with no waiting periods, effective day of group termination.
vs. purchasing plans independently per jurisdiction
Profile
Family office principal, 67. Managing health spend for three generations — principal, spouse, two adult children, and four grandchildren under 18. Existing coverage: a patchwork of individual plans accumulated over 12 years, some lapsed.
Gap Analysis
No unified coverage architecture. Duplicate benefits on some members, gaps on others. Adult children in different states on incompatible networks. No coordinated second-opinion protocol. Mental health coverage fragmented across three carriers.
Placement Strategy
Consolidated to a single Family Office tier program with a named advisor team. Unified network across all jurisdictions. Implemented a standing second-opinion panel at Cleveland Clinic and Johns Hopkins. Established behavioral health continuity for all covered members. Structured premium funding on a step-pay schedule aligned to annual distribution timing.
Outcome
Nine-member household unified under a single coordinated program.
annually vs. prior fragmented structure
Research Report
2025 HNWI Coverage Benchmark
Premium ranges, carrier appetite shifts, and placement trends across 340 HNWI engagements from Q1 2024 through Q1 2026. The analysis your wealth advisor doesn't have.
- —34-page placement intelligence report
- —Carrier appetite matrix by condition type
- —E&S vs. admitted premium benchmarks
- —COBRA gap timing analysis
Complimentary Engagement
Run My Full Analysis
We prepare a complimentary coverage gap report before our first conversation. No obligation. No boilerplate recommendations. The analysis reflects your specific exposure profile.