Compare what comes out of your paycheck, what care may cost, and the employer dollars available to help.
About 3 minutesNo personal health information
PPO
Traditional PPO Plan
First-dollar office and Rx copays
A $2,000 individual / $4,000 family embedded deductible, with familiar first-dollar office and prescription copays.
Employee-only cost per paycheck
$23
Individual deductible
$2,000
Out-of-pocket maximum
$5,000
Employer None
—
Traditional PPO Plan$1,002 total / month
Employer $952 Employee $50
$23 from each of 26 paychecks
HSA-eligible
HSA / HDHP Plan
Lower premium + HSA opportunity
A $1,800 self-only / $3,600 aggregate family deductible. After it is met, most in-network care is $0, with limited urgent, ER, and brand-Rx copays.
Employee-only cost per paycheck
$0
Individual deductible
$1,800
Out-of-pocket maximum
$5,000
Employer HSA
Varies by tenure
HSA / HDHP Plan$893 total / month
Employer $893 Employee $0
$0 from each of 26 paychecks
$0 preventive care on both plansEligible ACA-recommended preventive services are covered at no cost when received from an in-network provider and billed as preventive. What qualifies depends on current federal recommendations and factors such as age, sex, and individual health risks. Diagnostic or follow-up care may have cost sharing.
$0 care can change the math.You can model virtual primary, urgent, and mental health visits through First Stop Health—and $0 medications coordinated through SHARx when they cost $350 or more for a 30-day supply or are specialty drugs. Eligible imaging and elective procedures coordinated through Valenz can also reduce the member’s net cost to $0.
Estimates are educational and are not a guarantee of benefits or expenses. Official plan documents control.
