It’s Open Enrollment season — the one time of year when you get to make important decisions about your health insurance coverage for the year ahead. Whether you’re evaluating options through your employer or on your own, choosing the right plan can feel overwhelming.
Your insurance advisor walks people through this process every day and can help you make sense of your options too.
If you take expensive medications or have ongoing health conditions, it’s especially important to talk with them about how each plan covers your specific drugs and visits so you don’t end up with surprise costs.
Before you meet, log in to your insurance portal and review what you actually spent on prescriptions and medical care in 2024–2025 — those real numbers are the best guide to which plan will work for you.
Step 1: Know Your Choices
Many employers—including ours—help cover the cost of health insurance, contributing around $600 per month (about $7,200 per year) per full-time employee to sponsor the Base Plan, making it premium-free for staff.
Most employers offer:
- A Base Plan — typically a high-deductible health plan (HDHP) with no or low premiums and HSA eligibility
- One or more Buy-Up Plans — traditional copay-style plans with higher premiums but lower deductibles
Example:
| Plan | Biweekly Premium | Annual Cost | Deductible |
| Base Plan (HDHP) | $0 | $0 | $3,000 |
| Buy-Up Plan 1 | $145 | ~$3,800/year | $1,500 |
| Buy-Up Plan 2 | $115 | ~$3,000/year | $500 |
Step 2: Understand the Trade-Off
When you choose a Buy-Up Plan, you’re essentially pre-paying for peace of mind:
- You pay higher premiums every paycheck.
- That money is gone at the end of the year, whether you use a lot of care or hardly any.
- Premiums do not roll over or earn interest.
When you choose the free Base Plan and put the money you would have spent on premiums into a Health Savings Account (HSA) instead, you:
- Build a tax-free safety net for current and future medical costs.
- Save on taxes (often around 25% or more, depending on your tax bracket).
- Keep unused money year to year — it rolls over and stays yours, even if you change jobs or retire.
Example: Base Plan + HSA
You choose the free Base Plan and contribute the $3,800 you would have paid for Buy-Up Plan 1 into an HSA:
- You save about $950 in taxes.
- You now have $3,800 in your HSA for medical expenses.
- If you only spend $1,000 on care this year, you still have $2,800 left, growing tax-free for the future.
Example: Buy-Up Plan 1
You choose Buy-Up Plan 1:
- You pay about $3,800 in premiums.
- You still have a $1,500 deductible.
- If you use only a modest amount of care, you’ve still spent $3,800 in premiums that do not roll over or grow.
Example: Buy-Up Plan 2
You choose Buy-Up Plan 2:
- You pay about $3,000 in premiums over the year.
- You still have a $500 deductible before the plan fully kicks in.
- If you only use a little care, much of that $3,000 is spent whether you needed it or not.
Side-by-Side Comparison: Trade-Off Examples
| Plan Choice | Premiums Paid | Out-of-Pocket Costs (example year) | Money Kept or Saved |
| Base Plan + HSA | $0 premium, $3,800 to HSA | $1,000 in care | $2,800 left in HSA (tax-free, rolls over) |
| Buy-Up Plan 1 | $3,800 in premiums | Up to $1,500 deductible | $0 saved; premiums are spent for that year |
| Buy-Up Plan 2 | $3,000 in premiums | $500 deductible (if met) | $0 saved; premiums don’t roll over |
Step 3: Ask Yourself These Questions
- Did I use a lot of medical care this year?
- Am I expecting surgery, pregnancy, or a major diagnosis?
- Do I prefer a lower deductible or lower premiums?
- Can I afford to contribute to an HSA — and do I feel comfortable using it?
Step 4: Use a Simple Rule of Thumb
| If You… | Then… |
| Are healthy and don’t expect major care | Choose Base Plan + HSA |
| Like predictable copays or expect moderate care | Consider Buy-Up Plan 2 |
| Know you’ll have significant costs early in the year | Buy-Up Plan 1 might be worth it |
Final Tip
Don’t just look at the premium. Add up your total potential costs — and factor in what you get to keep.
Your health insurance should protect you — but it should also work for your budget and your long-term financial health.
Need help making the right decision? Talk to your HR rep or schedule time with your company’s insurance advisor to walk through the numbers together.
Make this year the year you feel confident about your coverage.
