A health plan cost comparison calculator that prices the whole year, not just the premium

Employee benefits brokers supporting open enrollment for client groups, and individual health agents helping people choose among Marketplace metal levels. In both cases the decision is between a lower premium and lower out-of-pocket costs, and the calculator turns that trade-off into two yearly totals the visitor can test.

Benefits brokers can place the calculator on an open enrollment resource page they maintain for a client group, so employees can model the employer's options with their own expected care. Agree with the employer in advance how employee submissions will be used and who will follow up.

Individual health agents can pair it with the HSA vs traditional plan calculator on the same page, so a visitor drawn to a high-deductible plan can also see the tax side of an HSA.

For each plan, the visitor pays all costs up to the deductible, then their coinsurance share of the rest, capped at the out-of-pocket maximum. Twelve months of premiums are added and employer HSA or HRA money is subtracted. A worst-case year adds premiums to the full out-of-pocket maximum, less employer money.

The model is deliberately simple. It does not model copays, separate drug deductibles, services covered before the deductible such as preventive care, out-of-network care, or family versus individual deductibles. Expected costs should be plan-allowed amounts, not billed charges. Employer HSA or HRA money is counted as if fully used.

Those simplifications make the comparison easy to follow and easy to explain on a call. Suggest that visitors try a low and a high care estimate, as the tooltip advises, to see where the cheaper plan stops being cheaper.

• Yearly savings with the lower-cost plan
• Which plan costs less at the care level entered
• Total yearly cost for Plan A and Plan B
• Worst-case year for Plan A and Plan B

In each plan's Summary of Benefits and Coverage, the standard document every health plan must provide. It lists the deductible, coinsurance, copays and out-of-pocket maximum, so a visitor with two summaries in front of them can complete the comparison in a few minutes.

Brokers running open enrollment can attach both summaries to the same email that links to the calculator. For Marketplace shoppers, the plan details shown on HealthCare.gov or the state Marketplace give the same figures.

If the visitor has a premium tax credit, they should enter their share of the premium after the credit. The ACA premium tax credit calculator estimates that figure first.