[ HOW OTHERS CHOOSE ]

John and his wife Maria are both in good health. This year, they both got their preventive care throughout the year, which is fully covered by their current plan, the HSA Green Plan. Next year, John and Maria plan to get their preventive care again. As John is comparing plans, he knows no matter which plan they choose, the cost will be covered 100%. They don’t plan on any other out-of pocket medical or prescription drug expenses in 2026. Plus, he values the annual Company HSA contribution and lower monthly payroll contributions. He plans to re-enroll in employee + spouse coverage in the HSA Green Plan for 2026.

He compares the plans side by side and confirms that the HSA Green Plan is still the right fit. He sees that if they don’t have any out-of-pocket expenses next year, they could end up with money to roll over into their HSA the following year to keep saving for future medical expenses. See how the math works for him:

	PPO Plan	HSA Blue Plan	HSA Green Plan
Annual Employee Payroll Contributions	$2,868	$2,868	$1,056
Total Expense (premiums only since they plan on no out-of-pocket expenses)	$2,868	$2,868	$1,056
Company HSA Contribution	$0	$2,000	$1,500
Total Annual Cost	$2,868	$868	-$444

Shelly is a single parent with a child who takes a Tier 3 medication year round. Because the prescriptions are filled every 90 days, Shelly already uses the mail-order program to keep costs down. She likes the predictability of copays and the convenience of not having to refill at the pharmacy every month.

When she looks at all three plans side by side, Shelly sees that the PPO Plan is the best financial choice. Even though she won’t get a company HSA contribution, the copay savings for her child’s prescriptions outweigh the difference. By enrolling in employee + child coverage in the PPO Plan, Shelly can better manage her family’s budget and feel confident she’s choosing the most cost-effective option. Here’s how it works out for Shelly:

	PPO Plan	HSA Blue Plan	HSA Green Plan
Total Out-of-Pocket Expenses (4 mail-order refills of a Tier 3 medication)	$700	$4,080	$4,800
Annual Employee Payroll Contributions	$2,328	$2,328	$840
Total Expenses (claims costs + premium)	$3,028	$6,408	$5,640
Company HSA Contribution	$0	$2,000	$1,500
Total Annual Cost	$3,028	$4,408	$4,140

Mark has two active, young kids. Between a few sports injuries and common illnesses throughout the year, he knows he’ll meet the deductible and plans on reaching his out-of-pocket maximum. He considers the new PPO Plan because the copays for certain covered services are appealing, but he’s been pretty happy with his current plan, the HSA Green Plan. Plus, he relies on the annual Company HSA contribution. He’s not sure he’s ready to make a change but does the quick math just to compare.

When he looks at all three plans side by side, Mark decides to enroll in the HSA Blue Plan for employee + children coverage. He’s surprised to see that changing plans could save him some money even though the HSA Blue Plan has higher monthly employee contributions than the HSA Green Plan. Here’s how it works out for Mark:

	PPO Plan	HSA Blue Plan	HSA Green Plan
Out-of-Pocket Maximum	$7,600	$7,600	$9,600
Annual Employee Payroll Contributions	$2,398	$2,398	$840
Total Expenses (out-of-pocket maximum + premium)	$9,928	$9,928	$10,440
Company HSA Contribution	$0	$2,000	$1,500
Total Annual Cost	$9,928	$7,928	$8,940

Rosie manages a chronic condition, so she sees a specialist regularly and gets refills of her prescription medication every 90 days. She already uses the mail-order program to help save on her prescription drug costs. She also likes the idea of paying set copays. On the other hand, she’s currently enrolled in the HSA Blue Plan and really likes getting the Company HSA contribution, which the PPO Plan doesn’t offer.

Rosie decides to enroll in the PPO Plan for employee-only coverage because her specialty visits and prescription refills all have copays. It’s more predictable for her, and she notes that copays do count toward her annual out-of-pocket maximum. Even without the Company HSA contribution, she’ll end up paying less out of pocket. Here’s the quick math for Rosie:

	PPO Plan	HSA Blue Plan	HSA Green Plan
Total Out-of-Pocket Expenses (four specialty visits + four prescription refills)	$860	$3,800	$4,800
Deductible Remaining	$600	$0	$0
Out-of-Pocket Maximum Remaining	$2,940	$0	$0
Annual Employee Payroll Contributions	$1,308	$1,308	$480
Total Expenses (claim costs + premium)	$2,168	$5,108	$5,280
Company HSA Contribution	$0	$1,000	$750
Total Annual Cost	$2,168	$4,108	$4,530

Angela needs family coverage for her spouse and three kids. As a family this year, they used additional services outside of their routine medical care, including two LiveHealth Online visits, outpatient mental health care, some prescriptions and an urgent care visit that required X-rays.

Angela first considers the new PPO Plan because of the copays for the types of day-to-day services she thinks they’ll use again next year. After reviewing all three options, however, she sees that the HSA Green Plan will likely save her the most money out of pocket. Since this is her first time enrolling in a Worthington Steel medical plan, she takes time to think through what her family will need and chooses the plan that best fits their needs and budget. Here’s her math:

	PPO Plan	HSA Blue Plan	HSA Green Plan
LiveHealth Online visits	$30 ($15 copay x2)	$70 ($35 fee x 2)	$70 ($35 fee x2)
Tier 1 Prescription	$10	$35	$35
Outpatient Mental Health Service	$200	$200	$200
Urgent Care Visit	$50	$120	$120
X-Ray	$25	$250	$250
Total Out-of-Pocket Expenses	$315	$675	$675
Deductible Remaining	$1,000	$3,225	$5,225
Out-of-Pocket Maximum Remaining	$7,285	$6,925	$8,925
Annual Employee Payroll Contributions	$3,924	$3,924	$1,416
Total Expenses (claim costs + premium)	$4,239	$4,599	$2,091
Company HSA Contribution	$0	$2,000	$1,500
Total Annual Cost	$4,239	$2,599	$591

Carlos covers his whole family under his medical plan, but one family member attends weekly therapy sessions to support their mental health. That adds up to more than 50 in-person visits each year. Carlos appreciates that therapy is covered under all plans, but when he looks closer, the costs vary a lot depending on which plan he chooses.

The PPO Plan stands out because of its predictable $25 copay for each session. With weekly visits, the savings are significant compared to the HSA options, which would require him to meet a higher deductible and then continue paying more per session. Even without a Company HSA contribution, Carlos saves over $1,000 by enrolling in the PPO Plan for family coverage. The consistency of copays gives him peace of mind and helps him budget for the year.

Here’s now the numbers work out for Carlos:

	PPO Plan	HSA Blue Plan	HSA Green Plan
Total Out-of-Pocket Expenses (52 in-office therapy sessions)	$1,300	$4,640	$6,860
Annual Employee Payroll Contributions	$3,924	$3,924	$1,416
Total Expenses (claims costs + premium)	$5,224	$8,564	$8,276
Company HSA Contribution	$0	$2,000	$1,500
Total Annual Cost	$5,224	$6,564	$6,776

Maya was recently diagnosed with multiple sclerosis (MS), a chronic condition that requires significant medical care throughout the year. Her treatment plan includes regular neurologist visits, MRIs, infusion therapy, physical therapy, lab monitoring and high-cost specialty prescriptions. She also anticipates needing durable medical equipment to help manage her mobility. With all of these services, Maya knows she’ll reach her annual out-of-pocket maximum no matter which plan she chooses.

The PPO Plan’s low deductible and predictable copays are appealing, but it doesn’t offer an HSA contribution. She also notes that although PPO copays don’t count toward the deductible, they do apply to the out-of-pocket maximum. That makes the math important. When she looks at the numbers, Maya sees that the HSA Blue Plan is her best option. It has a lower deductible and more coinsurance coverage than the HSA Green Plan, plus the most generous Company HSA contribution. That contribution helps offset her expenses and gives her more peace of mind as she manages the high costs of living with MS.

Here’s the cost comparison for Maya’s situation:

	PPO Plan	HSA Blue Plan	HSA Green Plan
Out-of-Pocket Maximum	$3,800	$3,800	$4,800
Annual Employee Payroll Contributions	$1,308	$1,308	$480
Total Expenses (out-of-pocket maximum + premium)	$5,108	$5,108	$5,280
Company HSA Contribution	$0	$2,000	$1,500
Total Annual Cost	$5,108	$4,108	$4,530