One plan or two?

A free web app that helps dual-income households decide how to enroll during benefits open season. You upload both spouses' Summary of Benefits and Coverage (SBC) documents, and it compares every way the family could enroll — everyone on Spouse A's plan, everyone on Spouse B's, or split — and shows, in dollars, which arrangement wins.

Free. No sign-up, no account, no personal information. Your plan data stays in your own browser.

No. Open Season gives educational estimates based on the numbers in your plan documents. It is not a licensed broker or advisor, and it can't guarantee savings. Always verify against your official plan documents before enrolling.

Nothing leaves your device. There are no names, emails, or health details to collect — the app never asks for them.

Comparing premiums instead of total cost. The premium is just the entry fee. What matters is premium + what you'll actually pay when you get care: deductibles, copays, coinsurance, up to the out-of-pocket maximum. A cheap-premium plan with a $7,000 deductible can cost a family far more over the year than a pricier-premium plan with a $1,500 deductible.

Build the full annual picture for each option: (1) yearly premiums, (2) expected cost-sharing based on how your family actually uses care, (3) the worst case — everyone hits the out-of-pocket max. Then compare the totals, not any single number. That's exactly what Open Season does.

Most dual-income couples default to separate plans without ever running the numbers. Sometimes one family plan wins by thousands; sometimes splitting wins. There is no universal right answer — it depends on the two plans' premiums, deductibles, networks, and your family's expected care. Compare all three arrangements every year, because the math changes when premiums and plan designs change.

Look backward, then adjust forward. Last year's visits, prescriptions, and any planned procedures (a surgery, a pregnancy, orthodontics) are your best predictors. Then run a low, expected, and high scenario — the plan that wins in all three is the easy choice; if different plans win different scenarios, weigh which scenario you believe.

This is the big one. Some family plans have an embedded deductible: each person only has to meet the individual deductible before the plan starts paying for them. Others — many HDHPs — have an aggregate family deductible: nobody gets coverage until the entire family deductible is met, even if one person racks up huge bills alone. Two plans with the same "$4,000 family deductible" can behave completely differently. Check the SBC.

The ACA caps what any one person pays in-network (the embedded individual out-of-pocket max), even under family coverage. But out-of-network spending often has a separate — or unlimited — max, and premiums, balance-billed charges, and non-covered services never count toward the max. "Out-of-pocket maximum" does not mean "the most you can possibly spend."

Usually not — copays typically apply from day one without touching the deductible, but they usually do count toward the out-of-pocket max. The exact treatment varies by plan, so check the SBC rather than assuming.

Yes. Some plans — especially HMOs — run prescription coverage on its own track with its own deductible or out-of-pocket limit, separate from medical. If you take expensive brand-name drugs, this matters enormously, and it's easy to miss because the headline numbers are medical-only.

Not necessarily. "Takes our insurance" can mean the practice accepts something from that carrier — not your specific plan and network. Always verify the doctor, the hospital, and the lab/imaging facility are in-network for your exact plan. An in-network surgeon at an in-network hospital can still generate out-of-network bills from the anesthesiologist or the lab.

If you go out-of-network, the provider can bill you the difference between their charge and what insurance pays — on top of your higher out-of-network cost-sharing. Federal law (the No Surprises Act) protects against surprise balance bills for emergency care and for certain non-emergency care at in-network facilities — but ground ambulances, for example, are not covered by those protections.

Preventive services are free when coded as preventive and done in-network. If the visit turns diagnostic — you mention a symptom and the doctor investigates — it can be re-coded and billed. Same visit, different code, different bill.

Many plans won't cover certain drugs or procedures until you get advance approval, or until you've tried cheaper alternatives first ("step therapy"). The SBC's "yes, covered" can quietly mean "covered after you jump through hoops." If anyone in the family takes specialty drugs, read the formulary — the drug's tier matters more than whether drugs are "covered."

Some employers charge an extra monthly fee — often $100 or more — to cover a spouse who has access to their own employer's plan. It may be buried in enrollment materials. Factor it into the comparison.

An HSA (Health Savings Account) pairs with a qualifying high-deductible plan, the money is yours forever, and it rolls over year to year. An FSA (Flexible Spending Account) is use-it-or-lose-it — unspent money mostly disappears at year-end (plans may allow a small rollover or grace period). Also: contributing to a general-purpose FSA can disqualify you from HSA contributions, including through a spouse's FSA that covers you.

If you leave a job, COBRA lets you keep the plan — at up to 102% of the full premium, including the share your employer was paying. People routinely discover their "$200/month" plan actually costs $1,800.

The Summary of Benefits and Coverage — a standardized, plain-language summary of a health plan's costs and coverage that federal law requires every employer plan to provide. Same format everywhere, so plans can be compared apples to apples.

Because before it, comparing health plans was nearly impossible — every insurer described coverage in its own jargon, on its own terms, burying the numbers that matter. The Affordable Care Act created the SBC as a single uniform document: the same definitions, the same cost-sharing breakdown, the same coverage examples, no matter whose plan it is. It's the only document designed from the ground up to let regular people compare plans side by side. That's exactly why Open Season is built on it — the SBC is the one place where the truth about a plan is written down in comparable form.

Your HR or benefits portal, your insurer's website, or just ask HR — employers are legally required to provide it within 7 business days of your request.

You can enter the key numbers manually: premiums, deductibles, out-of-pocket maximums, copays, and coinsurance. It's more work, but it beats guessing.

SBC documents (PDF). That's it — the parser is built for the standardized SBC format, not full plan brochures, benefit guides, or ID cards.