Educational estimates only — not insurance advice. Open Season is not a licensed insurance broker. Verify coverage and costs against official plan documents before enrolling.
Net annual estimate = payroll premium + modeled in-network medical spending − employer HSA contribution − estimated HSA tax savings.
HSA contributions and tax-savings math
For each enrolled HSA-eligible employer plan, count the entered employer and employee annual deposits once, regardless of the number of covered people. Estimated tax value = (employer deposits + employee deposits) × selected household marginal rate. Net total in each usage scenario = gross premium + modeled care − employer seed money − estimated tax value. In family-on-A or family-on-B coverage, do not count the unused employer’s HSA inputs. Separate plans counts both eligible enrolled policies once.
Employee deposits are a transfer into your own savings, not a separate insurance charge or a second cost reduction. The same entered amounts apply to each coverage tier; adjust them if the employer contribution changes with enrollment. This simplified combined-contribution tax value is not an actual tax-return calculation: employer deposits are normally already tax-excluded. State/payroll taxes, contribution limits, eligibility timing, withdrawal restrictions and HRA benefits are not calculated. Review IRS rules and keep combined spouse contributions within applicable limits.
Gross premium-plus-plan-cap exposure is shown without HSA offsets, because account deposits do not change contractual deductibles or out-of-pocket limits. Net annual estimates may be negative if modeled benefits exceed modeled spending; this does not imply a negative insurance bill.
Usage assumptions01
Usage inputs (per person)
ScenarioAllowed chargesPrimary care / specialist visits
Low$1,000.002 / 0
Average$6,000.004 / 2
High$30,000.008 / 6
Mostly routine care: 2 primary care visits, no specialist visits; $1,000 in allowed charges per person. Regular appointments and some treatment: 4 primary care and 2 specialist visits; $6,000 in allowed charges per person. Frequent treatment or major medical care: 8 primary care and 6 specialist visits; $30,000 in allowed charges per person. These scenario values are illustrative inputs, not a prediction of claims.
How annual cost is built
THE COST MODEL
Annual premium + modeled out-of-pocket
Payroll premium per paycheck × the selected frequency (52 weekly, 26 every two weeks, 24 twice monthly, 12 monthly, or 1 annual) for the coverage tier used by that configuration. Add any annual spousal surcharge for the family-on-one-employer arrangements.
CAP APPLIEDSingle person: individual max. Family: aggregate family max OR embedded min(family max, individual max × covered members).
For each covered source, total allowed charges = the per-person scenario amount × members covered. Every covered person uses the same illustrative scenario; uneven use by different family members is not modeled. For plans with visit copays, the model removes assumed allowed charges of $150.00 per primary care visit and $250.00 per specialist visit, then clamps remaining non-visit charges at zero. A one-person policy uses min(non-visit allowed, individual deductible). For two or more covered people, aggregate deductible paid = min(non-visit allowed, family deductible). Embedded deductible paid = min(non-visit allowed, family deductible, covered members × min(non-visit allowed ÷ covered members, individual deductible)). Visit copays are assumed outside the deductible and added after this calculation, then the applicable out-of-pocket limit is applied.
When a visit uses coinsurance instead, its $150.00 or $250.00 allowed charge stays in the deductible pool. We allocate the deductible proportionally across those visits and other care, then apply each visit’s own percentage to its remaining charges and the model coinsurance estimate to remaining other care. A model rate suggested from matching diagnostic, imaging and hospital rates is an assumption to review—not a universal plan benefit. Prescription and other service rules can differ.
The displayed premium-plus-caps ceiling excludes out-of-network and non-covered costs. Coverage summaries are shown for review, but maternity, prescriptions and other benefit-specific spending are not separately modeled. Confirm actual benefit rules in the plan documents.
What is included02
What is included
Exactly three arrangements: all household members on Plan A, all on Plan B, or each spouse on their own employer coverage with children assigned as selected. For automatic child placement, the lower incremental annual cost of adding children (employee-plus-children premium minus employee-only premium) is used; this is not a search for the optimal medical-cost or network assignment. With children, their parent uses employee-plus-children coverage and the other spouse uses employee-only. Without children both use employee-only. Separate plans has no spouse surcharge. Everyone on one plan uses employee-plus-spouse for a couple without children, otherwise employee-plus-family.
03
What remains uncertain
Allowed charges, covered services, network status, referrals, prescription tiers, excluded services, HSA/HRA offsets, tax effects and actual claim timing may change your costs. Non-covered and out-of-network spending may sit outside the in-network out-of-pocket limit. No unknown is a confirmed zero.
Sources and limits
2027 FEHB sources and benefit limits
All 51 employee-paid premiums across the 17 listed options and three enrollment tiers match OPM’s 2027 fee-for-service rate chart, checked October 8, 2026; the chart marks all 17 options Nationwide. Annual premiums use the biweekly rate × 26. Enrollment codes, the rate-chart link and each option’s latest-listed 2026 brochure are in Employer Plans. OPM’s plan-information page still lists 2026 brochures, so 2027 eligibility and benefit changes are not verified. Template deductibles, coinsurance, out-of-pocket limits and benefit notes remain illustrative or unknown; no unsupported values have been presented as official benefits. Review each brochure and SBC extraction suggestion before applying or enrolling.