A high-deductible plan saves money only if the premium difference outruns what employees now pay at the counter.
Moving to an HSA-qualified plan trades lower premiums for higher out-of-pocket cost, and that trade looks very different for a healthy single employee than for a family managing a chronic condition. We model the designs against your current plan on your own census and claims, so the tradeoff is a number you can see.
The comparison is total cost by employee, not premium by plan.
Premium, employer HSA funding and expected out-of-pocket spending together make up what a plan really costs. We calculate all three for every design we put in front of you.
Employee Total Cost
Premium contributions plus expected out-of-pocket spending, less any employer HSA deposit. We show it for low, typical and high users, because the average employee does not exist and the high user is the one who will call HR.
Employer Total Cost
Premium savings less the HSA funding you put in. We test several deposit levels, because a deposit that is too small leaves employees exposed and one that is too large erases the savings that justified the change.
Replace or Offer Alongside
A CDHP can replace the current plan or sit next to it. Offering both lets healthier employees choose the CDHP, which can raise the cost of the plan left behind, so we price that effect before you decide.
Pharmacy Exposure
Employees on maintenance drugs pay full cost until the deductible is met, unless the drug falls within the preventive care the IRS allows before the deductible. We model their spending explicitly, because pharmacy is where the deductible is felt first.
An HSA-qualified plan has to meet IRS limits every year, and the limits move.
For 2026 an HSA-qualified plan needs a deductible of at least $1,700 self-only or $3,400 family, with out-of-pocket costs capped at $8,500 and $17,000. Contributions from all sources are limited to $4,400 self-only or $8,750 family.
What Comes Before the Deductible
Preventive care and telehealth can be covered before the deductible without losing HSA status. A copay for office visits, added to make the plan feel familiar, disqualifies the plan, which is why we review every benefit line, not only the deductible.
The Embedded Deductible
A family plan can include an individual deductible within the family deductible, but not one set below the family minimum. We check the design at the individual level, because that is where a plan that looks compliant can fail.
New Options From 2026
Beginning in 2026, bronze and catastrophic plans are treated as HSA-compatible, and direct primary care arrangements no longer block HSA eligibility, subject to IRS conditions. We weigh whether either changes your design choices.
The same design can help one employee and cost another in the same year.
Illustrative figures, not a quote. Suppose a CDHP lowers an employee’s annual premium contribution by $1,200, you deposit $600 in the HSA, and the deductible is $3,000.
A Low User
An employee who needs little care keeps most of the $1,200 premium difference plus the $600 deposit, and anything unspent stays in the HSA. For this employee the CDHP is plainly better.
A High User
An employee who meets the $3,000 deductible pays it before the plan shares cost, against $1,800 of premium savings and deposit. Whether they end up behind depends on what the old plan’s copays and coinsurance were costing them.
What Your Claims Add
Your claims show how many employees sit in each group. We use that distribution, not a national average, to set a deposit that keeps high users whole or close to it while the plan still saves money.
What employers ask before adding a CDHP.
Should the CDHP replace our current plan?
Not always. Full replacement produces the largest savings and the most disruption. A side-by-side offer is gentler but can raise the cost of the other plan, so we price both paths.
How much should we put in the HSA?
Enough that the employees most likely to meet the deductible are not left worse off, within a budget that still saves money. The model shows that tradeoff at several deposit levels.
What about spouses with other coverage?
A spouse’s general-purpose FSA or non-qualifying plan that covers the employee can make them ineligible to contribute to an HSA. We flag this at enrollment, because the rule surprises people and the correction falls on them.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
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