Plan B Cost

Plan B

Enter the plan name, type of plan, plan costs, and coinsurance or copay amounts for the second plan that you want to compare.

Plan Name

Plan Type

Employer Annual HSA Contributions

Total HSA contributions exceed 2019 limit. Adjust to $X,XXX or less.

Individual Annual HSA Contributions

Monthly Health Plan Premium

Annual Deductible

Annual Out-of-Pocket Maximum

Office Visit Coverage
Select All
Select All
Counts towards deductible
Routine Preventative Care
%
Specialist Office Visit
%
Diagnostic Coverage
Diagnostic Costs
%
Lab & Radiology
Imaging tests
%
Hospital Coverage
Inpatient Visits
%
Outpatient Visits
%
Emergency Room Care
%
Prescription Drug Coverage
Generic
%
Brand
%
Other Costs
Other
%