Terms and Limitations

The Annual Cost Estimator provides general estimates and may not reflect your actual out-of-pocket costs. Your actual costs and use of medical services may differ from the statistical averages and expected service frequencies used in the tool. Your actual costs at time of service will be determined and governed by the terms of the health plan coverage that you enroll in. The Estimator focuses on a limited set of commonly used medical services. Because your and your dependents' medical service needs may change, consider additional services you and your dependents may need and how each health plan covers them. This tool is intended as one of several resources to help you choose a health plan.

All information you enter is anonymous and will not be saved or shared with your employer or health plans. Your responses are used solely to estimate potential out of pocket costs under available plans.

Review the estimates carefully and adjust them to reflect you and your dependents' health care needs for the coming year. For plans with different benefit levels (e.g., in-network vs. out-of-network), estimates assume all services are received from in-network providers offering the highest benefit level. Using other providers may result in higher costs.

Cost estimates are based on statistical averages and publicly available data. Actual costs may vary. Neither your employer nor the creators of this tool guarantee the accuracy of the data or results.

This tool is designed to estimate the annual cost for a person’s use of standard health care services commonly included on SBC documents. The calculation model assumes the use of in-network services, embedded deductibles (individual then family), a single deductible (for individual and family) and a single out-of-pocket maximum (for individual and family.) Either a copay or coinsurance can be applied to a service. Assumed service counts and costs default to typical values and can be modified. Events are calculated sequentially (by plan, person, service and event). Deductibles and out-of-pocket maximums for individuals and families can modify the overall cost.

The Annual Cost Estimator is not an application for enrollment.