CFO Corner Week 42: Stop Letting Your Health Plan Choose Itself
Open enrollment is the one window each year when you can change your health plan, your HSA or FSA contributions, and your coverage without a qualifying life event. It's also one of the biggest spending decisions most people make all year — and one of the most rushed. This week's CFO Corner is a straightforward way to make that decision on purpose.
The Reframe Open enrollment isn't paperwork — it's thousands of dollars in premiums locked in for twelve months. And letting your plan auto-renew is still a decision. It's just one you didn't look at.
The myths to clear up
"My plan auto-renews, so I'm fine." Premiums, deductibles, networks, and drug coverage can all change year to year — even when the plan name stays the same.
"The cheapest premium is the cheapest plan." Premium is only one of three numbers that matter.
The Total-Cost Formula Annual premiums + expected out-of-pocket costs − employer contributions (HSA/HRA money) = your real cost.
Worked example
PPO | High-Deductible Plan | |
Annual premium | 1,800(150/mo) | 720(60/mo) |
Deductible | $1,000 | $3,000 |
Out-of-pocket max | $4,000 | $6,000 |
Employer HSA contribution | — | $750 |
Light year (~$500 of care) | $2,300 | ~$470 |
Rough year (hit the max) | $5,800 | $5,970 |
In a light year, the high-deductible plan saves more than $1,800. In a worst-case year, it costs about $170 more. Running both scenarios tells you far more than comparing premiums alone.
Use this year's data What you actually spent on care this year is your best predictor of next year. (If you did the Week 36 homework, you already have this number.)
HSA basics for 2027 According to the IRS, 2027 HSA contribution limits are $4,500 for self-only coverage and $9,000 for family coverage, with an additional $1,000 catch-up for those 55 and older. Contributions go in pre-tax, can be invested and grow, and come out tax-free for qualified medical expenses — and unlike an FSA, the balance rolls over and stays with you if you change jobs.
FSA rule of thumb FSAs are generally use-it-or-lose-it, so elect only what you're confident you'll spend — recurring prescriptions, contacts, scheduled appointments — and estimate on the conservative side.
The reality check
The math can't account for your comfort level. If a large deductible landing all at once would derail your budget, the "cheaper" plan may not be the right one right now.
A high-deductible plan works best when you fund the HSA or have cash set aside.
Always confirm your doctors are in network and your prescriptions are on the plan's drug list before you submit.
What's in your control Your plan tier, your HSA or FSA amount, who's covered (including whether a spouse's plan is the better deal), and whether you add or drop extras like supplemental life or disability coverage.
This week's homework
Pull what you actually spent on care this year from your insurance portal.
Run the total-cost formula on your top two plans — for both a light year and a rough year.
Confirm your doctors and prescriptions are covered, set your HSA or FSA amount, and submit before your deadline.
Reflection prompt If next year goes exactly like this one, which plan would you wish you'd picked?
