Your share of the premium is only one part of the price of workplace health coverage. Compare the care you expect to use, the providers you need, and the most you could owe for covered care before you make your 2027 election.
Start with your own enrollment packet
In KFF’s 2026 survey, workers with employer-sponsored family coverage contributed an average of $7,471 toward annual premiums, up 9% from 2025. Your plan may differ, so use your own enrollment documents for the comparison. Read the October 2026 survey.
Your employer sets the enrollment process and provides the plan choices. Ask for the 2027 Summary of Benefits and Coverage (SBC) for each option, the employee payroll rates, and the enrollment deadline. The SBC summarizes covered benefits, cost sharing, and limits. See the Department of Labor’s guide to plan information.
Check the coverage tier you need: employee only, employee plus spouse, employee plus children, or family. Eligibility and payroll prices can differ. Confirm which dependents qualify and when coverage starts. If your plan year does not start in January, compare the actual coverage period instead.
Understand the costs you may pay
The premium is your payment for coverage, even when you do not use care. Multiply your employee deduction by the number of deductions in the plan year. Do not count the employer’s share as a cost you pay.
A deductible is what you pay for certain covered services before the plan begins sharing those costs. Some services can be covered before you meet it. A copay is a fixed charge. Coinsurance is a percentage of the allowed cost. Check which rule applies to each service. See the Department of Labor’s SBC template.
For family coverage, ask whether an individual family member has a separate deductible or out-of-pocket limit within the family limit. Also check any separate prescription deductible and the cost of services before the deductible.
Compare two possible years
Estimate annual payroll premiums plus your expected cost for care and prescriptions. Count deductible payments, copays, and coinsurance only once as parts of that care estimate. Then compare a high-use year using each plan’s in-network maximum, while keeping premiums separate.
Lower payroll premium
- $100 per month × 12 = $1,200 in premiums
- $2,000 in estimated covered care costs
- $600 employer HSA contribution available for eligible expenses
- $2,600 estimated net cost
Higher payroll premium
- $200 per month × 12 = $2,400 in premiums
- $700 in estimated covered care costs
- No employer account contribution
- $3,100 estimated net cost
Illustration only. Both care estimates use in-network covered services, assume the HSA funds can pay all $600, and exclude taxes and uncovered or out-of-network care.
In this scenario, Plan A costs $500 less: $1,200 + $2,000 − $600 = $2,600, versus $2,400 + $700 = $3,100. Different care needs can reverse the result. Confirm the timing and conditions of an employer contribution before subtracting it.
If the two plans had in-network out-of-pocket maximums of $5,000 and $3,000, their premium-plus-maximum amounts would both be $6,200 before account contributions. That comparison is useful for a costly year, but it does not include premiums for other benefits or noncovered care.
Check the care you actually use
A network is the group of providers that contract with a plan. Check the exact 2027 plan and network, not just the insurance company’s name. Ask your doctors and facilities whether they expect to participate, and confirm with the plan. Check hospitals, labs, mental health providers, and pharmacies too.
For each prescription, check the plan’s drug list, price tier, preferred pharmacy, and any prior authorization or quantity limit. Ask how much you pay before and after any deductible. If you need ongoing treatment, ask how the plan handles a provider or medication that is not covered.
Compare referrals, out-of-network coverage, and rules for care away from home. Plan types may use different networks and referral rules. The actual plan documents control the comparison. The SBC template shows where to find these details.
Understand employer contributions and accounts
An employer may contribute to a health savings account (HSA), a health reimbursement arrangement (HRA), or a flexible spending arrangement (FSA). These are different benefits. Ask which expenses qualify, when funds are available, and what happens if you leave.
An HSA requires an eligible individual and qualifying coverage. Employer contributions count toward the applicable HSA contribution limit. An HRA is funded by the employer. A health FSA may allow a carryover or a grace period if the plan provides one. Its unused balance is generally forfeited otherwise. Certain other coverage, including a general-purpose health FSA, can affect HSA eligibility. Read IRS Publication 969.
Do not treat your own account contribution as a discount from your pay. It is your money set aside for eligible expenses. The tax effect depends on your situation and the applicable rules.
Finish before the deadline
Check your current elections
Read what happens if you take no action. Some benefits may require a fresh election.
Compare the full household
Check dependent eligibility, payroll cost, networks, prescriptions, and the plan’s rules for each person.
Submit and save proof
Complete the employer’s process before its deadline. Save the confirmation and review the first pay statement and ID cards.
If you miss open enrollment, contact your benefits office promptly. Certain events can give otherwise eligible employees or dependents a special enrollment opportunity. These include marriage, birth, adoption, and certain losses of other coverage. The applicable rules and request deadlines matter. See the Department of Labor’s special enrollment FAQs.
For covered group plans, the federal rules generally require at least 30 days to request enrollment after these events. Some other events have different rules or periods. Ask the plan immediately instead of assuming every change qualifies.
Source notes
Sources checked November 2, 2026. Plan-specific terms and employee costs come from your employer’s documents.
U.S. Department of Labor: plan information and the SBC. Read the guidance.
U.S. Department of Labor: SBC template and examples of cost-sharing fields. Read the template.
Internal Revenue Service: Publication 969 on HSAs, FSAs, and HRAs. Read Publication 969.
U.S. Department of Labor: special enrollment rights. Read the FAQs.
Frequently asked questions
Does the lowest premium mean the lowest total cost?
No. Add your annual payroll premiums to your estimated costs for covered care and prescriptions. Compare employer account contributions and check the network and out-of-pocket maximum.
Can I change my health plan after enrollment closes?
Some qualifying events permit special enrollment for otherwise eligible employees or dependents. Ask your benefits office promptly about the event, required documents, and deadline.
Can I use an HSA with every workplace plan?
No. HSA contributions require qualifying coverage and other eligibility conditions. Ask your benefits office and review IRS Publication 969 before contributing.
Will my current doctors be in every plan my employer offers?
Not necessarily. Check the exact network for each plan and confirm participation with both the provider and the plan for the relevant coverage period.