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How to Compare Coverage During Open Enrollment

Writer: Sandstone Wealth Management
Sandstone Wealth Management
18 hours ago
4 min read
family with small child walking in the park

The opportunity to reassess your health insurance coverage happens during open enrollment. It arrives during a busy few weeks every year, and most people move through it quickly. The choices made inside this window shape what comes out of every paycheck, what gets set aside pretax, and what stays invested for future health costs. Treating open enrollment as a financial decision rather than routine paperwork is where the real value lies.

The scale of the dollars involved makes the case.


According to the Kaiser Family Foundation (KFF), the average annual premiums for employer-sponsored health insurance in 2025 were $9,325 for single coverage and $26,993 for family coverage.1 Those figures represent a significant share of total compensation, and the elections you make during open enrollment determine how efficiently those dollars work for you.


Learning how to choose employee benefits with an investor's mindset means looking past the surface of each option and evaluating the total picture. The framework that follows walks through three areas where a few minutes of attention can pay off for years.

Compare Health Plans by Total Cost

The plan with the lowest monthly premium is not automatically the best value. The only way to know for sure is to look at total cost, which means adding up the premium, the deductible, your realistic expected out-of-pocket spending, and any tax effects from how the plan is funded.

Consider a side-by-side comparison of two common plan types:


insurance enrollment graphic

In this example, the traditional plan comes out slightly ahead for someone with predictable medical needs. For someone who rarely visits the doctor, the high-deductible plan paired with a health savings account (HSA) could be the better choice. One plan isn't universally better than another, but the plan premium alone does not tell the whole story.

How to compare benefits packages effectively starts with this total-cost lens. Run the numbers for your own household using your expected doctor visits, prescriptions, and any planned procedures for the year ahead.

Reframe the HSA as an Investment Account

An HSA paired with a high-deductible health plan is one of the few accounts that receives a tax break going in, growing, and coming out. Contributions reduce your taxable income, investment growth is not taxed, and withdrawals for qualified medical expenses are also not taxed. That three-layer tax treatment is what makes the HSA different from every other savings vehicle available to most employees.


Unlike a flexible spending account, or FSA, unused HSA funds carry forward year to year. An FSA is generally a use-it-or-lose-it pretax account for the current year, while an HSA is long-term, portable, and investable. Once your HSA balance exceeds a near-term buffer for expected medical costs, the remaining amount can be invested for growth rather than held as cash.


For 2026, the IRS contribution limits for HSAs are $4,400 for self-only coverage and $8,750 for family coverage, with an additional $1,000 catch-up contribution available for those age 55 and older.2 These limits apply to the combined total of employer and employee contributions.


The decision to choose a high-deductible plan to access an HSA involves a genuine tradeoff. A high-deductible plan means paying more out of pocket if you need care before the deductible is met. For someone with predictable and consistent healthcare needs, a different plan may come out ahead. The choice depends on your individual health spending patterns and comfort with higher near-term costs in exchange for longer-term investing upside.


Unused HSA balances can also function as an additional retirement account for future healthcare costs, which creates a natural connection to the next area of your benefits review and your retirement planning.

Use the Benefits Window to Check Your 401(k) Match

The benefits review is a natural moment to revisit a decision many people never look at outside enrollment season: whether your 401(k)-contribution rate is high enough to capture the full employer match.


An employer match is additional money your employer adds to your retirement account based on what you contribute, up to a set percentage of your salary. Contributing below that threshold means leaving part of your total compensation on the table. If your employer matches contributions up to 5% of salary and you contribute 3%, you are forfeiting 2% of your pay in matching dollars.


During open enrollment, take a few minutes to confirm your current contribution rate and compare it to your employer's matching formula. If you are below the full match threshold, increasing your contribution by even 1% or 2% can capture dollars that are already part of your compensation package.


This check takes minimal effort but can add thousands of dollars per year to your retirement savings, depending on your salary and your employer's formula.

Your Open Enrollment Checklist

Bringing the three evaluation threads together, here is a short checklist you can walk through during your own benefits review:


  • Compare the total cost across health plan options, not just premiums.

  • Decide whether a high-deductible plan paired with an HSA fits your current and future needs.

  • Confirm that your 401(k)-contribution rate captures the full employer match.

  • Consider whether your HSA balance exceeds your near-term medical buffer and could be invested.

  • Think about how these elections fit into your broader financial plan.


These decisions work best when evaluated together. Each one affects your cash flow, your taxes, and your long-term goals in different ways. If you want help thinking through how your benefits elections fit into your overall financial picture, consider talking with a financial advisor who can look at the full picture alongside you.

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