A Benefits Broker and His Wife Have Two Days to Pick Health Plans. Their Math Comes Down to Two Numbers.

Todd and Tiffany Dolci's two employers open enrollment two days apart. The premium line alone gets the choice wrong.

By Capital Wealth · Published Tuesday, November 3, 2026 · Source: The Wall Street Journal, Monday, November 2, 2026, whose market figures are the Friday, October 30 close (Personal Journal)

Key Points

Workers pay an average of $7,471 toward family coverage this year, up 9%, per KFF. Nearly half of large employers expect changes that raise out-of-pocket costs next year.
Last fall the Dolcis moved to his high-deductible plan. Premiums fell from about $1,350 a month to $595, and his employer adds $3,000 a year to their HSA.
Tiffany alone on Surest, a UnitedHealthcare plan with copays and no deductible, costs $178 a month. The whole family through her employer runs $512 to $1,254.
Step three is two numbers per option. The floor is premiums minus employer HSA money. The ceiling adds the out-of-pocket limit. Her Surest range is about $2,100 to $8,100.
The split saves about $25 a month in premiums but costs $600 a year in employer HSA money. It pays off only through her specialist and drug bills under copays instead of a $3,400 deductible.

$7,471

Average worker share of family coverage this year, up 9% (KFF)

$595

The Dolcis' monthly premium on his high-deductible plan, down from about $1,350

$178

Tiffany alone on her employer's Surest plan, per month

$600

Less a year his employer would put in the HSA if she leaves his plan

$A weekly pill organizer, a stained coffee mug and folded reading glasses on a worn wooden kitchen table, soft daylight through vertical blinds.$

The Dolcis' switch to a high-deductible plan cut premiums by about $9,000 this year, even as Tiffany spent $5,000 or more at doctors and the pharmacy.

In one line: A benefits broker prices his family's two employer health plans at their floor and ceiling, and the premium line alone gets it wrong.

Todd Dolci sells health benefits for a living. His wife, Tiffany, is the one who uses them. She has chronic conditions and sees specialists more than anyone else in the family. Last fall she went along with his math. This year his employer opened enrollment on Monday, Nov. 2, and hers runs until Wednesday, Nov. 4. Two days, dozens of plan combinations, and this time she wants a say.

The Journal's Dalvin Brown and Ashlea Ebeling followed the couple's math. Workers pay an average of $7,471 toward family coverage this year, up 9%, per KFF. Many couples never compare their two employers' plans. “This conversation rarely happens,” Todd said. People default to what they had.

The Dolcis didn't. Last fall Todd moved the family off his employer's low-deductible PPO and onto its high-deductible plan. The premium fell from about $1,350 a month to $595. His employer puts $3,000 a year into a health savings account that rolls over. The switch cut their premiums by about $9,000 this year. Tiffany still spent $5,000 or more at doctors and the pharmacy, so it didn't feel cheaper to her. It was. “I was like, are you sure?” she said.

Three steps, two numbers

Now her employer offers Surest, a UnitedHealthcare (UNH) plan with copays and no deductible in network. Step one is premiums. Tiffany alone on Surest costs $178 a month. The whole family through her employer runs $512 to $1,254, and her employer adds nothing to an HSA. Step two is the options, his plan, hers, or a split. Moving the kids to her plan saves nothing, since his HSA deposit gets cut in half. Step three gives two numbers per plan. The floor is a year of premiums minus employer HSA money. The ceiling adds the plan's yearly out-of-pocket limit. Her Surest range is about $2,100 to $8,100. His plan for himself and the kids runs $2,300 to $12,300 at this year's rates.

Todd's early math says she should move. Taking her off his plan cuts his premium by about $200 a month. Add her $178 and the family pays about $571, about $25 less than now. But his employer would put $600 less into the HSA. That $25 a month is about $300 a year, computed, so the split loses money on paper. It wins only because her specialists are in Surest's network. She would stop paying toward a $3,400 deductible before coverage kicks in. With regular visits and expensive prescriptions, she could recoup the savings and more.

Our read

Health Costs, with Insurance, M11, and Cash Flow, M5. The lesson is in step three. The bold premium number in your HR packet is the one that misleads. Price every option at its floor and at its ceiling. Then ask who in the house actually uses care. A pricier plan with copays can beat a cheap plan with a deductible for the person who sees specialists every month. Watch the account rules too. A general-purpose health FSA that covers a spouse blocks both of you from new HSA contributions. General planning principles, not advice for anyone in particular.

Here's where it touches your plan. If you and your spouse both have coverage at work, open both packets this week, before the first window closes. For each plan, write two numbers. A year of premiums minus any employer HSA money is the floor. Add the out-of-pocket limit for the ceiling. Then set last year's doctor and pharmacy receipts next to them. If one of you is weighing an FSA, check that it doesn't cancel the other's HSA. You pack the umbrella before the sky turns. Bring the two numbers to your next review and we'll fit them into the plan.

What It Means For Your Portfolio

Hold. Price each health plan at its floor and its ceiling.

A $25 monthly premium saving can lose to a $600 HSA cut, so price each plan at its floor and ceiling before you choose.

General planning principles, not advice for anyone in particular. For every plan on offer, write the least you could pay (a year of premiums minus employer HSA money) and about the most (premiums plus the out-of-pocket limit). Weight the result by the family member who uses care most.

Check the account rules before you elect. A general-purpose FSA that covers a spouse ends HSA eligibility for both of you. Dental and vision can come from the other employer.