Open Enrollment in One Hour: The Total-Cost Method
By the Stoia team · August 16, 2026 · 6 min read
Most people spend more time choosing a phone than choosing the health plan that will decide four figures of next year's money, and the most common strategy is "keep whatever I had." Open enrollment rewards exactly one hour of arithmetic, and the arithmetic is one equation: what each plan costs you in total, at the amount of care you actually use. Here is the hour, budgeted.
Minutes 0–10: write down the only equation
A health plan's sticker price is the premium, but your real cost is:
Total cost = a year of premiums + what you pay for care, capped by the out-of-pocket maximum.
The plan with the lowest premium is not the cheapest plan; the plan with the lowest deductible is not the safest plan. Only the total, computed at your usage level, ranks them honestly. Everything else in the benefits booklet is detail.
Minutes 10–30: run two plans at three usage levels
Suppose your employer offers two options. Plan A is the traditional choice: a $310 monthly premium ($3,720 a year), a $750 deductible, 20% coinsurance after that, and a $3,500 out-of-pocket maximum. Plan B is a high-deductible plan: a $150 monthly premium ($1,800 a year), a $3,200 deductible, and a $6,900 out-of-pocket maximum, with the employer dropping $800 into your HSA. Now price three kinds of year:
| Your year | Plan A total | Plan B total (after $800 HSA seed) |
|---|---|---|
| Light: $400 of billed care | $4,120 | $1,400 |
| Medium: $3,000 of billed care | $4,920 | $4,000 |
| Heavy: hits the out-of-pocket max | $7,220 | $7,900 |
The answer flips with usage: Plan B wins the light and medium years by a wide margin, Plan A wins the catastrophic year by a few hundred dollars. These numbers are invented, but the shape is typical, and it explains the honest rule of thumb: the high-deductible option tends to win for people with low or predictable care, while the low-deductible plan buys certainty for a year you already know will be expensive (a planned surgery, a pregnancy, an ongoing condition with costly care). Run your own plans' real numbers the same way; it is twenty minutes with a benefits PDF and a phone calculator.
Minutes 30–40: the HSA changes the math again
A high-deductible plan unlocks the health savings account, the most tax-favored account in the US system: contributions go in pre-tax, grow untaxed, and come out untaxed for qualified medical expenses. Unlike an FSA it is yours forever, rolls over completely, moves with you between jobs, and can be invested, which is why some people treat it as a stealth retirement account and pay small medical bills out of pocket while the balance compounds. The HSA calculator shows what steady contributions become on a decades-long timeline, and it carries the current contribution limits so you do not have to memorize them. If the plan comparison above came out close, an employer HSA seed plus the tax savings on your own contributions is very often the tiebreaker.
Minutes 40–50: the FSA estimate discipline
If you choose the traditional plan, the flexible spending account gives you pre-tax dollars for medical costs, with one sharp edge: elect too much and the surplus is forfeited at year-end. The discipline is to fund it only with expenses you can name in advance: the two dental cleanings, the glasses you replace every year, the copays for a prescription you know you refill monthly. Add those up, elect that number, and treat any use-or-lose anxiety in December as a lesson for next year's election rather than a reason to buy a third pair of sunglasses. Since premiums and FSA elections both come out of pay pre-tax, the take-home change is smaller than the sticker change: the paycheck calculator shows what any election actually does to your deposit.
Minutes 50–60: the boxes people skip
Two checkboxes near the end of enrollment deserve a real read. Group life insurance often includes a free base amount (commonly one times salary) with cheap supplemental coverage on top: worth taking, and worth knowing it usually does not follow you when you leave the job, so it supplements rather than replaces an individual policy. Long-term disability, which replaces a portion of your income if you cannot work, is statistically far more likely to matter during your career than life insurance, and the group rate is usually the best price you will ever see for it. Ten minutes on these two boxes is the highest-leverage reading in the whole packet.
The default is a trap
Doing nothing usually re-enrolls you in last year's choices, and last year's choices quietly changed: premiums move, deductibles move, networks drop your doctor, and your FSA election may reset to zero or repeat at last year's number, whichever your employer chose. The plan that was right when you were single and 28 is often wrong with a kid and a knee surgery scheduled. One hour, once a year, at the equation above: that is the entire method.
Whatever you elect becomes a set of paycheck deductions and, ideally, a growing HSA balance: pieces of one financial picture. Stoia is built to keep that whole picture, premiums, balances, and all, in one place you actually look at.