Most online HDHP vs PPO calculators ignore the HSA tax savings, the employer HSA contribution, and what happens to the break-even when you bake both in. This one models all three. Defaults are set to typical large-employer 2026 figures. Replace any field with your own SBC numbers; results update live.
Inputs default to typical large-employer 2026 figures. Replace each value with what appears on your benefits portal. Results update live.
Annual premium savings
+$2,400
HDHP cheaper on premiums
Break-even point
Never
HDHP always cheaper
HSA tax savings / yr
$1,050
Annual tax benefit of HSA
The HDHP is cheaper at every level of medical spending with these plan parameters.
Annual medical spending (billed) →
Every employer benefits portal looks different, but every plan must publish a Summary of Benefits and Coverage (SBC) form. The form is standardised by the federal government and contains all six numbers the calculator needs.
On the benefits portal, look for "your cost per pay period". Multiply by pay frequency (24 for semi-monthly, 26 for biweekly) and divide by 12. Use the employee-only or family figure to match your coverage.
On page 2 of the SBC, the row labelled "Overall deductible". For family plans, note whether the deductible is aggregate (whole family must hit it before coinsurance starts) or embedded (each member has their own sub-deductible).
Also on page 2 of the SBC. Look for "coinsurance" or "your share". Typical PPO coinsurance is 10 to 20 percent; HDHP is often 20 to 30 percent. Enter your percentage, not the insurer's.
Page 1 or 2 of the SBC, labelled "out-of-pocket limit" or "maximum out of pocket". This is your worst-case annual exposure for in-network care. Premiums do not count toward this number.
Found in the HDHP plan summary or benefits guide, often as a separate line item like "Employer HSA contribution" or "Wellness HSA reward". Common amounts are $500, $1,000, or $1,500. Enter the annual total.
Your marginal federal rate plus state and FICA where applicable. A 22 percent federal bracket employee paying state tax of 5 percent and FICA on payroll-deducted HSA contributions has an effective rate near 35 percent. Use 22 plus your state if unsure.
Each scenario page contains plan-specific cost modelling, real-world spending averages, and the trade-offs that apply to that audience. They are the longer-form companion to the calculator above.
$1,500 / yr expected
Routine physical, occasional urgent care, generic meds.
$6,500 / yr expected
Well-child visits, ear infections, sports injuries, occasional ER.
$15,000+ billed
Prenatal, delivery, postnatal, plus the plan-year boundary risk.
$5,000 to $12,000 / yr
Specialist visits, ongoing medication, regular labs.