Employer health plans tend to be pretty strong. Strong coverage costs a lot. You probably just didn’t notice when your employer was paying for part of it. Now that you’re on your own, you can probably find a Marketplace plan for cheaper. Definitely check. But how much progress have you made toward your deductible so far?

Your fate lies behind these walls of text. This, my friends, is what it’s like to choose your health insurance. And your choices are hidden in a page that’s black with small print, written in a language you don’t understand, and littered with numbers that frighten you. So let’s demystify your SBC (summary of benefits and coverage) so you can make good decisions.

If your company covers most or all of dependents’ premiums, there’s no downside to adding your spouse to your plan. If both partners are in that position, why not both add each other to the other’s plan? You can see ALL the doctors and just pay whichever bills less, right? It doesn’t work that way.

COBRA isn’t real, like Santa Claus and the Tooth Fairy. I’m not saying that companies don’t have to follow the law. I’m just saying that there isn’t a basket of COBRA snakes in Washington, DC administering your health insurance like the IRS administers taxes.

The metal tiers are more about risk tolerance than coverage: Lower tier = pay less monthly, but pay more when you go to the doctor Higher tier = pay more monthly, but pay less when you go to the doctor

A health savings account (HSA) is an interest-bearing bank account where you can put pre-tax dollars in and use them for healthcare costs. But to be eligible to contribute to an HSA, you need a special high-deductible, high-premium health (HDHP) health plan.

I’m talking about the small business where an employee is on their spouse’s insurance or a Marketplace plan and the company just reimburses them for all or part of the premium like a regular business expense. You're not supposed to do that.

The One Big Beautiful Bill Act (OBBBA) increased your health insurance premiums in two meaningful ways: It cut pandemic-era premium tax credits (which help the working poor get healthcare) and it cut funding for Medicaid (which pays for healthcare for the very poor).

Let’s be real: Insurance isn’t there to protect you. It's is a financial product made to maximize shareholder value.

Since employer group plans need to offer the same coverage to everyone, employer-sponsored plans are sometimes the only way that people with serious or chronic health conditions can get any disability or life insurance at all. 

The game begins. You have one calendar year to spend the money. The company has a year to collect it back from you. If you both follow the plan, you’ll both walk away scot-free, with the taxes you didn’t spend still in your pocket.

What if, instead of inflating wages with cash, the company offered to pay for something even more valuable than cash? The health of workers and their families. 

Did you know that if your company has more than 50 employees (100 in CA, CO, NY, and VT), the employer sees all the prescriptions people take?  They don’t know who, but if there are fewer than 100 people it’s pretty easy to guess who needed a prescription to control their excessive underarm sweating. Or who's on Lithium.

The many layers of humans and technology that go into insurance deductions can make it hard to track down where the problem is. And because of the old school systems insurance companies still use, it can be like traveling back in time. 

For years, health insurance costs have already been increasing at more than double the rate of inflation. But even factoring in that trend, next year’s numbers seem like a prank. 

Insurance premiums have been increasing at more than double the rate of inflation for the past 3 years. In 2026, employer group plans are expected to increase nearly 8%. 

Employers have discretion about what's covered in their HRA plan, which is what makes them so useful. The company decides the annual limit, as well as specifications like whether to cover deductible expenses, post-deductible expenses, and/or over-the-counter expenses and services.

A PEO is an insurance broker, a guardrail, and a payroll provider. But it’s not a brain. Some people need a PEO. Some need a person. Most don’t know which they are.

What we’re really seeing is misaligned incentives disguised as authority. They have no reason to follow through, just respond. We wouldn’t put up with this in any other business service.

Even the fancy ben admin tools. Somewhere behind the curtain, someone is downloading a form and forwarding it to a carrier. Often using unsecured email.