It’s open enrollment season—a chance to review and select your company or personal health insurance plan for the coming year. If your company provides insurance, this isn’t just a checkbox task; benefits can make up around a third of your total compensation. Taking the time to make thoughtful choices can enhance your well-being, save you money, and protect your future.

No matter whether you are shopping through your company’s offerings or the Marketplace, let’s walk through the key benefits you’ll want to consider, so you can make the most of them next year. And keep in mind Insureous Health Solutions can help you enroll or make sure you enroll in the best plan for you and your family.

Health Insurance: HMO vs. PPO

One of the most important choices is your health insurance plan. Most employers offer two main types of plans: HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization).

• PPO (Preferred Provider Organization)
  • Offers access to a large network of healthcare providers at pre-negotiated rates.
  • Provides more freedom to choose doctors and specialists, often without referrals.
  • Typically comes with higher premiums, but the flexibility may be worth it if you have specific healthcare needs or preferred providers.
• HMO (Health Maintenance Organization)
  • Generally has a smaller network of providers, but with lower premiums.
  • Requires a referral from a primary care physician to see a specialist.
  • Offers lower costs but fewer choices—great if you don’t anticipate needing specialty care or prefer predictable costs.

Choosing the Best Plan:
When deciding, consider these factors:

1. Cost of Care – Look at the premium deducted from each paycheck.
2. Usage – Estimate your healthcare needs for the year and review the deductible.
3. Risk Tolerance – Check the out-of-pocket maximum for unexpected events.
4. Network – Make sure your preferred doctors are in-network to avoid extra costs.

HSA vs. FSA: What’s the Difference?

Both Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) let you save for medical expenses with pre-tax dollars, but they work a little differently.

• HSA (Health Savings Account)
  • Functions like an investment fund specifically for healthcare expenses.
  • Contributions grow tax-free, and withdrawals are tax-free if used for qualified medical expenses.
  • In 2024, the contribution limits are $8,300 for families and $4,150 for individuals (estimated to increase slightly in 2025).
  • Funds roll over indefinitely—no “use-it-or-lose-it” policy here.
• FSA (Flexible Spending Account)
  • Lets you set aside pre-tax dollars for healthcare costs but has a “use-it-or-lose-it” rule.
  • In 2024, the limit is $3,200, with an estimated increase to $3,300 in 2025.
  • Some FSAs allow a small rollover, but you generally need to use most of the funds within the plan year.

Pro Tip: If you can afford out-of-pocket costs now, let your HSA funds grow by investing them. You can even keep the receipts and reimburse yourself later when it’s more financially advantageous.

Dental and Vision Insurance

While often overlooked, dental and vision insurance are essential add-ons.

• Dental Insurance covers routine exams, cleanings, and sometimes more advanced procedures. While it may not be as crucial as health insurance, it can still save you money on preventive care.
• Vision Insurance is a must if you wear glasses or contact lenses, covering annual eye exams and helping with the cost of eyewear.

Even if you don’t anticipate major dental or vision expenses, these plans provide valuable preventive care at minimal cost.

Disability Insurance

Disability insurance protects your income if you’re unable to work due to illness or injury.

• Short-Term Disability provides coverage for temporary conditions, often with a lower cost and shorter payout period.
• Long-Term Disability is more critical, particularly for high earners. It offers coverage for extended or permanent disabilities, usually after an initial waiting period.

Consider: If you have a solid emergency fund, short-term disability may be less essential. However, long-term disability is a wise choice for most, as it can prevent financial hardship in the event of a prolonged disability.

Life Insurance

Most employers offer a base level of life insurance, typically 1–2x your salary, at no cost to you. You may also have the option to purchase additional coverage.

• Basic Coverage through your employer is generally convenient but won’t transfer if you change jobs. Also, reapplying after a job change can be costly if your health status changes.