Transparent calculator methodology
See when each family deductible begins sharing costs
A family deductible amount does not show whether one person can reach an individual threshold first. This simulator applies covered allowed claims in order so the difference between embedded and aggregate designs stays visible.
What the estimate includes
- Separate embedded and aggregate plan premiums and limits
- Covered allowed claims assigned to family members in sequence
- Deductible, coinsurance, individual out-of-pocket, and family out-of-pocket tracking
- Claim-level patient and plan cost estimates
How the comparison works
For each claim, the model applies the applicable remaining deductible, then coinsurance, while enforcing individual and family out-of-pocket ceilings. It repeats the same claim sequence for both plan designs and adds employee premiums.
Important limitation
Plan documents control. This estimate excludes copays, separate prescription deductibles, services covered before the deductible, excluded care, balance billing, and plan-specific claim rules. Confirm the deductible structure in each Summary of Benefits and Coverage.