Plan Year Benefit Calculations

In an effort to provide more flexibility in plan administration, we now calculate benefits based on your plan year as well as on calendar year. Here is how each works:

  • With a plan year calculation, your employees’ benefits reset on your plan’s renewal date, so that’s the only date you and your employees need to remember. This affects deductibles, out-of-pocket maximums, and benefits that have a limited number of visits per year. So, for example, if your plan has a $500 deductible, any expenses an employee incurs up to that amount that were applied to the deductible are reset to $0 on your plan renewal date.
  • With a calendar year calculation, your employees’ benefits reset January 1st. This affects deductibles, out-of-pocket maximums, and benefits that have a limited number of visits per year.