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titleEmployee + Spouse/Employee + Child(ren) Coverage Scenarios

Employee + Spouse/ Employee + Child(ren) Coverage Scenarios

Some of you may be wondering how likely, on average, it is to experience a high claims year. The statistics below may help you to see that the likelihood of experiencing a very high claims year is fairly low. (These statistics are based upon information received from our benefits consulting firm, Marsh Consulting Group.)

  • 1% of couples/households will experience $100,000 or more in annual claims in any given year.

  • 4% of couples/households will experience about $40,000 in annual claims in any given year.

  • 30% of couples/households will experience about $5,000 in annual claims in any given year.

  • 65% of couples/households will experience about $2,100 or less in annual claims in any given year.

These are simply statistics and you know your household's medical situation the best. 

Out-of-pocket maximums to consider: 

  • HS 2000 - $8,000
  • HS 3000 - $10,000
  • HS 5000 - $10,000

 Examples to consider 

This chart shows three different household scenarios in annual claims and how this plays out for the HS 1500, HS 3000 and HS 5000 plans.

  • Couple/Household 1 — $1,000 or less in annual claims

  • Couple/Household 2 — $5,000 in claims

  • Couple/Household 3 — $40,000 in claims

  • Couple/Household 4 — $100,000 and above in claims

NOTE: This chart takes into account the Reliant Employer HSA Contributions that will help offset your expenses. Additionally, you may receive as much as a 20% tax savings if you elect to personally contribute into your HSA account (employee contributions).

 Scenario 1: $1000 or less in claims


HS 2000 Annual CostHS 3000 Annual CostHS 5000 Annual Cost

Medical Costs: $1,000 or less in claims

$0 (preventive only) to $1,000$0 (preventive only) to $1,000$0 (preventive only) to $1,000
HSA Employer Contribution$600 from Reliant$600 from Reliant$600 from Reliant

Medical Costs

Minus HSA Employer Contribution (Use the HSA account to pay these costs)

= *Total Remaining Annual Costs

*This is the amount you may consider making employee contributions into the HSA account to help offset

$0 to$1,000

-$600

$0 - $400

$0 to $1,000

-$600

$0 - $400

$0 to $1,000

-$600

$0 - $400

Scenario 2: $5,000 or less in claims


HS 2000 Annual CostHS 3000 Annual CostHS 5000 Annual Cost

Medical Costs: $5,000 in claims

Deductible: $4,000

10% Coinsurance: $100

Total: $4,100

Deductible: $5,000

10% Coinsurance: $0

Total: $5,000

Deductible: $5,000

No Co insurance

Total: $5,000

HSA Employer Contribution

$600 from Reliant

$600 from Reliant

$600 from Reliant

Medical Costs

Minus HSA Employer Contribution (Use the HSA account to pay these costs)

= *Total Remaining Annual Costs

*This is the amount you may consider making employee contributions into the HSA account to help offset

$4,100

-$600

= $3,500

$5,000

-$600

= $4,400

$5,000

-$600

= $4,400

Scenario 3: $40,000 or less in claims


HS 2000 Annual CostHS 3000 Annual CostHS 5000 Annual Cost

Medical Costs: $40,000 in claims

Deductible: $4,000

10% Coinsurance: $3,600

Total: $,000

Deductible: $6,000

10% Coinsurance: $3,400

Total: $9,400

Deductible: $10,000

No Co insurance

Total: $10,000

HSA Employer Contribution

$600 from Reliant

$600 from Reliant

$600 from Reliant

Medical Costs

Minus HSA Employer Contribution (Use the HSA account to pay these costs)

= *Total Remaining Annual Costs

*This is the amount you may consider making employee contributions into the HSA account to help offset

$7,600

-$600

= $7,000

$9,400

-$600

= $8,800


$10,000

-$600

= $9,400


Scenario 4: $100,000 and above in claims


HS 2000 Annual CostHS 3000 Annual CostHS 5000 Annual Cost

Medical Costs: $100,000 and above in claims

Deductible: $4,000

10% Coinsurance: $4,000

Total: $8,000

Deductible: $6,000

10% Coinsurance: $5$4,000

Total: $10,000

Deductible: $10,000

No Co insurance

Total: $10,000

HSA Employer Contribution

$600 from Reliant

$600 from Reliant

$600 from Reliant

Medical Costs

Minus HSA Employer Contribution (Use the HSA account to pay these costs)

= *Total Remaining Annual Costs

*This is the amount you may consider making employee contributions into the HSA account to help offset

$8,000

-$600

= $7,400

$10,000

-$600

= $9,400

$10,000

-$600

= $9,400


*All out-of-pocket medical costs may be paid for from the HSA account - see Maximum Employee HSA Contribution Amounts for details of how much you can contribute into the HSA as a personal employee contribution.

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