Synthetic demoPlan-year review2026 to 2027
Where are costs moving across plans?
Plan years 2026 to 2027, 4 plans, run demo. Each field of each plan is counted once.
Fields by category and direction
| Category | Up | Down | No change | Added | Removed | Not comparable | Needs review |
|---|---|---|---|---|---|---|---|
| Premium | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
| Deductible | 0 | 1 | 2 | 0 | 0 | 0 | 0 |
| Maximum out-of-pocket | 0 | 1 | 1 | 0 | 0 | 0 | 1 |
| Copays | 4 | 1 | 12 | 0 | 0 | 0 | 1 |
| Drugs | 1 | 3 | 8 | 0 | 0 | 0 | 0 |
| Allowances | 2 | 0 | 4 | 0 | 0 | 0 | 0 |
Changes and values needing review (17 fields)
| Plan | Field | 2026 | 2027 | Direction |
|---|---|---|---|---|
| H9999-001 | Monthly premium | $0.00 a month | $25.00 a month | Up |
| H9999-001 | Specialist visit | $45.00 copay a visit | $45.00 copay a visit | Needs review |
| H9999-002now H9999-001 | Monthly premium | $25.50 a month | $25.00 a month | Down |
| H9999-002now H9999-001 | Medical deductible | $250.00 a year | $0.00 a year | Down |
| H9999-002now H9999-001 | Maximum out-of-pocket (in network) | $6,700.00 a year | $4,900.00 a year | Down |
| H9999-002now H9999-001 | Primary care visit | $5.00 copay a visit | $0.00 copay a visit | Down |
| H9999-002now H9999-001 | Emergency room | $110.00 copay a visit | $125.00 copay a visit | Up |
| H9999-002now H9999-001 | Urgent care | $35.00 copay a visit | $40.00 copay a visit | Up |
| H9999-002now H9999-001 | Inpatient hospital stay | $295.00 copay a day | $325.00 copay a day | Up |
| H9999-002now H9999-001 | Outpatient surgery | $200.00 copay a visit | $250.00 copay a visit | Up |
| H9999-002now H9999-001 | Drug deductible | $200.00 a year | $0.00 a year | Down |
| H9999-002now H9999-001 | Drug tier 1 | $2.00 copay a prescription | $0.00 copay a prescription | Down |
| H9999-002now H9999-001 | Drug tier 2 | $10.00 copay a prescription | $8.00 copay a prescription | Down |
| H9999-002now H9999-001 | Drug tier 3 | $45.00 copay a prescription | $47.00 copay a prescription | Up |
| H9999-002now H9999-001 | Dental allowance | $1,500.00 a year | $2,000.00 a year | Up |
| H9999-002now H9999-001 | Over-the-counter allowance | $150.00 a year | $50.00 a quarter | Up |
| H9999-004 | Maximum out-of-pocket (in network) | $3,400.00 a year | $3,400.00 a year | Needs review |