Why Healthcare Costs Can Vary So Much for the Same Service

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Many people are surprised to learn that the cost of healthcare services can vary significantly, even when the service itself appears to be exactly the same.

For example, two individuals may receive the same imaging test, lab work, or office visit and receive very different bills depending on where the service was performed, whether the provider was in-network, and how their health plan is structured.

One of the biggest factors affecting cost is provider networks. In-network providers have negotiated contracted rates with insurance carriers, which are generally lower than out-of-network pricing. Out-of-network care may result in higher deductibles, coinsurance percentages, or additional balance billing depending on the plan.

Health plan design also plays a major role in what someone pays out of pocket. Traditional PPO plans often include fixed copays for services such as office visits or prescriptions, which can make costs feel more predictable. HSA-compatible high-deductible health plans typically operate differently. In many cases, individuals enrolled in HSA plans may pay the full contracted cost of services until the deductible is met, after which coinsurance may apply.

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IRS Announces 2027 HSA Contribution Limits

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The IRS released the contribution limits for Health Savings Accounts (HSAs) for 2027. In the upcoming year, we will see an HSA contribution limit increase to $4,500 for individuals and an increase to $9,000 for a family. The IRS implemented inflation-adjusted parameters for health savings accounts in Revenue Procedure 2026-24.

For 2027, individuals with self-only coverage can contribute up to $4,500 to their HSAs, up from $4,400 in 2026. Individuals enrolled in family coverage can contribute up to $9,000, up from $8,750 in 2026. The IRS also noted that the 2027 catch-up contribution for those aged 55 and older will remain $1,000, unchanged from 2026.

Health Savings Accounts remain a valuable tool for individuals and families enrolled in qualified high-deductible health plans (HDHPs). HSAs offer tax advantages, allow unused funds to roll over from year to year, and can serve as a long-term savings vehicle for future healthcare needs.

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Understanding Copays vs. Coinsurance

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Many people have heard the terms copay and coinsurance, but understanding the difference between the two can help make healthcare costs more predictable and easier to understand.

A copay is usually a fixed dollar amount paid for a specific service, such as a primary care visit, specialist appointment, or prescription. For example, you may pay a $30 copay for an office visit regardless of the total cost of the appointment.

Coinsurance works differently. Instead of paying a fixed amount, coinsurance is a percentage of the cost of a service that you are responsible for paying after meeting your deductible. For example, if your plan has a 20 percent coinsurance, you may pay 20 percent of the allowed cost for a covered service while your health plan pays the remaining amount. Out-of-network care may also result in higher out-of-pocket costs, as coinsurance percentages and allowed amounts can differ from those for in-network services.

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CalCPA Health Coverage Options: A Deep Dive into Plan Variety and HSA Leadership (Part 2 of 3)

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Via an Interview with Ron Lang (CEO of CalCPA Health), By Phil Calhoun (CEO of California Broker Media)

CalCPA Health Coverage Options: A Deep Dive into Plan Variety and HSA Leadership (Part 2 of 3)

In the second installment of our in-depth look at CalCPA Health, CEO Ron Lang discusses the breadth of coverage options available to California’s CPA and financial professional firms. This part of the interview explores the organization’s philosophy on plan design, its industry-leading approach to Health Savings Account (HSA) plans, and how CalCPA Health’s flexibility and integration set the plans and support as a leader in the competitive group health market for many businesses in the financial services industries.

A Broad Spectrum of Plans: Choice and Customization

CalCPA Health offers an exceptionally wide range of medical plans with about 40 in total. The plans span from Preferred Provider Organizations (PPOs), Exclusive Provider Organizations (EPOs), Health Maintenance Organizations (HMOs), and an extensive suite of HSA-eligible high-deductible health plans. This variety is designed intentionally to meet the diverse needs of small and mid-sized firms that often have employees with different healthcare preferences and financial situations.

While some national insurers may abruptly cancel plans and move members to new options, CalCPA Health takes a more measured approach. The organization is mindful about removing plans from the market and prefers to maintain continuity for its members, even as it regularly reviews and refines its offerings to avoid overwhelming employers and employees with too many choices.

HSA Plans: A Core Strength and Differentiator

One of the standout features of CalCPA Health is its strong emphasis on HSA-eligible plans. Roughly half of CalCPA Health’s insured population is enrolled in an HSA plan, a figure far above the national average of approximately 24 percent (and even higher compared to California’s average). This is no accident; as Lang explains, the CPA and financial professional audience is uniquely positioned to appreciate the tax advantages and long-term savings potential of HSAs.

Why HSAs Are So Popular with CalCPA Health Members

  • Tax and Savings Benefits: HSAs allow for pre-tax contributions, tax-free investment growth and tax-free distributions to cover qualified medical expenses. Unused funds roll over year-to-year, accumulating for future healthcare needs.
  • Financial Literacy: CalCPA Health’s clients, primarily CPAs and financial professionals, tend to understand and value these benefits, making them more likely to enroll and actively use HSAs as part of their overall financial planning.
  • Talent Attraction and Retention: Many firms use HSA plans as a recruitment and retention tool, offering employer contributions to HSAs outside of 401(k) plans and without running afoul of discrimination rules. This flexibility is highly valued by both owners and employees.

A Wide Range of HSA Plan Designs

CalCPA Health offers the largest selection of HSA-eligible plans in the state, starting at the federal minimum deductible and increasing in increments as high as $6,500. This allows firms and employees to select plans that match their risk tolerance and financial goals. Many members start with lower deductibles as they build up their HSA balances, then move to higher deductible plans as their comfort with the HSA model grows and balances in the account total more than the plan deductible.

Fully Integrated HSA Administration

CalCPA Health’s HSA plans are fully integrated with HealthEquity, streamlining administration for both employers and employees. Employees can pay providers directly from their HSA, reconcile debit card transactions, and manage their accounts online. Employers benefit from simplified processes for adding new hires, changing contribution amounts, or deleting HSA contributions, which reduce administrative burdens.

Other Plan Types: PPOs, EPOs, and HMOs

In addition to high-deductible PPO plans which are HSA eligible, CalCPA Health provides a full suite of traditional PPO plans, which offer flexibility to see any provider but with cost savings for using in-network doctors and hospitals. EPO plans are also available, providing in-network-only coverage without the requirement for primary care physician referrals, which isa popular choice for firms that want simplicity without the restrictions of an HMO.

For those who prefer the predictability and coordinated care of an HMO, CalCPA Health partners with Anthem Blue Cross to offer HMO and Select HMO plans. These plans require members to choose a primary care physician and obtain referrals for specialty care, but they offer no-claims paperwork for in-network services and comprehensive coverage, including mental health and substance abuse services.

Mix-and-Match Flexibility and Kaiser Integration

One of CalCPA Health’s unique features is its willingness to allow firms to “mix and match” plan types. Employers can offer any combination of copay, HSA, and Anthem Blue Cross HMO plans, tailoring benefits to the needs of their workforce. Furthermore, CalCPA Health will write plans alongside Kaiser Permanente, accommodating employees who prefer to stay with Kaiser without imposing participation requirements, as long as adverse selection is avoided. This flexibility is rare among group health providers and demonstrates CalCPA Health’s commitment to meeting member needs.

Network Strength and Member Experience

All CalCPA Health plans leverage the Anthem Blue Cross provider network—the largest in California—ensuring broad access to doctors, specialists, and hospitals. Members also benefit from value-added services like LiveHealth Online, which provides telemedicine and online mental health visits, and a single point of administration for medical, dental, vision, life, and disability plans.

Conclusion

CalCPA Health’s approach to plan design is rooted in flexibility, member education, and a deep understanding of its professional audience. By offering a broad spectrum of PPO, EPO, HMO, and especially HSA-eligible plans, with fully integrated administration and unmatched customization, CalCPA Health empowers CPA and financial services firms to provide high-quality, cost-effective benefits that attract and retain top talent. In the final part of this series, we’ll examine the value-added services, wellness programs, and future trends shaping CalCPA Health’s ongoing evolution.

https://calcpahealth.com/about-group-insurance-trust-calcpa-health/

https://calcpahealth.com/shop-for-a-plan/medical-plans/

https://calcpahealth.com/pdf/Plan_Brochure/2025_CalCPA_Health_Plan_Brochure.pdf

Part 3 Coming Next Month

CalCPA Health Coverage Options: A Deep Dive into Plan Variety and HSA Leadership (Part 2 of 3)

Via Interview with Ron Lang By Phil Calhoun

https://issuu.com/articles/112224906

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How Trump’s “One Big Beautiful Bill” Impacts Health Savings Accounts

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Trump’s “One Big Beautiful Bill” (OBBB), passed on July 4, 2025, initially promised significant changes to Health Savings Accounts (HSAs). However, the final version of the legislation contained modest updates to HSA policy. Current HSA holders get to keep what they have, but significant reforms such as extending eligibility to those on Medicare or relaxing contribution restrictions, were abandoned in negotiations. Instead, the bill primarily focuses on restructuring Medicaid and welfare programs, implementing work mandates, and providing tax credits tied to families and newborn savings accounts.

Health Saving Accounts were thought to have a larger presence in the bill that would have placed HSAs as a centerpiece of healthcare funding and provided areas for growth by softening regulations of who can contribute, such as those on Medicare Part A.  Without eligibility expansion, HSAs remain mostly unchanged, and tax-advantaged growth remains limited to current users.

Here’s a breakdown of what changes OBBB brings to HSA plans:

  • If you are enrolled in a Bronze or Catastrophic ACA plan, you are now eligible to contribute to HSAs starting January 1, 2026.
  • HSA funds can be used for Direct Primary Care (DPC) arrangements. DPCs typically follow the model of a monthly fee, which covers office visits prior to meeting the HDHP deductible. With OBBB, these monthly fees now fall under qualified HSA expenses if they do not exceed $150/month for an individual or $300/month for families.
  • First-dollar coverage for telehealth services no longer disqualifies HSA status, which allows plans to provide low or no-cost telehealth services before satisfying your deductible if you are enrolled in a qualified HDHP without using your HSA contributions.

HSAs remain a useful tool for eligible taxpayers and serve as a tax-savings vehicle.

Triple Tax Advantage

  • Pre-tax Contributions – Money goes in tax-free, reducing your taxable income
  • Tax-free Growth – Funds grow tax-deferred through interest and/or investments (no capital gains)
  • Tax-Free Withdrawals – As long as funds are used for qualified medical expenses, withdrawals are tax-free

Saving for the Future

  • You can invest your HSA balance (once you hit a threshold set by your carrier, allowing it to grow like a retirement account)
  • Can be used in retirement tax-free for medical expenses, or after age 65, for any reason (income taxes apply only if not used for qualifying healthcare expenses)

HSA funds roll over year-to-year, and don’t have a use-it-or-lose-it rule like Flexible Spending Accounts (FSAs). Additionally, you can use your HSA funds for a wide range of expenses, including copays, prescriptions, dental and vision care, mental health services, and certain over-the-counter items (such as pain relievers, allergy medications, and first-aid supplies). Lastly, you OWN your HSA – it stays with you if you change jobs or retire. You control how and when it is used, allowing you to learn how they work and ensure you make the most out of the account.

While the “One Big Beautiful Bill” fell short of delivering the HSA expansion many had hoped for, it did make some notable improvements. It’s clear that Health Savings Accounts remain one of the most innovative tools for managing healthcare costs, both now and in the future. In today’s uncertain and costly healthcare environment, understanding and maximizing your HSA is essential.  For those enrolled in an HSA, remember, it isn’t just a spending account — it’s a strategy.

Posted by CalCPA Health | July 2025

 

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IRS Announces 2026 HSA Contribution Limits

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The IRS recently released the contribution limits for Health Savings Accounts (HSAs) for 2026. In the upcoming year, we will see an HSA  contribution limit increase to $4,400 for individuals and an increase to $8,750 for a family. The IRS implemented inflation-adjusted parameters for health savings accounts in Revenue Procedure 2025-19.

For 2026, individuals with self-only coverage can contribute up to $4,400 to their HSAs, up from $4,300 in 2025. Family plans can contribute up to $8,750, up from $8,550 in 2025. The IRS also noted that the 2026 catch-up contribution for those aged 55 and older will remain $1,000 for 2026, unchanged from 2025.

According to Fidelity Investments’ 2024 Retiree Health Care Cost Estimate, a single 65-year-old retiring can expect to spend an average of $165,000, or $330,000 per couple, in health care and medical expenses throughout retirement. These figures are up nearly 5% over 2023 and more than doubled from the first estimate in 2002. Understanding how to save and invest with an HSA plan is key to helping you plan for future expected and unexpected medical expenses.

If you are in an HSA and have questions about how to get the most out of the plan, CalCPA Health can help answer your questions. CalCPA Health is at the forefront of HSA adoption, offering the most HSA plan options in California. CalCPA members have a strong understanding of the tax benefits HSAs provide. Education is key, and CalCPA Health is here to help whether or not you are in one of our plans. We are a resource for you, so please feel free to ask questions by emailing info@calcpahealth.com.

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Selling Health Savings Accounts to CPAs and Financial Professionals in California: A Guide for Health Insurance Brokers

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Health Savings Accounts (HSAs) are valuable for managing healthcare costs, offering tax advantages and long-term savings opportunities. As a health insurance broker in California, you can leverage HSAs to build relationships with qualified* Certified Public Accountants (CPAs) and financial professionals (wealth management, advisors, financial institutions, etc.) who advise their clients on financial matters. Here is a guide on effectively selling HSAs to CPAs and financial professionals in California.

1. Understand the Benefits of HSAs
Just because a CPA or financial professional may have a strong understanding of finances and taxes does not mean they understand the full benefits of HSAs.
Before you approach these clients, ensure you have a comprehensive understanding of HSAs and the benefits they can provide:

*Tax Advantages: Contributions to HSAs are tax-deductible, grow tax-free, and can be withdrawn tax-free for qualified medical expenses. This means money can be earned (income), invested (investment returns), and used to pay expenses without ever being taxed.

*One way to look at the HSA tax advantage:
Example: An HSA subscriber in the 25% tax bracket is enrolled in a $2000 deductible qualified HDHP. Since they pay the deductible with pre-tax dollars, the $2000 deductible would be comparable to a $1500 non-HSA deductible plan. The tax-preferred effect (savings) continues beyond the deductible, all the way up to their out-of-pocket maximum. An $8,000 OOP max would behave like a $6,000 OOP max in a non-HSA plan.

*Cost Savings: HSAs are paired with qualified high-deductible health plans (HDHPs), which typically have lower premiums than comparable non-HSA plans.

*Tax-free Investment Returns: HSA funds can be invested, growing into a retirement nest egg similar to a 401K or IRA, except there are no Required Minimum Distributions, and you do not pay tax on the investment earnings when you use the money for qualified health care expenses.

*Flexibility and Ownership: The employee owns HSA funds and stays with them throughout their career (from job to job) and into retirement. There are no use-it-or-lose-it provisions like FSA’s.

Attract and Retain: HSAs have become a valuable tool in today’s tight labor market for employers to attract and retain talent. With no discrimination tests like 401K plans, employers easily add a valuable employee benefit to their benefits package.

Important Note: The tax effects mentioned above are federal taxes. California is one of only two states that do not recognize HSAs. Given this, the benefit from the federal tax effect is typically good enough to make the HSA math work for most companies and employees.

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IRS Announces 2025 HSA Contribution Limits

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The IRS has recently released the contribution limits for Health Savings Accounts (HSAs) for 2025. In 2024 we saw a significant increase, mainly in response to continued pressures from inflation. In the upcoming year, we will see another adjustment upwards, yet smaller than the 2024 increases.

For 2025, individuals with self-only coverage can contribute up to $4,300 to their HSAs, up from $4,150 in 2024. Family plans can contribute up to $8,550, up from $8,300 in 2024. This change reflects a steady acknowledgment of the need for greater financial flexibility in managing health expenses.

The IRS hasn’t released the 2025 catch-up contribution yet for those age 55 and older. It is currently set at $1,000 for 2024, unchanged from 2023.

According to Fidelity Investments’ 2023 Retiree Health Care Cost Estimate, a 65-year-old retiring this year can expect to spend an average of $157,500, or $315,000 per couple, in health care and medical expenses throughout retirement. Understanding how to save and invest with an HSA plan is key to helping you plan for future expected and unexpected medical expenses.

If you are in an HSA and have questions about how to get the most out of the plan, CalCPA Health can help answer your questions. Approximately 45% of CalCPA Health medical subscribers are enrolled in a Health Savings Account. Education is key and CalCPA Health is here to help – whether you are in one of our HSA plans or not. We are a resource for you – feel free to ask questions by emailing info@calcpahealth.com.

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2024 Contribution Limits for Health Savings Accounts (HSA) Announced

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The Internal Revenue Service released the annual maximum 2024 contribution limits for HSAs under high deductible health plans (HDHPs). For 2024, we will see the largest jump in recent years for contribution limits – mainly due to continued high inflation. The annual limit on HSA contributions for an individual will be $4,150 (up from $3,850 in 2023) and $8,300 for family coverage (up from $7,750 in 2023).  HSA “catch-up” contribution for participants 55 and older, can contribute an extra $1,000 to their HSA, which is the current amount in place for 2023.

Effective January 1, 2024 – Contribution Limits for Health Savings Accounts

Tax Year Individual Coverage Limit Family Coverage Limit
2024 $4,150 $8,300
2023 $3,850 $7,750
2022 $3,650 $7,300
At age 55, members are allowed to contribute an additional $1,000 

What is a HSA? It is a tax-advantaged account, paired with a high-deductible health insurance plan (HDHP), that allows you to save pre-tax dollars for future qualified medical expenses. You can invest the funds in the HSA account tax-free and grow your savings. You own the account, it travels with you if you change jobs, change your health plan, or retire.

 

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2023 Health Savings Accounts Limits Are Released By The IRS

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The IRS has released the contribution limits for Health Savings Accounts (HSA) for 2023 and the numbers are significantly higher than in prior years, as you can see from the chart below. Knowing these numbers will help employers prepare for open enrollment and think about their contribution levels as well as help employees understand the benefits of contributing to their HSAs.

Tax Year Individual Coverage Limit Family Coverage Limit
2023 $3,850 $7,750
2022 $3,650 $7,300
2021 $3,600 $7,200
At age 55, members are allowed to contribute and additional $1,000 

What is a HSA? It is a tax-advantaged account, paired with a high-deductible health insurance plan (HDHP), that allows you to save pre-tax dollars for future qualified medical expenses. You can invest the funds in the HSA account tax-free and grow your savings. You own the account, it travels with you if you change jobs, change your health plan, or retire.

 

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