An embedded deductible enables each family member to have their own individual deductible within the larger family deductible. Spending toward the individual deductible also counts toward the family deductible, and coverage kicks in for that member once their individual deductible is met, even if the family deductible isn't met yet.
This gives members faster access to their benefits while still letting the plan mirror the structure of the underlying group health plan. This article walks partner and organization admins through turning on embedded deductible and setting thresholds for a health reimbursement arrangement (HRA).
Requirements to set up an embedded deductible
An embedded deductible is available only for benefit plans built from a Traditional HRA template with a Member Pays First payout structure. If your benefit plan doesn't use this template and payout structure, the option won't appear.
How to set up embedded deductible
Note for admins managing multiple organizations
Choose the appropriate organization or division from the Organizations tab before following the steps below.
Go to the benefit plan's Coverage section.
Select the Embedded Deductible toggle.
For each coverage level, select whether it's an individual coverage level. Coverage levels marked individual won't include embedded deductible options. All other coverage levels, like Individual +1 or Family, will.
How to set individual and family thresholds
For each coverage level where embedded deductible applies:
Enter the Individual Threshold: the amount a single member must spend before the plan starts paying out for them.
Enter the Family Threshold: the combined amount across all enrolled family members that opens payout for the entire family.
Confirm the individual threshold is less than or equal to the family threshold. The system will flag this if it isn't.
Review the maximum employer contribution summary, which updates automatically based on your thresholds.
How embedded deductibles appear to admins and members
During enrollment, admins can select View Coverage Level Details to review the plan's payout structure, including the Individual Threshold, Family Threshold, and maximum employer contribution, before finishing enrollment.
Once enrolled, members can see their own progress toward both thresholds in Health Wallet. After a member meets their individual threshold, or the family threshold is met, they'll see their progress toward the plan limit instead.