Short answer: Because employee needs vary, many employers offer a menu, a low/medium/high or “base-and-buy-up” structure, that lets employees self-select between richer, more predictable coverage and leaner, lower-premium plans. A single plan is simpler to administer but fits fewer people well.
One plan rarely fits everyone. Some employees can’t afford high premiums; others can’t afford high out-of-pocket costs; and many won’t fund a tax-advantaged account even when it would help them. Consumer-directed (HDHP) designs in particular are not universally a good fit: some employees feel underinsured, some decline coverage, and some enroll but never use the savings vehicle.
For that reason, offering multiple options is often appropriate: a base-and-buy-up structure, or a low/medium/high menu, lets employees self-select based on their own finances and risk tolerance. The trade-off is administrative complexity and, sometimes, carrier participation rules that apply across the menu.
The practical move is to match the menu to the workforce you actually have: if your population skews younger and healthier, an HDHP-plus-HSA option may be popular; if it skews older or lower-income, a richer low-deductible option should anchor the menu.
Sources
- Employee Benefits KB (Employer Decision Framework, plan menus, workforce realities).
Content history
Originally published: June 16, 2026
Last reviewed: June 16, 2026