Plan Year vs. Calendar Year

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Leadership

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This video explains the difference between a "Plan Year" and a "Calendar Year" in the context of health insurance and benefits:

  • Calendar Year refers to the standard January 1st to December 31st period, often dictating when deductibles, out-of-pocket maximums, and other insurance plan elements reset or change.

  • Plan Year is specific to an individual company's health insurance plan; it defines the 12-month period during which the company's health insurance benefits are calculated. This period might not align with the calendar year (e.g., May 1st to April 30th).

The confusion arises when a company's plan year does not match the insurance company's calendar year. For example, if the plan year starts on May 1st but the insurance resets deductibles on January 1st, employees might mistakenly think their deductibles reset with the plan year, leading to misunderstandings that the HR or benefits manager needs to clarify.