| Illustrative feature | Configuration A | Configuration B |
|---|---|---|
| Annual premium | $480 | $480 |
| Eligible illness examination fees | Included | Excluded |
| Annual insurer payout ceiling | $5,000 | $10,000 |
| Payment on eligible charges | 80% | 80% |
These are invented configurations, not available quotes, named products or average prices. Assume the same relevant history exclusions, covered treatment scope and usable payment process. For the two independent tests below, assume any applicable deductible is already satisfied and the full stated payout capacity remains. The examples do not represent the full contract of either insurer discussed later.
| Separate test, not a forecast | A: owner’s share of this test bill | B: owner’s share of this test bill |
|---|---|---|
| $600 of illness examination fees, all otherwise eligible | $120 | $600 |
| $9,000 of other eligible treatment, with no examination fee in this test | $4,000 | $1,800 |
In the first test, A pays $480 and B pays nothing for those fees. In the second, 80% of $9,000 is $7,200: A’s payment stops at $5,000, while B pays $7,200. The identical premium is payable under either choice and does not change these differences. Any deductible already paid is outside the displayed incremental bill shares.
These are alternative situations, not two claims to add together. Actual combinations of fees and treatment can consume the same annual limit. Use the real contract calculation if you run this test on your own offers.