Using data from both company records and an insurance provider, the authors develop a direct measure of out-of-pocket costs incurred by employees choosing a health care plan. Previous studies have used characteristics of medical plans and demographic variables as proxies for OPC. By better specifying the consequences of the health care choice, the authors show how the demand for health plans is kinked in a manner consistent with risk aversion. The results suggest that using the proposed OPC measure can help practitioners and researchers better understand and predict the pattern of employee health care benefit choices.