Lots more in the article link below than what I've posted. As I've stated before, a gold plan will not look like other gold plans. Your job will change from underwriting guru, to matching up medical conditions to the best AV plan for that condition, plus an AGI/subsidy analysis. More confusion means more job security.
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While actuarial values will be used to categorize qualified health plans (QHPs) into metal tiers, it might not offer consumers a complete picture, according to an issue brief released last month by The Commonwealth Fund.
Products with identical actuarial values could have very different out-of-pocket costs depending, for example, on the enrollee's medical usage and the plan's annual deductible levels. To allow for more accurate comparisons, state exchanges could create stricter rules for products sold within an exchange. Exchanges, for example, could opt to narrow the range of allowed deductibles or out-of-pocket maximums, or require plans to use copayments instead of coinsurance, according to the brief, "Choosing the 'Best' Plan in a Health Insurance Exchange: Actuarial Value Tells Only Part of the Story."
Although plans sold inside an exchange must also be available outside of it, not all plans sold outside of the exchange will be available inside of it, says Jon Gabel, a senior fellow with NORC at the University of Chicago in Washington, D.C., and co-author of the issue brief.
Actuarial Value, EHBs Will Shape Products, But Plans May See Some Design Flexibility | AIS Health
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While actuarial values will be used to categorize qualified health plans (QHPs) into metal tiers, it might not offer consumers a complete picture, according to an issue brief released last month by The Commonwealth Fund.
Products with identical actuarial values could have very different out-of-pocket costs depending, for example, on the enrollee's medical usage and the plan's annual deductible levels. To allow for more accurate comparisons, state exchanges could create stricter rules for products sold within an exchange. Exchanges, for example, could opt to narrow the range of allowed deductibles or out-of-pocket maximums, or require plans to use copayments instead of coinsurance, according to the brief, "Choosing the 'Best' Plan in a Health Insurance Exchange: Actuarial Value Tells Only Part of the Story."
Although plans sold inside an exchange must also be available outside of it, not all plans sold outside of the exchange will be available inside of it, says Jon Gabel, a senior fellow with NORC at the University of Chicago in Washington, D.C., and co-author of the issue brief.
Actuarial Value, EHBs Will Shape Products, But Plans May See Some Design Flexibility | AIS Health
