Consumers Union Reviews Concept of “Actuarial Value” Under Health Reform

January 12, 2012 Off By administrator

Consumers Union Reviews Concept of “Actuarial Value” Under Health Reform
News from Kaiser Family Foundation:

January 11, 2012

“Actuarial value is a concept long used by health insurance plans and actuaries but is generally unfamiliar to consumers, regulators and policymakers,” explains a new brief by Consumers Union. The brief is based on a public forum held in October 2011 where a “panel of experts discussed how the measure is employed in the new health reform law, the definitional and measurement issues associated with its use, and how to craft a measure that is usable by consumers.” The term “actuarial value,” defined as “the average share of medical spending paid by the plan for a defined set of covered services across a standard population of both healthy and sick consumers” and takes into account both the range of medical services and cost-sharing requirements. The health reform law will use actuarial value to “categorize health plans sold in the individual and small group markets into coverage levels. The four levels – Bronze, Silver, Gold and Platinum – must have actuarial values of 60%, 70%, 80% and 90% respectively.” Actuarial value will also be used “to determine the amount of federal tax credits that middle-to-lower income families can use to purchase individual and family plans in the Exchange, starting in 2014,” among other measures.

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