OE8 Webinar: Part V Plan Design

Plan Design

In this Health Reform: Beyond the Basics webinar presented on October 1, 2020, Sarah Lueck, Senior Policy Analyst, provides an overview of health plan design, including cost-sharing charges in marketplace plans, eligibility for cost-sharing reductions, and how plan design affects consumers’ costs. She also covers the expansion and risks of skimpy plans.

↓ View Presentation Slides (PDF)

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Elements of Plan Design

  • Basic elements of marketplace plans
  • Essential health benefits
  • Types of cost-sharing charges
  • Maximum out-of-pocket limit
  • Actuarial value and metal tiers
  • Examples

Cost-Sharing Reductions

  • Levels of cost-sharing reductions
  • Examples
  • Cost-sharing for American Indians and Alaska Natives

Skimpy Plans

  • Skimpy plans vs. AC-compliant plans
  • Limitations of short-term plans
  • Direct enrollment websites

Additional Resources

Key Facts About Cost-Sharing Reductions

Key Facts About Cost-Sharing Charges