Webinar OE6: Plan Design
In this Health Reform: Beyond the Basics webinar presented on September 20, 2018, 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 costs for consumers — and talks about the expansion of skimpy plans outside of the marketplace.
This is Part III is a four-part series on core elements of eligibility and enrollment.
Presentation Slides
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Elements of Plan Design
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Premiums vs. cost-sharing charges
Essential health benefits (EHBs)
Types of cost-sharing charges
- Maximum out-of-pocket limit
- Metal levels and actuarial value
- Example: How cost sharing works
- Embedded vs. aggregate family cost sharing
- In-network vs. out-of-network
Cost-Sharing Reductions
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Definition of cost-sharing reductions (CSR)
- Example CSR plans
- Termination of CSR payments in 2017
- Cost sharing for American Indians and Alaska Natives (AI/AN)
Skimpy Plans
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Increase in skimpy plans
- Skimpy plans vs. ACA-compliant plans
Short-term plans
Q&A
Additional Resources
Resources | View resources links
Webinar OE6: Plan Selection Strategies
Key Facts:
Reference Guide: Yearly Guidelines and Thresholds
Beyond the Basics Webinar Series | View all webinars
Key Facts About Health Reform | View all key facts
Tools and Resources | View all tools and resources
Frequently Asked Questions | View FAQs
