Webinar OE6: Plan Selection Strategies

The Right Fit: Helping Consumers Navigate the Plan Selection Process

In a special Health Reform: Beyond the Basics webinar presented by Dave Chandrasekaran, a training consultant and certified application counselor, on September 25, 2018, Part IV provides an in-depth lesson on effective strategies to support consumers with understanding how commercial insurance works, evaluating and comparing Marketplace plans, and selecting the plan that best meets their families’ needs.

This is Part IV in a 4-part series on core elements of eligibility and enrollment.

Presentation Slides

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Overview of What’s Covered

Overview of Marketplace Plans

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Overview of cost sharing

  • Explaining cost-sharing terms
  • First dollar coverage
  • No cost sharing for preventive services
  • Negotiated rates for services

Overview of covered benefits

  • Other covered services
  • Prescription drugs cost sharing and formularies

Provider networks

  • Types of provider networks
  • Searching for a provider


Trends in Marketplace Plans

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Partial exemptions from the deductible

Deductible-only plans

Additional prescription drug tiers

Narrow and/or tiered provider networks

  • Inaccurate provider directories


Strategies to Help Consumers

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Preparing for open enrollment

  • Tracking changes in the lowest-cost plan options
  • Comparing differences in provider networks
  • Studying all plans in your area

Tailoring search based on consumer needs

  • Renewal or new applicant?
  • Prescription drugs or current doctors?
  • Major health needs or anticipated procedures?
  • Finding options for first dollar coverage

Understanding consumer tradeoffs

  • Bronze vs. silver plans
  • Paying more to preserve access to providers or prescriptions
  • Bronze plan + community-based coverage or other alternate sources of care
  • Benefits of coverage vs. going uninsured


Live Plan Selection Demonstration via

Please note that this section of the webinar features a live web-browsing demonstration that is not reflected in the static slides.

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Scenario 1: General plan comparison (single adult)

Scenario 2: Weighing in-network doctors and current prescriptions (married couple)

Scenario 3: Comparing out-of-pocket costs (family of three)





Additional Resources

Resources | View resources links

Worksheet: Marketplace Plan Comparison Worksheet

Webinar OE6: Plan Design

Key Facts:

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