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How Private Health Coverage Works: A Primer – 2008 Update

How Private Health Coverage Works: A Primer— 2008 UpdateThis primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee organizations…

Toplines: National Survey of Enrollees in Consumer-Directed Health Plans

These toplines provide the complete survey questions and findings from the National Survey of Enrollees in Consumer-Directed Health Plans conducted between June 21 and July 10, 2006. The survey looks at the views and experiences of people enrolled in consumer-directed health plans as compared to people with traditional health insurance.Toplines…

Explaining Health Care Reform: What Is An Employer “Pay-or-Play” Requirement?

To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which…

Health Insurance Market Reforms: Rate Review

Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the…

How Accessible is Individual Health Insurance for Consumer in Less-Than-Perfect Health?

This report documents the findings of a study examining access to health insurance coverage in the individual market for people with health problems. Seven hypothetical consumers with varying health conditions were defined and insurers and HMOs in eight different markets around the country were asked to consider them as though…

Explaining Health Care Reform: What is Health Insurance?

A key element in any comprehensive health reform plan is defining what health insurance is and the amount of insurance coverage people will have. There are two components to that coverage: the types of services covered (e.g., physician care, hospitalization, prescription drugs, etc.), and the cost sharing required of enrollees…

Insurer Rebates under the Medical Loss Ratio: 2012 Estimates

Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…

Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

Related ResourcesStudy Highlights Role of Geography and Plan Shopping Under Medicare Premium Support SystemMedicare Part D: A First Look at Part D Plan Offerings in 2013The Medicare Prescription Drug Benefit – An Updated Fact SheetOnline Consumer Guide to Medicare The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms…

Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group…

Pulling It Together: What Do We Want Health Insurance To Be?

Trends in the health insurance marketplace show substantial growth in high deductible health plans, especially among smaller firms, where 35% of workers are now covered by plans with a deductible of $1,000 or more. That’s according to our recently released employer health benefits survey, which we have been conducting now…