Smooth and accurate handling of deductibles in front of copays.
Deductibles or coinsurance after co-pays.
Co-pays or special deductibles allowed for any category shown in the SBC template
Mapping of deductible, co-pays, and coinsurance across all benefit categories.
Embedded or aggregate deductibles
Common deductibles or separate between medical and Rx.
Flexible HRA companion calculator.
Compile your own library of plans for future retrieval or cloning to build new plans.
“Actuarial Value” is a new word for an old idea. It’s simply the measure of the “richness” of a plan design. That is, how strong or weak are the deductibles and co-pays? If a change in deductible is worth 3%, for example, then the actuarial value (and the premium) has changed by 3%.
The value of plan design changes has always been of interest at renewal time for employers. Changing plan design to keep up with inflation and dampen renewal increases is sometimes an annual event. However, determining the value has been cumbersome – either ask the carrier for numerous options, use a table of pre-packaged plans, or, use the clumsy and approximate federal calculator. The third option, re-computing the entire claim data set under a different plan design seems accurate, but will require some intense resources and can be very misleading since the claims mix is erratic year to year. Last year’s claims are generally not the best estimate of next year’s claims.
The phrase “Actuarial Value” is now embedded in the new reform law and has raised awareness and interest in this concept. Plans must have a minimum Actuarial Value of 60%, among other things, to avoid penalties for employers with more than 50 employees.
The ability for brokers and employers to make side-by-side comparisons of health insurance products — based on their actuarial value — is at the heart of the reform law’s insurance exchange concept and provides great strategic advantage for plan modeling and financial planning of employee benefit plans.
ACA-Track is an Affordable Care Act (ACA) compliance service that provides the consulting and record keeping needed by large employers to comply with the shared responsibility provisions of the ACA.
AKUNAWARE is the best-in-class, strategic Total Rewards business intelligence platform designed by employee benefit consultants and business leaders to provide intuitive, at-a-glance information about each component of Total Rewards offering.