Dewonkify – Actuarial Value (Of Health Benefit Plans)

Author:Ms Julie Scott Allen
Profession:Drinker Biddle & Reath LLP

The Word: Actuarial Value (of health plan benefits)

Definition: Actuarial value outlines the percentage of medical costs that a health plan will cover.

Used in a Sentence: Actuarial value can help consumers navigate different health insurance plans as they weigh coverage options and their associated costs.

What It Means: Actuarial value is meant to define how "generous" a health plan is in covering health care costs. Understanding the actuarial value of a health plan helps consumers understand what they might have to pay (deductibles and coinsurance/copays) out-of-pocket in order to cover their overall health care costs.

History: Under the Affordable Care Act, actuarial value is utilized to help individuals and the small business market understand and compare health plan options offered inside and outside of...

To continue reading