Health insurance policy brief analysis

In general, the premium for a health insurance policy equals the average amount that an insurer expects to pay for services covered under the plan plus a loading factor that reflects the insurer’s administrative expenses and overhead (including any taxes or fees paid to the government) and profits (for private plans). An insurer’s costs for covered services reflect the scope of benefits that are covered, the plan’s cost-sharing requirements, the enrollees’ health status and tendency to use medical services, the rates at which providers are paid, and the degree of benefit management the insurer uses to restrain spending. Although the factors affecting premiums are complex and interrelated—and thus can be difficult to disentangle—this analysis groups the effects of the proposal on premiums into three broad categories:

• Differences in the amount of insurance coverage purchased,

• Differences in the price of a given amount of insurance coverage for a given group of enrollees, and

• Differences in the types of people who obtain coverage in each insurance market

CBO and JCT estimated the effect of the legislation on premiums in three broad insurance markets—nongroup, small group, and large group—as well as the contributions to the changes in premiums from each of those three sources of change. If you want to know more about medical needs, please visit http://www.insurancequotes.org/ and you might get little discounts surprise.