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A Look at the New “Simple Choice” Plans

A Look at the New “Simple Choice” Plans

After warning for months that consumers will have fewer choices when shopping for individual coverage this fall, in this article we’ll discuss some new options that may be available for the 2017 open enrollment period.

While it is true that health insurance companies are pulled out of the marketplaces in many areas, many of the non-profit co-ops are going under, and some of the biggest insurance companies are merging together—all of which reduce competition and limit the options we can present to our clients—it’s also true that the number of carriers and number of plan options differ from market to market. In some areas, there’s still a pretty good selection of plans both on-and-off the marketplace, and in those places consumers are struggling with an entirely different problem: how to compare a wide range of dissimilar products and make a buying decision they won’t later regret.

It is, after all, difficult to compare one health plan with another. With different premiums, copayments, deductibles, out-of-pocket limits, networks, and drug formularies, people don’t know how to prioritize the different features and benefits. They may have trouble choosing the best plan for themselves and their families, and might later question whether they made the right decision.

To help simplify the shopping process, the government is encouraging insurance companies to offer six new plan designs this fall. These “simple choice plans” allow consumers to make more of an apples-to-apples comparison by standardizing copays, deductibles, and OOP limits. HHS has created guidelines for the six plans but is not requiring carriers to offer them. If they are offered, they will be displayed prominently on the Healthcare.gov website according to marketplace CEO Kevin Counihan.

As Michelle Andrews with Kaiser Health News explains, the simple choice plans will be available in the bronze, silver, and gold levels of the marketplace (one in each), with three additional silver options for people who qualify for cost-sharing subsidies. As an example, the silver-level simple choice plan will have a deductible of $3,500, an out-of-pocket limit of $7,100, and standardized copayments for doctor visits and generic drugs.

We are well into Open enrollment, and it is interesting to see which insurers offer these new simple choice plans and in which markets, how the marketplace draws attention to the plans, and whether consumers take the bait. What do you think—has standardization simplified the plan selection process, or does it steer consumers away from plans that are a better fit for their situation?

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