Regulations

New Barometer: Health Network Size for Insurance Ratings

By Robert Sheen | March 30, 2016

New.jpeg2016 has thus far posed some significant changes in both the attitudes of citizens toward health care coverage and those required to provide it. However, looking ahead toward 2017, the focus will move to the health insurance agencies, as theACA insurance ratings will reflect a new criteria based on network size.

What does this mean for the scope of health care? The ratings will be based on the access level of each health insurance agencies to doctors and hospitals available within their network. While networks may be able to remain small in size, those looking to purchase health insurance will know ahead of time the range of the network, as the rating (defined as a label) will be included with each agency on the Marketplace website, along with a comparative analysis to other plans within the same geographic proximity.

As for the consumer, 2017 will bring other changes for them as well. The maximum for out of pocket costs will increase to $7,150 for individuals and $14,300 for families. The increase is $300 for individuals ($6,850 this year) and $600 for families ($13,700 this year), respectively. While any increase in fees feels problematic at face value to consumers, those in low-income households will be able to receive discounted rates for out of pocket costs like deductibles should they choose an available silver plan. Additionally, the ACA will still afford protection to insured consumers from potentially staggering out-of-pocket costs associated with certain illnesses such as cancer.

Perhaps the greatest change in health care for 2017 will be in the mindset for both the consumer and the network. Gone are the days when people will invest in health care plans blindly, unaware of what to expect and what to receive. As the new changes will also provide assistance from health insurance counselors year-round, consumers can take ownership of their plan and understand the scope of their coverage every step of the way.

Posted in ACA Compliance, Disclosure, Health Care Coverage, Regulations

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