Health insurance exercise
QUESTIONS
Using the above information about this household, navigate to the Connect for Health Colorado website.
Find the section on the website that allows you to compare plans and prices, and enter information about the household in order to answer the following questions.
1. Is this family or any of its members likely to qualify for Medicaid coverage in Colorado (called Health First Colorado) or another type of public coverage such as the Children’s Health Insurance Program?
a. Yes
b. No
2. Briefly explain why or why not?
3. If the family chooses to enroll in a private health insurance plan offered through Colorado’s Health Insurance Marketplace, how much is the monthly premium for the plan with the lowest premium, after taking into account any subsidy they may be eligible for (e.g. premium tax credit)?
$
4. Referencing the plan with the lowest premium, what type of ownership structure best describes the insurer that sells this plan? (Hint: this may require some investigation on the insurer’s website)
a. Private, for–profit organization
b. Private, nonprofit organization
c. Government organization
5. Referencing the plan with the lowest premium, is this plan likely to be the least expensive option available in Colorado’s Health Insurance Marketplace for this household when considering the total cost to be incurred by the family, including both the premium and the expected out–of– pocket costs?
a. Yes
b. No
6. Referencing the plan with the lowest premium, is this family expected to reach the annual out of pocket maximum for this plan?
a. Yes
b. No
7. A common rule of thumb for assessing whether a health plan will be affordable for a family is to determine whether the family’s expected spending on the monthly premium is less than 10 percent of the family’s total household income, AND the family’s expected spending on out– of pocket costs (excluding the premium) is less than 5 percent of the family’s total household income. This is known as the 10/5 rule. Using this rule, is the plan with the lowest premium likely to be affordable for this family?
a. Yes
b. No
8. Briefly explain why or why not.
9. The health plans offered on the Marketplace are classified as either Gold, Silver, or Bronze. Individuals under age 30 have a fourth option, known as a Catastrophic Health Plan. Which type of plan offers the lowest premiums for this family?
a. Gold
b. Silver
c. Bronze
d. Catastrophic
10. Which type of plan offers the lowest total expected costs for this family when considering both premiums and out–of–pocket costs?
a. Gold
b. Silver
c. Bronze
d. Catastrophic
11. Assume that the family chooses the plan with the lowest total expected costs including both premiums and out–of–pocket costs. What is the total expected monthly cost for this family including both premiums and out–of–pocket costs?
$
12. Assume that due to a new job offer, the household now estimates their total household income to be $65,000 annually. With this new income level, how much is the monthly premium for the plan with the lowest premium, after taking into account any subsidy they may be eligible for (e.g. premium tax credit)? In determining this amount, assume that any household members who are eligible for Medicaid or another public program will enroll in that program.
$
13. Using the 10/5 rule, is the plan with the lowest premium likely to be affordable for this family when earning $65,000 annually?
a. Yes
b. No
14. Looking at the plan with the lowest premium, is this family expected to reach the annual out of pocket maximum for this plan?
a. Yes
b. No
15. Which type of plan offers the lowest total expected costs for this family when considering both premiums and out–of–pocket costs, assuming their annual household income is $65,000?
a. Gold
b. Silver
c. Bronze
d. Catastrophic
16. Assume that the family chooses the plan with the lowest total expected costs including both premiums and out–of–pocket costs. What is the total expected monthly cost for this family including both premiums and out–of–pocket costs, assuming annual household income of $65,000?
$
17. Assume that due to a new job offer, the household now estimates their total household income to be $130,000 annually. With this new income level, how much is the monthly premium for the plan with the lowest premium, after taking into account any subsidy they may be eligible for (e.g. premium tax credit)? In determining this amount, assume that any household members who are eligible for Medicaid or another public program will enroll in that program.
$
18. Using the 10/5 rule, is the plan with the lowest premium likely to be affordable for this family when earning $130,000 annually?
a. Yes
b. No
19. Looking at the plan with the lowest premium, is this family expected to reach the annual out of pocket maximum for this plan?
a. Yes
b. No
20. Which type of plan offers the lowest total expected costs for this family when considering both premiums and out–of–pocket costs, assuming their annual household income is $130,000?
a. Gold
b. Silver
c. Bronze
d. Catastrophic
21. Assume that the family chooses the plan with the lowest total expected costs including both premiums and out–of–pocket costs. What is the total expected monthly cost for this family including both premiums and out–of–pocket costs, assuming annual household income of $130,000?
$
22. Assume that the family moves to Houston, Texas (Harris County, zip code 77081) with their annual household income of $130,000. How much is the monthly premium for the plan with the lowest premium, after taking into account any subsidy they may be eligible for (e.g. premium tax credit)? In determining this amount, assume that any household members who are eligible for Medicaid or another public program will enroll in that program.
$
23. Assume that the family, now in Texas, chooses the plan with the lowest total expected costs including both premiums and out–of–pocket costs. What is the total expected monthly cost for this family including both premiums and out–of–pocket costs, assuming annual household income of $130,000?
$
24. Using the 10/5 rule, is the plan with the lowest total expected costs likely to be affordable for this family now in Texas when earning $130,000 annually?
a. Yes
b. No
25. Looking at the plan with the lowest total expected costs, is this family expected to reach the annual out of pocket maximum for this plan?
a. Yes
b. No
