Actuarial Value

Actuarial Value

In health insurance, the estimated percentage of a typical policyholder's medical bills that an individual plan is expected to pay. A policyholder may receive less than the actuarial value in coverage if he/she has few medical expenses (because the bills may not exceed the deductible) and may receive more than the actuarial value if he/she has numerous expenses. The actuarial value is considered a good baseline for the coverage most policyholders will receive most of the time. The Affordable Care Act of 2010 in the United States requires health insurance providers to calculate and publicize the actuarial value of each plan.
References in periodicals archive ?
They might be able to leave out some of the benefits required by the ACA essential health benefits package, and, unlike ACA-complaint small-group plans, they might be able to offer plans that cover less than 60% of the actuarial value of the essential benefits package.
15 would make changes to special enrollment periods, open enrollment, guaranteed availability, network adequacy rules, essential community providers, and actuarial value requirements.
The proposal would eliminate an ACA provision that now requires an individual or small-group major medical plan to cover about 60 percent of the actuarial value of the ACA "essential health benefits" package, or list of benefits a solid health plan ought to cover.
Consumers purchasing health insurance through a state-based or federal health insurance marketplace can choose bronze plans, which have an actuarial value of 60 percent; silver plans, which have an actuarial value of 70 percent; gold plans, which have an actuarial value of 80 percent; or platinum plans, which have an actuarial value of 90 percent.
2) To qualify as a CRAT, a trust must provide 1) at least annually to one or more then-living noncharitable beneficiary(ies) in what must be the sole noncharitable distribution, a fixed-dollar annuity ranging from 5 percent to 50 percent of initial trust asset fair market value (FMV) for the beneficiary's life or for a maximum 20-year term; and 2) at termination, the entire remainder interest with an actuarial value of at least 10 percent of initial trust asset FMV (tested at inception, not termination) must pass to one or more qualified charities.
The actuarial value of a health insurance plan is the average total costs of covered healthcare expenses the insurer is contractually obligated to pay.
If the city of Worcester continues with a pay-as-you-go approach, annually addressing only existing retiree health care costs instead of funding future retiree health care obligations, its liability increases each year as actuarial values rise and the actuarial value of assets remains static or declines,'' The Research Bureau stated in a recent briefing paper.
Actuarial accrued liability (AAL) $42,267,100 Actuarial value of plan assets $37,516,400 Unfunded actuarial accrued liability (UAAL) $4,750,700 Funded ratio (actuarial value of plan assets/AAL) 88.
Using difference-in-differences variation brought about by payment floors established by the 2000 Benefits Improvement and Protection Act, we find that for each dollar in increased capitation payments, MA insurers reduced premiums to individuals by 45 cents and increased the actuarial value of benefits by 8 cents.
However, under the prior rules, the retiree had to include the actuarial value of the deferred annuity in his or her account balance, inflating the account balance and resulting in larger RMDs.
Risk transfers are intended to offset the effects of risk selection on plan costs while preserving premium differences due to factors such as actuarial value differences.
Reputation insurance coverage from companies such as AIG, Munich Re, Steel City Re and Zurich belong to the same class of value-added service coverages as kidnap and ransom insurance, for example, where the actuarial value of the covered losses (premium/ burden vs.