The mix of individual health plans sold outside of the ACA by brokers in 2016 is very different than the coverage sold through the exchanges, according to a study by the Robert Wood Johnson Foundation and discussed on the Health Affairs blog. Plans sold outside the exchange make up about a quarter of the individual market offerings.
More than half of the off-exchange plans offer out-of-network benefits. On the exchanges, only 36% of the plans do. Silver plans on the exchanges pay 70% of covered expenses. In the off-exchange market, a third of the plans are silver.
“While the federal and state exchanges, along with creators of decision support tools, have done much to present comprehensive information to consumers about on-exchange plans, similar information has thus far been lacking for off-exchange and small group plans,” the study notes.
Or, as Katherine Hempstead, who directs the health insurance research work for the foundation, tells Kaiser Health News: “Right now the off-exchange market is kind of the Wild West in terms of how consumers know what’s available.”
Source: Health Affairs