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"Simple Choice Plans" to Debut in 2017 Marketplace Enrollment

In an effort to make choosing an individual health plan easier for consumers, the Federal Government is encouraging insurers to offer “simple choice health plans” as an option when the 2017 open enrollment starts this November.

Insurers won’t be required to offer simple choice plans on the Marketplace; however, for insurers that choose to do so, the government is providing guidelines for creating a simple choice plan design at each of the current metal levels (bronze, silver, gold and platinum).

These new standardized plan designs will eliminate much of the confusion consumers experience when making comparisons between plans, providing guidelines for a simple choice plan at each of the bronze, silver, gold and platinum levels, and three more silver options for individuals who qualify for cost-sharing reductions based on their income.

These plans will have standardized deductibles and annual out-of-pocket maximums. Additionally, many services will allow consumers to pay flat-dollar copayments upfront instead of having to meet their deductible before insurance will cover the cost.  In Michigan, Ohio, Pennsylvania, Virginia and Wisconsin, where enrollment is high in individual plans, the simple choice plans will include newly established quality ratings for each plan.  This pilot program will use a five star rating system, and these quality ratings will arm consumers with information ranging from member experience to provider satisfaction.

A potential advantage of standardizing consumer choices is allowing consumers to make better, more informed choices. However, experts warn that offering both standardized and non-standardized plans could be confusing for consumers if the plans are not clearly distinguished from one another.