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The Affordable Care Act has had huge ramifications on self-funded health plans; market reforms have invalidated many plan designs that were previously used, and now that employees are required to have health insurance and many employers are required to offer health benefits as well, [3] the self-funded industry has enlarged.
Consumer-driven healthcare (CDHC), or consumer-driven health plans (CDHP) refers to a type of health insurance plan that allows employers or employees to utilize pretax money to help pay for medical expenses not covered by their health plan.
Self-insurance may not be possible when there is a legal obligation to hold insurance such as mandatory third-party car insurance that is required in some countries. In some cases organizations need to apply for special licenses to self-insure certain risks, such as employee benefits insurance.
Health and Welfare Trusts are divided into three sections, one of which is a Private Health Services Plan. Private Health Services Plans can be Insured (by an Insurance Company) or Self-insured (through an Insurer or Administrator). Self-insured Private Health Services Plans are often referred to as Health Spending Accounts.
The economic definition of underinsurance is a person's actual ability to pay for their recommended health care and services. This includes the cost of the insurance premiums, co-payments, and deductibles. An economic definition of underinsurance specifically defines a certain monetary limit above which the expenses of health care coverage ...
Scheduled health insurance plans are an expanded form of Hospital Indemnity plans. In recent years, these plans have taken the name mini-med plans or association plans. These plans may provide benefits for hospitalization, surgical, and physician services. However, they are not meant to replace a traditional comprehensive health insurance plan.
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MEC is the minimum amount of coverage that an individual must carry to meet the individual health insurance mandate, while EHBs are a set of benefits that qualified health plans (QHPs) must offer. [12] MEC is a low threshold; many forms of coverage that do not provide essential health benefits are nevertheless considered minimum essential coverage.