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People who elect the benefit but don't complete the signup process are still enrolled, they just can't consume the services until they run the gauntlet, discour
by jjoonathan 6y ago
People who elect the benefit but don't complete the signup process are still enrolled, they just can't consume the services until they run the gauntlet, discouraging service use and increasing profit.
- dragonwriter 6y agoUnder the ACA Medical Loss Ratio rule, insurers must refund premiums if they exceed a certain percentage of reimbursed costs across a plan (there's a couple different tiers with different limits.) In order to maximize profits, they need maximum utilization, which takes completing the signup, not just idle premium payment.
- jjoonathan 6y agoEh, I've seen accounting rules of that sort worked around with relative ease. It's not difficult to find ways to spend money that send value back your way, and even when you're in that position it's always the right move to ask for more. Budgeting incentives 101.