What do you mean by co-payments and deductibles?
When a prescription is handed over to you by a doctor, you make a small payment. The health plan you adopted pays the rest of the amount after the bill is prepared by the provider. This payment is termed as co-payment. And deductible is the amount you pay to your health plan every year before your plan start to make payments for claims. As an example, you have to pay $1000 before your $1000 deductible plan start to pay for the health services. Deductible plan is becoming common across plans due to the rise in health care costs.
What do you mean by the term “benefit rider”?
If you buy an additional insurance plan to cover the services not been covered by the health insurance plan recently bought, this additional insurance will be known as “benefit rider”. For example, if Dental benefit is not covered by your recently bought insurance plan but you provided this benefit to your employees, it will be known as “benefit rider”. In this case, an additional payment will be made by your firm.
How does a risk adjustment factor (RAF) works?
A risk adjustment factor evaluates the premium of companies. A high RAF means high premium and low RAF means low premium. State imposes a legal restriction on the number of carriers to fluctuate prices according in various groups so that the coverage can be as broader as possible. There are some diversified opinions too, whether this law promote or obstruct their set goals. For example, in California, insurers can vary only 10% to the premium amongst the entire group they insure.