BUILDING BLOCKS > CONSUMER

Access & Coverage Structure

How are consumers’ access options structured?

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Covered Benefits

Policy Definition: Covered benefits are services an insurance provider is responsible to pay for (dependent on benefit design) on behalf of a beneficiary.

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Underwriting and Rate Setting

Policy Definition: Underwriting and rate setting are methodologies that risk bearing entities use to determine costs associated with covered benefits to beneficiaries by utilizing consumer demographic and medical information.

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Insurance Design

Policy Definition: Insurance design dictates the parameters in which a consumer can access covered benefits

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Savings Accounts

Policy Definition: Savings accounts for health spending allow consumers or employers to contribute pre-tax dollars in specialized accounts to use towards health care expenses.

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