Analysis from HealthPocket Inc., a health insurance information site for consumers, shows that health insurers have some work to do in the areas of out-of-pocket expenses and transparency. The analysis indicates that 38 percent of plans did not disclose their deductible within its annual out-of-pocket limits, concealing the full amount a person could pay if the “Summary of Benefits” was not read carefully. Once these deductibles are factored in, many plans are not compliant with the Affordable Care Act (ACA).
Under ACA provisions, taking effect in 2014, health insurers will be required to offer plans that fit within four levels of coverage: Bronze, Silver, Gold and Platinum. The ACA plans would cap current out-of-pocket costs for consumers to $6,250 per calendar year. And, currently, 36 percent of all health plans had higher out-of-pocket limits than what Bronze plan—the highest out-of-pocket option—will permit, according to HealthPocket’s recent analysis of 9,752 health insurance plans for individuals and families under the age of 65.
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