Actuarial Value and Employer-Sponsored Insurance. Introduction


This paper explores the distribution of plan AVs for individuals enrolled in employer-sponsored insurance (ESI).  Note that there are many important issues related to calculating AV that are beyond the scope of this paper. For example, issues around the choice of data for calculating AVs (e.g., plan specific data or a national standard dataset) have been discussed in a brief released by the American Academy of Actuaries.  Many factors that may have large impacts on premiums are not discussed, including the health status of the covered population, the prices paid by plans for medical services and items, the breadth of the provider network, the plan’s coverage of out-of-network care, and use of utilization management tools.  This paper is intended for discussion only and is not guidance related to health reform.

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