Variable	Kappa	Definition
Language spoken
English	1.00	Content is primarily delivered in English.
Spanish	1.00	Content is primarily delivered in Spanish.
Ad objective
Enrollment	0.70	Ads explicitly mention, audibly or visually, enrolling in a health insurance plan and may provide details about the plan(s).
Branding	0.70	Ads provide the insurer name and potentially their market (e.g., BlueCross Blue Shield of Illinois) but do not provide any appeal to enroll or any explicit information about plans.
Branding/public service announcement	0.70	Ads provide information to the viewer about issues or resources broader than the health plan. Examples include information presented in celebration of or to raise awareness about a particular cause (e.g., heart health). Message of a Branding/PSA ad will primarily focus on an issue or resource rather than on the insurer or the plan(s) they offer.
Sponsor type
Federal	0.84	Ad is either Medicare or CHIP.
State	0.84	Ads focus on enrollment in individual health insurance plans from a State based Marketplace or traditional Medicaid or CHIP. There may be also be mention of small business insurance run by the state.
Private	0.84	Any ad for an insurance company (can be for-profit or non-profit), insurance agency, broker, health care system, or managed care organization.
Private ad sponsor
Insurance company	0.75	Any seller of an insurance plan including for-profit companies and nonprofit organizations.
Insurance company & health system	0.75	Includes organizations like Kaiser Permanente, UPMC, etc. that offer insurance and operate health care facilities.
Insurance broker	0.75	Includes ads for a service that will connect a consumer to insurance. The company does not actually offer insurance. These may be individual brokers or agents, or they may be a company that matches consumers to a variety of plans from other companies.
Product appeals
Explicit reference to insurance	0.79	Ad explicitly mentions ‘insurance’ either audibly or visually. Note: visual mentions in the fine print or small text at the conclusion of the ad does not count as a mention.
Brand/loyalty	0.62	Ad makes a point to talk about a company’s reputation through mention of experience (example: more than 75 years), ranking (#1 trauma center), or public opinion (more people in your community trust us). Note: mention of “they [insurer/health system] know what to do” would not be coded as relevant.
Benefit appeals
Prescription drugs	0.84	Ad mentions access to prescription drugs benefit or a pharmacy benefit.
Nonmedical benefits	0.77	Ad mentions benefits to enrollees beyond medical care such as job assistance, childcare, and transportation.
Choice of doctor available	0.83	Ad mentions the opportunity to choose one’s doctor or presents visually or audibly a message that leaves the viewer with the impression that the plan includes the choice of doctor.
Access to specialists	0.65	Ad mentions or visualizes that the plan offers access to specialists without going through a primary care doctor or administrative approval. An ad that labels a health care provider as a specialist and talks about the plan or services would be coded as yes because this implies to the viewer that the plan offers access to specialists.
Wellness programs	0.56	Ad mentions a wellness program or coaching available to enrollees. Note: mention of non-specific supports to help you lead a healthy lifestyle would not be coded as a wellness program as these supports could take on various forms. General health insurance advocacy or help navigating benefits would also not count here.
ACA-policy related references
Financial assistance available/subsidies/tax credits available	0.84	Ad explicitly mentions financial assistance by way of a subsidy or tax credit. Note: plans that mention cash back to consumers or an enrollment bonus of sorts would not be coded as a mention.
Mention of “marketplace”	0.74	Ad explicitly, either audibly or visually, mentions a “Marketplace” for health insurance enrollment. Note: we are looking for references related to health insurance, and not marketplace for other consumer goods.
Mention of “government”	0.65	Ad explicitly, either audibly or visually, mentions government. Examples include “government-run health care” or “government requirements,” “government website,” or a government seal.
Mention of “ACA” or “Obamacare”	1.00	Ad explicitly, either audibly or visually, mentions the terms “Affordable Care Act,” “ACA,” or “Obamacare.”
Avoiding penalties	0.66	Ad explicitly mentions that enrollment in the plan will help the consumer to avoid a penalty. aNote: The individual mandate was repealed and took effect in 2019, so should not be part of health insurance advertising during this open enrollment period.
Lower cost plans cheaper/better than the ACA	1.00	Ad explicitly mentions a comparison between the plan advertised being cheaper than an ACA or Obamacare plan.

Note. ACA = Affordable Care Act; CHIP = Children’s Health Insurance Program; UPMC = University of Pittsburgh Medical Center.