Table 2.
Cost-sharing Parameters for Firm and Simulation Plans
| Firm | Simulations | |||
|---|---|---|---|---|
| Basic | Enhanced | Bronze | Platinum | |
|
|
||||
| Deductible | 500 | 300 | 4500 | $0 |
| Coinsurance | 20% | 10% | 20% | 20% |
| OOP Max | 4750 | 2600 | 6500 | 1500 |
| Drug copay | Generic = $10 Brand=$5 | Generic = $10 Brand=$5 | Included in medical deductible, coinsurance, OOP max | |
Notes: Table shows cost-sharing parameters for plan options at the firm and for plan options in the Marketplace simulations. Firm parameters are used to create fij (OOP) for estimation of the choice model, simulation parameters are used to create fij (OOP) for Bronze and Platinum plans in the simulations. Under all plans, consumers pay the full cost of care up to the deductible, then they pay the coinsurance rate up to the out-of-pocket max. Beyond the out-of-pocket max, the consumer pays nothing. For the firm plans, drug coverage is not part of the price schedule, but coverage is identical in the two plans. For the simulations, drug spending is included with other medical spending in the non-linear price schedule. In the firm plans, ER visits and preventive visits are free of charge, but these visits make up only a small portion of total medical expenditures, so they considered to be priced with other medical spending.