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Question 1 - Imagine a health insurance market with 100 people. In this market in Year 1, 40 people expect to have $0 in health expenses per year, 35 people expect to have $250 in health expenses per year, 12 people expect $5,000 in health expenses per year, 10 people expect $10,000 in health expenses and 2 people expect $25,000 in health expenses and 1 person expects $40,000 in health expenses over the entire year. Assume insurance covers 100% of medical expenses and premiums are equal to expected costs.
a) If everyone values "just having insurance" in Year 1 at $2500 how many people would change their decision?
b) If there is an individual mandate penalty in Year 1 of $695 per year for not having insurance in addition to the "just having insurance" value of $2,500 how many people would change their purchase decisions? What would be the expected Y2 premium?
Question 2 - Scenario: You are a family of 3 (2 adults, 1 child) with an income of $62,000 living in Westchester, NY, zip code 10532, and are interested in a health plan for the year 2018 and you want a Medical Plan Only (no adult dental). Please use the New York State of Health website, prior assignments and online resources to assist you in answering the following questions. (Note use the 2017 poverty guideline because the 2018 guideline has not yet been released)
a) How much would you pay per month if you wanted to enroll in MVP's gold plan (if there are multiple options select the least expensive)? Use OSCAR with a premium of $1533.66 as 2nd lowest cost plan.
b) You and your family are enrolled in the MVP gold plan. Assume during the year you utilize specialist services with costs of service of $800 in January, ED visits with a cost of $2,500 for one visit in April and 4 preferred brand drug prescriptions all from September to December. All of these services are used by you. Your family uses $0 in services during the year. What is the cost sharing (not premium) total for the year?