Health Insurance Cost Sharing

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Chapters in this video

  1. 0:00 Premiums and Cost Sharing
  2. 1:57 Deductibles, Copayments, Coinsurance
  3. 3:05 $1,000 Allowed Amount Walkthrough
  4. 3:46 Allowed Amounts and URC/UCR
  5. 4:27 Out-of-Pocket Versus Benefit Maximums
  6. 5:37 Health Savings Account Eligibility
  7. 6:28 Rapid-Fire Cost-Sharing Recap

What this video covers

  • How gross premiums, net premiums, and employer contributions affect what a member pays to keep coverage in force
  • How a deductible differs from a copayment and coinsurance
  • How to calculate a member’s share of a $1,000 covered bill with a remaining deductible and coinsurance
  • How allowed amounts, network status, and usual, reasonable, and customary (URC) or usual, customary, and reasonable (UCR) benchmarks affect costs
  • What generally counts toward an out-of-pocket maximum, and how it differs from a benefit maximum
  • The conditions for making new Health Savings Account (HSA) contributions, including the role of Internal Revenue Service (IRS) rules
  • Why losing eligibility for new HSA contributions does not by itself end account ownership or prevent qualified withdrawals

Read the full lesson, free

This video's complete written lesson is free to read in the CertFuel app, no signup wall. The complete Life and Health course also includes adaptive practice questions and spaced-repetition flashcards, available in Free Beta.

Read the Free Lesson → free · no signup wall