How does coinsurance work, and what are the coinsurance requirements for the standard health benefits plans?
“Coinsurance” is a term used to express the promise by the carrier to share, on a percentage basis, payment for allowed charges for covered health care services with the covered person. The standard small employer Plans A through E have specified coinsurance requirements, but the actual coinsurance amount may vary depending on whether the plan is offered with or without a network feature. That is, when the plan is offered without a network (a plain indemnity plan), the coinsurance is specified as follows: for Plan A, the carrier pays 80% of allowed hospital charges for covered services, and 50% of allowed charges for all other covered services; for Plan B, the carrier pays 60% of allowed charges for covered services; for Plan C, the carrier pays 70% of allowed charges for covered services; for Plan D, the carrier pays 80% of allowed charges for covered services; and, for Plan E, the carrier pays 90% of allowed charges for covered services. When the standard plans are offered with a net
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