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Modeling Effects of Enrollee Choice


Geof Hileman, FSA, MAAA


In health insurance marketplaces, prospective insured individuals and groups are able to choose from a range of available plans. This study uses health care encounter data to simulate the choices faced by health insurance shoppers under a variety of conditions and measures the simulated effect of increased consumer choice and consumer information on medical loss ratios and, as a consequence, insurer profitability.


Modeling Effects of Enrollee Choice

Model Marketplace Simulation Instructions


The researchers’ gratitude goes to those without whose efforts this project could not have come to fruition: the Project Oversight Group and others for their diligent work overseeing the analytical methods and results and reviewing and editing this report for accuracy and relevance.

Project Oversight Group members:
Jonathan Nehring, FSA, MAAA
Jingyi Su, FSA, MAAA
Tan Tan, FSA, MAAA

At the Society of Actuaries:
Achilles Natsis, FSA, MAAA
Erika Schulty

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