Maine Life Insurance Practice Exam

Question: 1 / 400

What does a small-group health plan vary rates based on?

Claims history alone

Demographics and coverage type

A small-group health plan varies rates based on demographics and coverage type for several reasons. In the context of health insurance, demographics typically involve factors such as age, gender, and the number of employees within the group. These factors can significantly affect the risk profile of the insured group, determining how likely they are to utilize health services and incur claims costs.

Additionally, the type of coverage chosen—like the benefits covered, cost-sharing provisions, and overall coverage levels—also influences the rates. For example, plans with lower deductibles and out-of-pocket costs might be priced higher than those with higher cost-sharing.

Together, these elements create a more nuanced rating structure that reflects the unique characteristics of the group and the expected medical expenses, allowing insurers to set more tailored and equitable premiums for small businesses.

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Duration of employment

Employer's financial stability

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