ASOP 50
(DETERMINING MINIMUM VALUE AND ACTUARIAL VALUE UNDER THE AFFORDABLE CARE ACT)
SECTION 2
(DEFINITIONS)

Section 2
Definitions

ASOP 50 | §2.0 | INTRO TO SECTION 2

The terms below are defined for use in this actuarial standard of practice.

ASOP 50 | §2.1 | ACTUARIAL VALUE (AV)

A measure of the proportion of total allowed medical costs for a specified population that the health insurance plan is contractually obligated to pay.

ASOP 50 | §2.2 | AV CALCULATOR (AVC)

Data and methodology released or approved by Health and Human Services (HHS) that is used to determine the AV of a health insurance plan.

ASOP 50 | §2.3 | AVC-AV

The AV calculated using the AVC, including any adjustments for nonstandard plan designs.

ASOP 50 | §2.4 | ESSENTIAL HEALTH BENEFITS (EHBS)

The specific items and services that the ACA requires issuers to cover in benefit plans offered in the individual and small group markets. EHBs must include any benefit defined by the Secretary of Health and Human Services. In addition, some EHBs may be defined by individual states.

ASOP 50 | §2.5 | HEALTH INSURANCE PLAN

A contract or other financial arrangement providing hospital, medical, prescription drug, dental, or vision benefits, including a self-insured employer plan.

ASOP 50 | §2.6 | MINIMUM VALUE (MV) REQUIREMENTS

The minimum required AV for certain employersponsored health insurance plans, as defined by regulations issued pursuant to the ACA.

ASOP 50 | §2.7 | MV CALCULATOR (MVC)

Data and methodology released by HHS that is used to determine whether the MV requirement is met.

ASOP 50 | §2.8 | MVC-AV

The AV calculated using the MVC, including any adjustments for nonstandard plan designs.

ASOP 50 | §2.9 | NON-STANDARD PLAN DESIGNS

Plan designs that include benefits not reflected in the AVC or MVC.