ARSD 20:06:56:01. Definitions

(1) "Actuarial value," a measure of the percentage of expected health care costs a health plan will cover for a standard population and can be considered a general summary measure of health plan generosity; (2) "Actuarial value calculator," used to determine the actuarial value of applicable plans. It is developed using a set of claims data weighted to reflect the standard population projected to enroll in the individual and small group markets for the identified year of enrollment; (3) "Base-benchmark plan," the plan that is selected by the state from the options described in 45 CFR §156.100(a), or a default benchmark plan, as described in 45 CFR §156.100(c), prior to any adjustments made pursuant to the benchmark standards described in 45 CFR §156.110; (4) "De minimis variation," is the allowable variation in the actuarial value of a health plan that does not result in a material difference in the true dollar value of the health plan is +/-2 percentage points; (5) "Essential health benefits benchmark plan," is the standardized set of essential health benefits that must be met by a qualified health plan; (6) "HHS," United States Department of Health and Human Services; (7) "Premium adjustment percentage," the percentage by which the average per capita premium for health insurance coverage for the preceding calendar year exceeds such average per capita premium for health insurance.