Prepare for the Business of Healthcare and Health Policy Test. Study with multiple choice questions and explanations to ace your exam!

Multiple Choice

Which statement best describes individual insurance compared to employer-sponsored insurance?

Individual health insurance generally carries higher premiums than employer-sponsored coverage because the pricing and risk are spread differently. In employer plans, a large, stable group negotiates with insurers, and a substantial portion of the premium is paid by the employer. This group approach, along with tax advantages on employer-provided coverage, helps keep the cost per person lower. In contrast, individual plans cover smaller, more variable pools, have higher administrative costs per enrollee, and face less bargaining power with networks, which tends to push premiums higher. Subsidies can reduce costs for some individuals, but that doesn’t change the underlying pattern that, on average, premiums are higher in the individual market. The other statements don’t fit: premiums aren’t inherently lower, individual plans aren’t inherently government-subsidized, and individuals aren’t limited to families.

Individual health insurance generally carries higher premiums than employer-sponsored coverage because the pricing and risk are spread differently. In employer plans, a large, stable group negotiates with insurers, and a substantial portion of the premium is paid by the employer. This group approach, along with tax advantages on employer-provided coverage, helps keep the cost per person lower. In contrast, individual plans cover smaller, more variable pools, have higher administrative costs per enrollee, and face less bargaining power with networks, which tends to push premiums higher. Subsidies can reduce costs for some individuals, but that doesn’t change the underlying pattern that, on average, premiums are higher in the individual market. The other statements don’t fit: premiums aren’t inherently lower, individual plans aren’t inherently government-subsidized, and individuals aren’t limited to families.