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The Oxlo Individual and Small Group Health Insurance and Exchange Integration Solutions Blog

Normalize The Health Insurance Plan Data of Your Competitors

Posted by Andrew Day on Mon, Sep 19, 2011 @ 05:28 PM

Normalizing Health Insurance Plan Data

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Insurance companies post their health insurance plan data online in order to make the buying experience simpler for their customers.  Allowing the customer to easily navigate a website and find a plan that best suits their needs has become a necessity in the individual health insurance market.

However, insurers often use differing terminology to define similar coverage. This makes apples to apples comparisons difficult. 

If the data is normalized through the application of business rules, plans can be placed side by side for straightforward and meaningful comparisons. 

Rate Convert all Rates to a Monthly Rate
Deductible Fairly Standard
Is it an HSA? Simple Yes or No
Coinsurance Change all percentages to what is covered by the company
Out of Pocket Limit Display Out of Pocket Limit and what it would be if deductible is added (unless deductible is included)
Office Visit Cost Change all percentages to what is covered by the company
Maternity Coverage Change all percentages to what is covered by the company
Lifetime Max Convert values to use the same terminology and format
Prescriptions  
     Tiers How Generic Brand, Brand Name, Non-Formulary, and Specialty drugs are covered.  Separated, and with the same verbiage
     Annual Max Convert values to use the same terminology and format
     Deductible Fairly Standard
     Category Either Comprehensive, Generic/Limited Brands, or Not Covered

Better yet, use a data service that provides good clean normalized individual health insurance plan data out of the box and forget about the heavy lifting.

Tags: Health Insurance