Ignite Creation Date:
2025-12-25 @ 2:51 AM
Ignite Modification Date:
2025-12-26 @ 1:33 AM
Study NCT ID:
NCT07136233
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-08-22
First Post:
2025-08-08
Is NOT Gene Therapy:
False
Has Adverse Events:
False
Brief Title:
Impact of Benefit Inserts on Health Plan Selection and Utilization Among Renewing Covered California Members
Sponsor:
Covered California
Organization:
Study Overview
Official Title:
Evaluating the Impact of Educational Flyers Promoting $0 Deductibles and Lower Costs With Silver Plans on California Marketplace Plan Enrollment and Care Utilization
Status:
ACTIVE_NOT_RECRUITING
Status Verified Date:
2025-08
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The study aims to evaluate the impact of an informational flyer insert on health plan selection and health care utilization among Covered California renewing members during the 2025 plan year. The flyer highlights the enhanced Silver plan benefits, which were expanded in 2025 to include all enrollees, regardless of income level. Key benefits include $0 deductibles, lower monthly premiums, free preventive visits, and reduced costs for primary care, emergency care, and medications.
The main questions the study seeks to answer are:
* Does the informational flyer help overcome barriers that prevent consumers from switching to more beneficial plans?
* Does the flyer encourage current Silver Plan enrollees to increase health care utilization, such as preventive visits, primary care, and medication usage, by highlighting enhanced benefits like $0 deductible and lower costs?
To address these questions, researchers will compare outcomes between households that receive the flyer insert and those that do not. Covered California's administrative data will provide individual-level information on plan selection, while claims data will offer insights into healthcare utilization patterns. This approach will help determine the effectiveness of targeted communication in driving selection of more beneficial plan and improving healthcare utilization.
The main questions the study seeks to answer are:
* Does the informational flyer help overcome barriers that prevent consumers from switching to more beneficial plans?
* Does the flyer encourage current Silver Plan enrollees to increase health care utilization, such as preventive visits, primary care, and medication usage, by highlighting enhanced benefits like $0 deductible and lower costs?
To address these questions, researchers will compare outcomes between households that receive the flyer insert and those that do not. Covered California's administrative data will provide individual-level information on plan selection, while claims data will offer insights into healthcare utilization patterns. This approach will help determine the effectiveness of targeted communication in driving selection of more beneficial plan and improving healthcare utilization.
Detailed Description:
Background:
The Affordable Care Act (ACA) established health insurance marketplaces (commonly referred to as ACA marketplaces) to provide affordable insurance coverage. In addition to premium subsidies, administered through the form of advanced premium tax credits (APTCs), low-income consumers are eligible for reduced out-of-pocket costs when they enroll in a Silver plan through the ACA marketplaces. These ACA benefits, known as Cost-Sharing Reductions (CSRs), improve the plan generosity (through the form of lower copays and deductibles) while keeping premium costs at the level of a Silver plan. Traditionally, lower out-of-pocket costs are associated with higher premium payments, such as in the Platinum tier, whereas high out-of-pocket costs are paired with lower premiums, as in the Bronze tier. These CSR benefits are available for consumers who enroll in the Silver metal tier and have an income below 250 percent of the Federal Poverty Level (FPL).
California launched its own state-funded Cost-Sharing Reduction (CSR) program in 2024, increasing the benefit levels for those eligible for federally funded CSRs. These plans are referred to as "enhanced CSR plans." In the 2025 plan year, California expanded eligibility for enhanced CSR plans to all enrollees, regardless of income. This policy change improves affordability and accessibility by offering coverage comparable to Gold plans but with lower monthly premiums for all enrollees. Members already enrolled in Silver plans were automatically upgraded to the enhanced CSR plans, while those in other metal tiers (Bronze, Gold, or Platinum) had to take action to switch during the annual renewal period to benefit from these new plan designs. This study explores how additional communication in the form of an informational flyer insert about the new enhanced CSR plan benefits and their expanded eligibility may have helped overcome inertia, likely due to informational and awareness barriers, for renewing consumers.
Project Objective:
The primary objective of the study is to evaluate whether including an informational flyer insert with renewal notices affects consumer behavior in two key areas:
1. Enrollment in Enhanced CSR Plans: Assess whether members currently enrolled in other metal tiers are more likely to switch to the enhanced CSR plan when informed about the new benefits.
2. Health Care Utilization for Current Silver Plan Enrollees: Determine whether members already enrolled in Silver plans, who were newly eligible for enhanced silver benefits, increased their utilization of health care services after receiving the flyer insert which has information such as '$0 deductible', 'Lower monthly premiums', '$0 for preventative visits', 'lower costs for primary and emergency care visits', 'lower medication costs'.
This evaluation seeks to understand if targeted communication can effectively inform consumers about the availability of more affordable and generous health coverage options, thereby encouraging a shift towards plans that offer better value and accessibility.
The Affordable Care Act (ACA) established health insurance marketplaces (commonly referred to as ACA marketplaces) to provide affordable insurance coverage. In addition to premium subsidies, administered through the form of advanced premium tax credits (APTCs), low-income consumers are eligible for reduced out-of-pocket costs when they enroll in a Silver plan through the ACA marketplaces. These ACA benefits, known as Cost-Sharing Reductions (CSRs), improve the plan generosity (through the form of lower copays and deductibles) while keeping premium costs at the level of a Silver plan. Traditionally, lower out-of-pocket costs are associated with higher premium payments, such as in the Platinum tier, whereas high out-of-pocket costs are paired with lower premiums, as in the Bronze tier. These CSR benefits are available for consumers who enroll in the Silver metal tier and have an income below 250 percent of the Federal Poverty Level (FPL).
California launched its own state-funded Cost-Sharing Reduction (CSR) program in 2024, increasing the benefit levels for those eligible for federally funded CSRs. These plans are referred to as "enhanced CSR plans." In the 2025 plan year, California expanded eligibility for enhanced CSR plans to all enrollees, regardless of income. This policy change improves affordability and accessibility by offering coverage comparable to Gold plans but with lower monthly premiums for all enrollees. Members already enrolled in Silver plans were automatically upgraded to the enhanced CSR plans, while those in other metal tiers (Bronze, Gold, or Platinum) had to take action to switch during the annual renewal period to benefit from these new plan designs. This study explores how additional communication in the form of an informational flyer insert about the new enhanced CSR plan benefits and their expanded eligibility may have helped overcome inertia, likely due to informational and awareness barriers, for renewing consumers.
Project Objective:
The primary objective of the study is to evaluate whether including an informational flyer insert with renewal notices affects consumer behavior in two key areas:
1. Enrollment in Enhanced CSR Plans: Assess whether members currently enrolled in other metal tiers are more likely to switch to the enhanced CSR plan when informed about the new benefits.
2. Health Care Utilization for Current Silver Plan Enrollees: Determine whether members already enrolled in Silver plans, who were newly eligible for enhanced silver benefits, increased their utilization of health care services after receiving the flyer insert which has information such as '$0 deductible', 'Lower monthly premiums', '$0 for preventative visits', 'lower costs for primary and emergency care visits', 'lower medication costs'.
This evaluation seeks to understand if targeted communication can effectively inform consumers about the availability of more affordable and generous health coverage options, thereby encouraging a shift towards plans that offer better value and accessibility.
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?: