What term describes the average percentage of medical costs expected to be covered by a health plan over all enrolled individuals?

The term that describes the average percentage of medical costs expected to be covered by a health plan over all enrolled individuals is actuarial value. This concept reflects the overall adequacy of coverage that the health plan provides to its members.

Actuarial value is typically expressed as a percentage, indicating how much of the total expected healthcare costs for a standard population will be paid by the health insurance plan versus how much will be paid out-of-pocket by the individuals. For instance, a plan with an actuarial value of 80% would cover 80% of expected medical costs, leaving the remaining 20% for the enrollees to pay through copayments, deductibles, and coinsurance.

This metric is crucial for consumers who are evaluating health plans, as it helps them understand the level of financial protection the plan offers. The higher the actuarial value, the less cost-sharing the members will have to deal with.

Regarding the other options, while coverage ratio, premium rate, and benefit level relate to aspects of health insurance, they do not specifically define the average percentage of medical costs covered in the same manner as actuarial value does. Coverage ratio is not a standard term used in this context, premium rate pertains to the cost of obtaining coverage