Ratio of insurance expenditures used on care as opposed to administrative or other costs. Under ACA insurance companies are required to issue rebates to consumers if too large a share of the expenditures are allocated to costs not directly associated with care (max of 15% for large group plans, max of 20% for individual or small group plans).

A term referring to the likelihood of individuals making different choices due to insurance coverage; usually refers to people over-using medical services.

The Affordable Care Act requires every health care exchange to offer at least two multi-state plans – one from a non-profit, and one which does not cover abortion (except as permitted by federal law). Plans are to be overseen by the Office of Personnel Management.