Silver Cost Sharing Reductions in Practice

Hypothetical situation, anyone encountered this in real life, if so what was the outcome?





Client at 140% of poverty (94% CSR level). Client gets another job/increased income to 160% of poverty (if income stays the same for the rest of the year now eligible for 87% CSR level)



Plan originally enrolled in had $0 deductible, MOOP $600. (I am making these numbers up). We will call it Plan X-94.



Identical plan at 87% CSR has $0 deductible, MOOP $1800. We will call it Plan X-87.



Plan X with no CSR is $2500 ded/$5000 MOOP, 35% coinsurance, no copays.



Assume the client has met the $600 MOOP

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