Rules of Operation for the RAND Health Insurance Study

by Lorraine A. Clasquin, Marie E. Brown

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Describes the concepts and operations for HIS, a study to determine the effects of alternative health insurance plans upon the demand for medical services and the health status of the population. As part of the study a selected group of families are enrolled in health insurance plans operated by the HIS. This report outlines definitions of family unit, income, and accounting period as they relate to these insurance plans. (1) Family unit means family head and individuals residing with head either married to or, if under 18, related to or financially dependent upon head. (2) Income is defined as gross income reported on tax returns. (3) Accounting period is one year. A unique feature of the plans is that out-of-pocket expenditures for medical care are given an upper bound called the "maximum dollar expenditure" which is calculated as 5, 10, or 15 percent of income, depending on the plan in which enrolled.

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