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Biased Selection Defined

The phenomena whereby individuals or groups with atypical health risks disproportionately enroll in a specific health plan or type of health plan. Favorable selection occurs when a plan's enrollment predominantly consists of above-average health risks, while plans that disproportionately enroll individuals (and groups) of below-average health risks are said to experience adverse selection. Biased selection may be influenced by individual decisions in response to benefit design and plan characteristics as well as by insurer marketing and rating practices.

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Wed Feb 23

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