One of the challenges of choosing health insurance in an open enrollment period when the menu of choices is somewhat lengthy is avoiding dominated plans. A dominated plan is one where on all relevant to the decision maker characteristics it at best ties and typically loses to another option. Choosing a dominated plan means that you are choosing a plan that is objectively inferior to at least one other option. An inferior plan means the insurer will make more money from you compared to an optimal plan choice.
I will show an example below of Plan A being dominated by Plan B on a few characteristics:
Plan B beats Plan A on premium, deductible, coinsurance rate, maximum out of pocket and network. Plan A ties Plan B on PCP co-pay. A full domination plan analysis will probably look at more characteristics than those, but this is the short toy example of what to look for when thinking about a plan being dominated.
In the ACA, the creation of well defined, and mutually (or mostly mutually) exclusive metal bands would make unsubsidized dominated plans a rare event. From 2014-2017, subsidized dominated plans are easier to see as one could expect a company offer two Bronze plans priced significantly below the benchmark Silver plan with significantly different deductibles but otherwise identical cost sharing structures both be priced at zero for a particular subsidized buyer.
From 2018 to present, due to silver loading for CSR funding termination, dominated plan offerings are likely to be more common within a particular company in a particular region as gold plans are frequently priced underneath silver plans. In some regions, gold plans can have zero premiums after subsidies for large populations. As long as the benefit design is not too funky relative to silver and bronze plans, gold plans can readily dominate bronze and silver plans for subsidized buyers in certain regions.
So when you are looking for plans in either Medicare Advantage, Medicare Part D drug coverage or the ACA exchanges, look hard at dominated plans. And if you find one, avoid it.