Health Insurance Contract Analysis (2019: Corporate, CA, MI)

<br>These data include PDF files of 1496 health insurance contracts from the year 2019 in the United States. They come from 40 corporations [435 self-insured plans using third party administrators (TPAs)] and health insurance contracts from the individual, small group, and large group markets sold in the states of CA (852 plans) and MI (209 plans). The Excel spreadsheet is our coding sheet for all of these contracts analyzing transgender health care coverage options. <br><br>We drew these contracts from AXIACI from Leverage Global Consulting, a proprietary database that contains insurance plan offerings and coverage from private and public insurance market segments. Our use of the proprietary database for the purposes of public policy research and analysis in health insurance is governed by a data use agreement between Leverage and Professor Anna Kirkland.<br><br>We use the term “contract” to mean the Summary Plan Documents (SPD), which is the roughly 100-200 page document that an individual gets from their health insurance company describing coverage and exclusions. These are the documents contained here. Other documents include the Member Handbook, Certificate of Coverage, Summary of Benefits and Coverage, Subscribers Contract, medical policies, and drug formulary, all of which are distinct and differently regulated documents. <br><br><br>

本数据集包含2019年美国1496份健康保险合同的PDF文件。这些合同源自40家企业[其中435份为使用第三方管理机构（TPAs）的自保计划]，以及在加利福尼亚州（CA，852份计划）和密歇根州（MI，209份计划）发售的个人市场、小型团体市场与大型团体市场健康保险合同。附带的Excel电子表格为本研究的编码表，用于分析所有上述合同中的跨性别医疗保障覆盖方案。

本数据集的合同源自杠杆全球咨询公司（Leverage Global Consulting）旗下的AXIACI专有数据库，该数据库收录了私人与公共保险市场板块的保险产品供给与保障范围信息。我们基于该专有数据库开展健康保险领域的公共政策研究与分析，其使用受杠杆全球咨询公司与安娜·柯克兰教授签署的数据使用协议约束。

本次研究中所提及的“合同”特指计划摘要文件（SPD），即参保人从健康保险公司获取的、篇幅约100至200页的文档，用于说明保障范围与除外责任。本数据集即收录此类文档。其余相关文件还包括会员手册、保障凭证、福利与保障摘要、投保人合同、医疗政策以及药品处方集，这些文件各自独立且受不同监管规则约束。