Claw Back Calculation

[Tkruger]

The risk of underreporting income is somewhat limited. I mean what happens when the million dollar claim is paid but the guy should have paid his full deductible. How is that figured I to overall pricing?

Over 400% FPL client is fully responsible for the costs of the plan. Said plan has a MOOP. Said client would be on the hook for the full premium of the plan.

However if the client receives a reduced deductible and MOOP I'm not sure how that would be handled. If fraud can be proven I'm sure that there is a penalty that would be imposed.