Validation Methodology

Status: Active. Last updated April 12, 2026. Purpose: Repeatable process for validating AskFlorence pricing accuracy per state, per plan year.

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Why We Validate

AskFlorence calculates subsidized health insurance prices from multiple data sources and formulas. Errors in any component (premiums, SLCSP, FPL values, contribution brackets, CSR cost-sharing) produce wrong prices shown to consumers. Validation catches these errors before they reach users.

When to Validate

• New state onboarded - full validation before launch
• Annual plan year refresh - re-validate when new year's data is loaded
• Formula change - when IRS contribution brackets, FPL values, or CSR rules change
• After code changes to subsidy calculation, plan search, or eligibility routing

Validation Sources (ranked by authority)

Source	Authority	Coverage	Limitations
State marketplace (NYSOH, Covered CA)	Highest	State-specific, includes state programs	May be down, requires manual entry
Licensed broker	High	Real enrollment experience	Manual, time-consuming
KFF Subsidy Calculator	High	All states, independent	Doesn't show plan-level detail, just APTC
CMS API (federal states)	High	30 federal states	Doesn't cover SBE states
Issuer SBC documents	High	Plan-specific cost-sharing	Per-plan, not aggregated
Our own cross-source validation	Medium	Catches data pipeline errors	Circular if formula is wrong

Scenario Design

Every state validation must cover these categories:

Income Tiers

Category	FPL Range	What to Verify
Medicaid threshold	Below 138%	Medicaid routing, adjustment logic for denied applicants
CSR 94%	138-150%	$0 or near-$0 deductible, lowest copays, highest APTC
CSR 87%	150-200%	Moderate deductible reduction, reduced copays
CSR 73%	200-250%	Slight deductible reduction
APTC only	250-400%	Standard cost-sharing, APTC still applies
No subsidy	Above 400%	Full sticker price, no APTC (post-IRA cliff)

Household Compositions

Type	What to Verify
Single adult	Base case
Married couple, no kids	Couple tier multiplier, 2-adult SLCSP
Single parent + children	1-adult premium, children to CHP?, FPL household size
Married couple + children	2-adult premium, children to CHP?, FPL household size
Older adults (55+)	Age rating (federal states) or community rating (NY)

Geographic Coverage

Type	What to Verify
Multiple rating regions	Different SLCSP per region
Multiple counties in same region	Same premiums, different plan availability
Border/edge zip codes	Correct county/region assignment

State-Specific Programs

Program	States	What to Verify
Essential Plan	NY	EP routing, tier assignment, EP/QHP boundary
CAPS/CAPC	CA	State premium subsidy on top of federal APTC
Medicaid expansion	All	Threshold calculation, auto-adjustment
State CSR enhancements	NY (diabetes, pregnancy)	Additional cost-sharing reductions

What to Compare

For each scenario, record and compare:

Field	Our Value	KFF / State / Broker Value	Acceptable Variance
FPL %	calculated	calculated	$0 (must match exactly)
APTC	calculated	from source	Within $5/month
CSR tier	94/87/73/none	from source	Must match exactly
SLCSP (individual)	from DB	from state data	Within $1
Household premium	calculated	from source	Within $2
Deductible (CSR-adjusted)	from DB	from SBC/state	Must match exactly for standard plans
MOOP (CSR-adjusted)	from DB	from SBC/state	Must match exactly for standard plans
Key copays	from DB	from SBC	Must match for standard plans

Running Validation

Automated Script

Each state has a validation script at scripts/validation/{state}-validation-scenarios.js.

# Start dev server
npm run dev

# Run NY validation (15 scenarios)
node scripts/validation/ny-validation-scenarios.js

# Output goes to stdout — copy to validation doc

Manual KFF Comparison

1. Go to kff.org/interactive/subsidy-calculator
2. Enter: State, Zip, Income, # Adults, # Children, Ages
3. Record: APTC amount, SLCSP
4. Compare against our script output

Broker Validation

Share the scenario output with a licensed broker. Key scenarios to prioritize:

• Medicaid-adjusted cases (KFF just says "Medicaid eligible")
• State program boundaries (EP threshold in NY, CAPS in CA)
• Non-standard plan cost-sharing

Documentation

Results are stored in docs/validation/{state}-{year}.md with:

• Test parameters for each scenario
• Our calculated values
• Comparison source values
• Variance analysis
• Pass/fail determination
• Date validated and by whom

Re-validation Schedule

Trigger	Scope	Timeline
New plan year data loaded	Full re-run all scenarios	Within 1 week of data load
IRS bracket update	APTC scenarios only	Within 1 week of publication
FPL update	All scenarios (FPL% changes)	Within 1 week of publication
Code change to subsidy calc	Affected scenarios	Before merge
Quarterly spot-check	3-5 scenarios per state	Quarterly