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Zane Benefits Publishes New Information on Metallic Tiers of Coverage

Park City, Utah (PRWEB) September 06, 2013

Today, Zane Benefits, the number one online small business health benefits solution, published new information on metallic tiers of coverage.

According to Zane Benefits’ website, beginning in 2014, the Affordable Care Act will require health insurance plans to provide insurance plans by four standard levels of coverage. These four levels are called "metallic tiers" of coverage.

The different tiers (levels) include:


As the metal category increases, so does the percent of medical expenses that a health plan will cover, or the actuarial values.

The actuarial value of a plan is basically the percentage of costs a health plan covers in relation to how much the enrollee is expected to pay.

For example, an enrollee in a silver plan, which has a 70% actuarial value, would be expected to pay 30% of expected medical expenses - such as deductibles, co-payments, and coinsurance. The remaining 70% would be paid by the insurance company.

Because the measurement of an actuarial value is based on a standard population, the cost-sharing structure could vary from one plan to another.One plan might have a higher deductible, but a lower coinsurance to compensate for it to attain the desired actuarial value.

All enrollees of the same tiered plan should pay around the same out of pocket costs. But the way in which they pay this out of pocket amount will vary by plan.

The actuarial values of each plan:

Bronze plan 60%

Silver plan 70%

Gold plan 80%

Platinum plan 90%


Source: PRWeb
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