In 2014 and beyond, under the provisions of the Affordable Care Act, individual & fully insured small to medium sized group health insurance plans will have to fall within four categories referred to as Bronze, Silver, Gold and Platinum. These categories represent an actuarial valuation of how much financial exposure the policyholder has up to a maximum out-of-pocket financial exposure of $6350. It is a gross over simplification but for the average health insurance consumer, the closest I can come to explaining these "Metallic" plan categories is that Bronze represents 60% coverage, Silver equals 70% coverage, Gold equals 80% coverage and Platinum equals 90% coverage.
All of these plans, by law, must be guaranteed to be issued by the insurance carrier, cannot be subject to underwriting and must cover pre-existing conditions immediately with no lifetime limits on coverage. In addition, all plans must cover what are referred to as the Minimum Essential Benefits. These requirements range from covering a wide range of preventive care services at 100%, coverage for maternity, mental health & substance abuse along with a variety of other services including pediatric dental & vision to even educating women on how to nurse their babies (how the human race survived for thousands of years without the government providing for such training is a mystery to me).
Unfortunately, there really are no simple and concise ways to explain health insurance plans. Different state regulations also apply and each insurance carrier can design health insurance plans that fall within these four different "Metallic" categories that can vary widely in their appearance.
To make an informed choice for your health insurance as an individual or a business it is more important than ever that you seek out the advice of an experienced health insurance broker/consultant who understands the intricacies of the health insurance plans options and their associated costs that are available to you in your specific area.
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All of these plans, by law, must be guaranteed to be issued by the insurance carrier, cannot be subject to underwriting and must cover pre-existing conditions immediately with no lifetime limits on coverage. In addition, all plans must cover what are referred to as the Minimum Essential Benefits. These requirements range from covering a wide range of preventive care services at 100%, coverage for maternity, mental health & substance abuse along with a variety of other services including pediatric dental & vision to even educating women on how to nurse their babies (how the human race survived for thousands of years without the government providing for such training is a mystery to me).
Unfortunately, there really are no simple and concise ways to explain health insurance plans. Different state regulations also apply and each insurance carrier can design health insurance plans that fall within these four different "Metallic" categories that can vary widely in their appearance.
To make an informed choice for your health insurance as an individual or a business it is more important than ever that you seek out the advice of an experienced health insurance broker/consultant who understands the intricacies of the health insurance plans options and their associated costs that are available to you in your specific area.