The Four  Metal Levels, Bronze 60, Silver 70 (Enhanced Silver 73, 87, 94), Gold 80 & Platinum 90 

are based on Expected Claims Payment – actuarial value (AV).   This is one way Health Care Reform hopes to make shopping and comparing easier.   So, if you get a lower priced plan with less or fewer benefits, co-pays, deductibles you simply pay more when you have a claim.  Don’t worry, there is a stop loss – maximum out of pocket OOP, of say $7k so that you won’t break the bank.  All plans cover the 10 essential benefits.

2020 Metal Level Chart

Do you think your medical bills will be higher or lower than average for your age & zip code?

Expected  Payout (AV)  MLR Medical Loss Ratio      Bronze 60%    Click here for Enhanced Silver 70% – 94%     Gold 80%     Platinum  90%

What are the four metal levels?    
Understanding Health Care Costs
How to find plan that fits budget

Covered CA Certified Agent

Covered CA Certified Agent  
No extra charge for complementary assistance 
Appoint us as your broker  

Set Consultation Meeting via Phone, Skype or Face to Face 

Please get a proposal first, including subsidy calculation
Preliminary 2020 Quotes 

Video on how great agents are

Instant complementary quotes & subsidy calculation
Guaranteed Issue - No Pre X Clause - 
Quote & Subsidy Calculation -

No charge for our complementary services

Get a free instant quote now,

including the calculation of the  Cost Sharing Reductions in the Enhanced Silver 73-94% and subsidies – advance premium tax credit, if you qualify based on your income & Federal Poverty Level (Chart).

When you appoint us as Covered CA agent we can assist, advise and research for you, at NO ADDITIONAL charge.  Here’s the instructions.

Resources & Links

Covered CA on Metal Levels 

2017 Plan Booklet – Metal Tiers

One chart for Metal Levels and Enhanced Silver Cost Share Reductions

Covered CA now allows different metal levels for each member of family – Learn More CA Health Line 8.15.2016 * Insure Me Kevin.com 8.2.2016

♦  Detail on Molina Website

 

Compare Hospitals Outcomes (California Choice – Web MD Tool)

CMS said it will enforce the Affordable Care Act’s cap on annual out-of-pocket health care spending for individuals, regardless of whether consumers have an individual or family health plan.  the rule capped maximum out-of-pocket costs at $6,850 for individual plans and $13,700 for family plans annually.  Learn More⇒  Our Rx Page  ♦ Modern Health Care 9.15.2015 ♦  Final Market Rules 45 CFR Parts 144, 147, 153, 154, 155, 156 and 158

Bronze – Co Insurance after Deductible?

Insure Me Kevin.com

Covering Costs of High Deductible Plan?

Insure Me Kevin.com

More detail on Metal Tiers (Covered CA Agent Training)

What are Covered California standard benefit designs?

Health insurance plans must follow Covered California’s standard benefit designs.  With standardized benefits, consumers can accurately compare health insurance plans, because the benefits are the same for all plans offered in the Covered California marketplace. Additionally,  standardizing benefits ensures that the selected health insurance plans define what the consumers get and limit the consumer’s out-of-pocket costs by type of service. There is also a Catastrophic level,   (high deductible) that one can qualify for, if they are under 30 or the premium is unaffordable as being more than 8% of income.  Open Congress.org   Blue Cross Blue Shield    Blue Shield Catastrophic plan        Email us for rates.  [email protected]  

AB 639 (Chaptered) would Prohibit any [Insurance] product from being offered other than those with a standardized product design [metal level]  in the family  market.   Sounds like what we have with Medi Gap policies. Get the most recent status at http://leginfo.legislature.ca.gov/

I agree it will stifle innovation, so do you want same o same o or to be able to get a plan that fits your needs.  On the other hand isn’t it just a mathematical calculation to see what the actuarial value and essential benefits  is?    Get a FREE quote for Medical Coverage.   Term Life Insurance

sb639.senate.8.6.2013.analysis

8 comments on “Metal Levels – Platinum, Gold, Bronze – Silver & Enhanced

  1. I heard some comment on the news about healthcare… The guy said something about Obamacare and how you’re responsible for 7500.00 deductible and how that’s not good…

    • The news reporter is talking about Bronze plan, see above chart for details.

      Subsidies, deductibles and co pays are mainly based on Siver and Enhanced Silver see above.

      With all the court cases going on, the silver rates were increased as the government doesn’t have to pay the enhanced silver extra cost, thus Bronze plan for many of those earning less than say $30k for a single might be $1 or still very little.

      See icon above – three easy steps and get a quote and subsidy calculation.

      Please note also that there is no free lunch. Insurance rates are a function of what the insurance companies pay in your medical bills. See also medical loss ratio and why premiums are increasing.

      Check out this article in the San Luis Obispo Tribune 1.25.2019 on lack of choice and the special low rates going to those who earn between say $17 to 25k for a single, not those who make a 1/2 decent living.

Leave a Reply

Your email address will not be published.

wp-puzzle.com logo