What specific actuarial value must a gold health insurance plan meet according to the ACA?

What specific actuarial value must a gold health insurance plan meet according to the ACA?

• A. 80%
• B. 70%
• C. 90%
• D. 100%

Answer: (A)

The correct actuarial value for a gold health insurance plan, as outlined by the Affordable Care Act (ACA), is 80%. This means that, on average, a gold plan is designed to cover 80% of the healthcare costs for a standard population, while enrollees are responsible for the remaining 20% through out-of-pocket expenses. The ACA establishes a framework for four metal tiers of health plans (bronze, silver, gold, and platinum), each with a different actuarial value. Bronze plans cover about 60% of costs, silver plans approximately 70%, and platinum plans around 90%. The gold plan aims to strike a balance, offering more extensive coverage than silver and bronze plans, making it a suitable option for individuals who anticipate needing moderate to high healthcare services without facing the higher premiums associated with platinum plans. Thus, an 80% actuarial value is pivotal for categorizing a health insurance plan as "gold."

The correct actuarial value for a gold health insurance plan, as outlined by the Affordable Care Act (ACA), is 80%. This means that, on average, a gold plan is designed to cover 80% of the healthcare costs for a standard population, while enrollees are responsible for the remaining 20% through out-of-pocket expenses.

The ACA establishes a framework for four metal tiers of health plans (bronze, silver, gold, and platinum), each with a different actuarial value. Bronze plans cover about 60% of costs, silver plans approximately 70%, and platinum plans around 90%. The gold plan aims to strike a balance, offering more extensive coverage than silver and bronze plans, making it a suitable option for individuals who anticipate needing moderate to high healthcare services without facing the higher premiums associated with platinum plans. Thus, an 80% actuarial value is pivotal for categorizing a health insurance plan as "gold."