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Actuarial Value

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These levels are based on an actuarial value (AV) of benefits provided without cost sharing. AV is a measure of EHB coverage estimated to be paid by the QHP issuer for a standard population, expressed in percentages. The higher the AV, the more the enrollee will pay in monthly premiums and the less he or she will pay in out-of-pocket costs. It is important to emphasize that AV is an average measure of generosity – the percentage of medical costs the plan will cover after premium payments.

Catastrophic - A catastrophic plan offers a level of coverage that does not meet a specific AV but must comply with the maximum out-of-pocket limit

Bronze - 60% AV (the QHP issuer pays, on average, 60% of the cost of EHB coverage)

Silver - 70% AV (the QHP issuer pays, on average, 70% of the cost of EHB coverage)

Gold - 80% AV (the QHP issuer pays, on average, 80% of the cost of EHB coverage)

Platinum - 90% AV (the QHP issuer pays, on average, 90% of the cost of EHB coverage)

Next Topic: Out of Pocket Limits

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*ExploreObamacare.com is not affiliated with any government agency. All information provided is for informational purposes only and no guarantee of the accuracy is hereby implied. The information was the product of researching the Affordable Care Act Bill and is subject to change.
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