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Rate Variations

Questions answered

Age Rating Standards

  • Health insurance issuers are not allowed to charge an older adult more than three times the rate of a 21-year old.
  • States can establish age curve or default to federal age curve
  • Federal age bands:
    • 0-20
    • One-year bands between 21-63
    • 64 and older

Family Rating Standards

  • Family members included in rating:
    • 1 or 2 parents
    • Up to 3 family members under the age of 21
    • Dependent children 21 and older

Family premiums are based on the premiums for each family member, including each family member’s age and tobacco use.

The total family premium includes premiums for up to three children under the age of 21 and per-member rates for dependent children 21 and older.

Geographic Rating Standards

  • Premiums may reflect geographic rating areas in the state
  • Rating area is:
  •      Home address for Individual Market coverage
  •      Employer’s primary place of business in the state, for small group coverage

Tobacco Rating Standards

  • Health Insurance issuers cannot charge an individual who uses tobacco products more than 1.5 times the non-tobacco user’s rate
  • Tobacco rating can vary based on age (e.g., 1.2:1 for those under 35)
  • For small employers - covered individuals will be able to avoid the tobacco surcharge by participating in a wellness program

The rating variation permitted for tobacco use can only be applied to the portion of the premium attributed to the individual family member. Only the portion of the familiy members premium that uses tobacco will be affected—the portion of the premium for other family members will not be affected..

Next Topic: ObamaCare Plan Costs

Agents and Brokers are required to be trained to assist consumers with the application and decision making process. Using an Agent to enroll in a ObamaCare Health Plan will be the primary choice of many americans. After all agents have the inside track on companies and their promptness to handle claims and pay benefits in atimely fashion.

Our Agents are available 7 days a week.

We offer a free consultation which entails speaking one on one with a knowledgable Agent that has been state licensed and trained to answer your questions.

Next Topic: Coverage Basics

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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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