What Do the Bronze, Silver, Gold and Platinum designations mean?

All major medical health insurance plans for individuals and small employers will be assigned a bronze, silver, gold and platinum benefit level.  A Catastrophic option will also be available to those under the age of 30.

These new Catastrophic, bronze, silver, gold and platinum benefit levels actually refer to a plan’s actuarial value level… or “AV.”

You’re probably wondering, What is actuarial value?

The easiest way to explain it is to say that it is the percentage of total average costs for the benefits a plan covers within a given year.

So, a plan with a 70% actuarial value would typically cover 70% of the costs and the customer would typically be responsible for 30% of the costs after the plan’s out of pocket expenses have been met.

The different “AVs” have metallic designations:

  • A bronze plan is 60 percent
  • A silver plan is 70 percent
  • A gold plan is 80 percent
  • A platinum plan is 90 percent

Insurers may also offer catastrophic-only coverage to eligible individuals under the age of 30, which would have higher cost-sharing than the standard Metallic plans.

“Metal levels” are designed to allow consumers to compare plans with similar levels of coverage, based on monthly premiums, provider networks, and other factors with the goal of helping consumers make more informed decisions. The graphic below also helps explain these metallic levels:

 

 

Metalic Levels