Actuarial Value

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Actuarial Value

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The percentage of total average costs for covered benefits that a plan will cover.

• If a plan has an actuarial value of 70% it means the plan is estimated to pay 70% of covered healthcare costs. You would be responsible for 30% of the costs.

Unfortunately, there are a number of situations where you could be responsible for a higher or lower percentage. A lot will have to do with the policy.

The metal levels (bronze, silver, gold and platinum ) are based off an actuarial value.

• Cost-sharing reductions can result in a person purchasing a silver plan with much improved actuarial value. A complicated subject but one that can greatly benefit people with lower income.

Related content

Qualified Health Plan

• Bronze, Silver, Gold and Platinum plans

Cost-Sharing Reductions