Insurance Exchange and Minimum Value Standard

Under the Affordable Care Act the employer sponsored health insurance plan sold to employees must meet a Minimum Value Standard.  An employer sponsored health plan meets the "minimum value standard" if the plans share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs (Section 36B (c)(2)(c)(ii) of the internal revenue code of 1986.  Health and Human Services rules must be utilized for determining minimum standard value.

Minimum value is calculated (HHS MV Calculator) by dividing the anticipated covered medical spending of essential health benefits (EHB) coverage (for the population covered by a typical self insured group plan) by the total anticipated allowed charges for EHB coverage for a typical self insured group health plan population. 

This Minimum Value Standard (actuarial value) measures the relative generosity of benefits covered by the health insurance plan.  Under the ACA Affordable Care Act a health insurance plans actuarial value (60% is minimum value standard) indicates the average share of medical spending that is paid by the plan, as opposed to being paid out of pocket by the consumer. 

So, we can see the actuarial values (60% is minimum value standard) are used to categorize insurance plans in to health benefit tiers.  See below:

Bronze = 60%  (this is the minimum value standard)

Silver = 70%

Gold = 80%

Platinum = 90%

Gold of course being more generous than bronze.  An employer group who purchases an insurance product through a work setting would need a plan that delivers a 60 percent contribution to the total share of medical spending.

    WATCH  FOR  US

Web site www.homecarepath.com

 

Twitter  https://twitter.com/seniorcareWI

 

Facebook https://www.facebook.com/pages/SENIOR-CARE-AT-HOME-CARE-PATH-COM/124865717538950?ref=hl

App  http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Blog  http://homecarepathseniorcare.blogspot.com/

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life