Silver Plan Cost-Sharing Options for 2015 Health Insurance
A recent report published by the Kaiser Family Foundation reviewed the main cost-sharing options in various health plans available through the federal marketplace based on data collected by Healthcare.gov.
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According to the research, standard silver plans are expected to have an actuarial value of 70%, with enrollees paying the other 30% through cost-sharing, including deductibles, copayments, and coinsurance. People earning incomes ≤150% of the federal poverty level (FPL) can enroll in a CSR94 plan, which has an actuarial value of 94%. Those earning between 150% and 200% of the FPL can enroll in a CSR87 plan where the actuarial value is 87%. Enrollees with incomes between 200% and 250% of the FPL can enroll in a CSR73 plan where the actuarial value is 73%.
According to the data, the CSR87 and CSR94 plan variants have much lower deductibles, with averages of $737 and $229, respectively, compared with deductibles averaging >$2000 for CSR73 and standard silver plans. Out-of-pocket limits for CSR87 and CSR94 plans average around $1692 and $881 compared to >$4000 for CS73 and the standard silver plan.
The upper limit for out-of-pocket expenses for the 2015 silver plan is $6600 for single coverage and $13,200 for family coverage. The maximum out-of-pocket limit for the CSR87 and CSR94 plan variants is $2250 for single coverage and $4500 for family coverage. For the CSR73 plan, it is $5200 for single coverage and $10,400 for family coverage.—Rosemarie Bodrucki
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