A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Featured

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13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

Latest News & Topics

Latest News & Topics

Featured

Featured
Finalized federal rule reduces total duration of short-term health plans to 4 months
A finalized federal rule will impose new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – will limit STLDI plans to three-month terms, and to total duration – including renewals – of no more than four months.
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Silver plan

What is a Silver plan?

healthinsurance.org health insurance glossary

Under the Affordable Care Act, individual/family (self-purchased) and small group plans are classified by metal levels: Bronze, Silver, Gold, and Platinum.

The classification depends on the actuarial value (AV) of the plan, which measures the percentage of medical costs that the plan would cover for a standard population.

Silver plans have an actuarial value of about 70%, although there’s a small de minimus range allowed: Silver plan AV can range from 68% to 72% in the small group market, and from 70% to 72% in the individual/family market.1

But the ACA’s cost-sharing reductions (CSR, also called cost-sharing subsidies) are only available on Silver plans. If a person qualifies for CSR benefits and selects a Silver plan, the plan’s actuarial value will be increased to 73%, 87%, or 94%, depending on the person’s household income. This can essentially result in a Silver plan that provides more robust coverage than a Gold or even Platinum plan, depending on the enrollee’s income.

Silver plans play a particularly important role in the individual health insurance market. The ACA’s premium subsidies (premium tax credits) are based on the cost of the benchmark plan, which is defined as the second-lowest-cost Silver plan in a given area. (Subsidies can be used to offset the cost of any metal-level plan.)

How many marketplace enrollees have Silver plans?

Silver plans are by far the most popular metal level among marketplace enrollees. During the open enrollment period for 2023 health coverage, more than 8.9 million people enrolled in Silver plans, out of a total of 16.4 million marketplace enrollees (the next closest was Bronze coverage, selected by 5.3 million enrollees)2

Footnotes

  1. HHS Notice of Benefit and Payment Parameters for 2023 Final Rule Fact Sheet” Centers for Medicare and Medicaid Services. April 28, 2022. 
  2. 2023 Marketplace Open Enrollment Period Public Use Files” Centers for Medicare and Medicaid Services. March 2023. 
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