65. Under the Affordable Care Act, Insurers MUST offer plans within health insurance exchanges that meet distinct levels of coverage. What metal tier is REQUIRED to have an actuarial value of 70% with covered individuals paying 30% through deductibles, co-pays, and other cost sharing features?
Answer: D
The required metal tier under the Affordable Care Act with an actuarial value of 70% is the Silver Plan.
The Silver Plan is mandated to have an actuarial value of 70%, meaning that on average, the plan covers 70% of healthcare costs while the individual pays 30% through various cost-sharing mechanisms.
A) Bronze Plan.
The Bronze Plan has an actuarial value of approximately 60%, which means it covers about 60% of healthcare costs, requiring individuals to pay 40%. This does not meet the requirement of a 70% actuarial value as specified in the question.
B) Platinum Plan.
The Platinum Plan offers a higher actuarial value of around 90%, where the plan covers 90% of costs and individuals are responsible for only 10%. While it exceeds the requirement, it is not the correct answer since the question specifically asks for the tier with a 70% actuarial value.
C) Gold Plan.
The Gold Plan has an actuarial value of approximately 80%, meaning it covers 80% of healthcare costs with individuals paying 20%. Although it provides a higher coverage level than required, it still does not align with the 70% actuarial value specified in the question.
D) Silver Plan.
The Silver Plan is the correct answer as it is specifically required to have an actuarial value of 70%. This means it covers 70% of healthcare costs, aligning perfectly with the question's stipulation regarding the required tier.
Conclusion
The Silver Plan is the only option that meets the essential criterion of having a 70% actuarial value under the Affordable Care Act. The other options, Bronze, Gold, and Platinum, fall outside this requirement, either providing less or more coverage than stipulated, thus confirming that D) Silver Plan is the definitive correct answer.