California Standardizes Healthcare Benefits for Its Insurance Marketplace
Feb. 14—California announced it has established standardized benefit plans, deductibles, and copayments for its insurance marketplace, or insurance exchange, as part of the Affordable Care Act.
Per federal requirements, consumers can choose from four varying levels of plans—bronze, silver, gold, and platinum. Households earning less than 250 percent of the federal poverty level (FPL) can receive financial help if they enroll in a silver plan; the less income they earn, the more financial assistance they can receive. For example, individuals earning between 150 to 250 percent of the FPL can expect to pay $20 to see their primary care physician, while those earning 100 to 150 percent would pay $4.
California’s approach to copays and deductibles for the mandated benefit levels may signal the approach that will be seen in other states.
Publication Date: Thursday, February 14, 2013