Insurance · Medicare, Medicaid, and ACA

What are 'metal tiers' in ACA marketplace plans?

Correct answer

Bronze, Silver, Gold, and Platinum tiers indicating the plan's actuarial value (the percentage of healthcare costs the plan covers on average) — 60%, 70%, 80%, 90% respectively

  1. A Required precious metal investments
  2. B Bronze, Silver, Gold, and Platinum tiers indicating the plan's actuarial value (the percentage of healthcare costs the plan covers on average) — 60%, 70%, 80%, 90% respectively
  3. C Brand names
  4. D Annual fees

Why this is the answer

ACA marketplace plans are organized into four metal tiers based on actuarial value (AV) — the percentage of total healthcare costs the plan covers on average for a typical population. Bronze: ~60% AV (insurer pays 60%, members pay 40% through deductibles, copays, co-insurance); Silver: ~70% AV; Gold: ~80% AV; Platinum: ~90% AV. Higher metal tiers have higher premiums but lower cost-sharing. Catastrophic plans exist for those under 30 or with hardship exemptions, with very high deductibles. Silver plans qualify for cost-sharing reductions for households earning 100-250% of federal poverty level, which can effectively boost Silver to Gold or Platinum levels of coverage at Silver premium prices. The tier system helps consumers compare plans without needing actuarial expertise.
Source: NAIC Model Outline, Metal Tiers

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