Understanding Health Care Terms   

Our glossary of Health Insurance, Health Care, and Health Plan terms and definitions can help you understand your benefits and coverage, and help you to shop for a plan.

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    Actuarial Value 

    Actuarial value (AV) measures the average value of expected benefit costs in a health insurance plan. Health plans are grouped into four metal levels based on actuarial value: bronze, silver, gold and platinum. A bronze plan pays 60 percent of the cost of covered benefits. A silver plan pays 70 percent. A gold plan pays 80 percent. A platinum plan pays 90 percent of the cost of covered benefits. Premiums are lowest in a bronze plan, highest in a platinum plan. 


    Affordable Care Act 

    The Affordable Care Act (ACA) was signed into law on March 23, 2010. It aims to help make health insurance accessible and affordable for everyone. It is changing who can get health insurance, how they receive care, what it costs and who pays for it. 


    Affordable Coverage 

    The Affordable Care Act (ACA) defines “affordable coverage” for employer plans. Employer coverage is “affordable” if employee costs do not exceed certain limits. The employee share of the premium cannot be more than a set percentage of the household income. Employees may get a lower-cost health plan through the Marketplace if employer coverage is not affordable. 


    Aggregate Deductible 

    There are two types of deductibles: aggregate deductible and embedded deductible. In general terms, a deductible is the dollar amount you pay until health insurance kicks in to pay some (or all) of your costs. When you have an aggregate deductible, your deductible amount applies for the whole family. It can be met by one family member or multiple family members covered by the plan. 

    For example, with an aggregate deductible, one person with high medical costs could reach the deductible amount for the whole family and then the health plan will pay for all family members. This is different from an embedded deductible, which is set up with lower, single deductible amounts for each person covered. With an embedded deductible, each member of a family plan must meet their individual deductible amount before the health plan will pay for their medical costs. 

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