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Certified Public Accountant, New Jersey
Manny Forlenza CPA

Plan Types

There will be four types of insurance plans to choose from: Bronze, Silver, Gold, and Platinum. The more expensive the plan, the greater the portion of medical costs that will be covered. 

  • BRONZE: The insurance plan would pay 60% of covered health care costs. The enrollee would be responsible for paying 40% of the costs. Unless the individual qualifies for the catastrophic plan, this is the minimal insurance that meets the individual mandate. The cost of bronze-level insurance is used to determine whether insurance is affordable: the cost must not be greater than 8% of family income to be considered affordable.
  • SILVER: The insurance plan would pay 70% of covered health care costs. The enrollee, on average, would be responsible for paying 30% of the costs. This is also known as the Benchmark Plan that is used in determining an enrollee’s eligibility for insurance subsidies.
  • GOLD: The insurance plan would pay 80% of covered health care costs. The enrollee would be responsible for 20% of the costs.
  • PLATINUM: The insurance plan would pay 90% of covered health care costs. The enrollee would be responsible for 10% of the costs.

In addition to these four plan levels, catastrophic plans will offer essential health benefits, but with high deductibles. Only young adults under 30 and individuals exempted from the individual mandate because they cannot find affordable insurance are allowed to purchase catastrophic plans and be considered covered under the individual mandate.