Metal Tier definition

Metal Tier means a category of health plan— Catastrophic (Minimum Coverage). Bronze, Silver, Gold, Platinum — based on the percentage the plan pays of the average overall cost of providing essential health benefits to members. Catastrophic or Minimum Coverage does not cover any benefits other than three primary care visits per year before the deductible is met. The percentages the plans will spend, on average, are 60% (Bronze), 70% (Silver), 80% (Gold), and 90% (Platinum).
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Metal Tier means a level of coverage described in paragraph 1.26.
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Metal Tier means the level of coverage, in relation to actuarial value, as defined by the ACA and the US Department of Health and Human Services (HHS).
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Examples of Metal Tier in a sentence

  • Step 1: Set Metal Tier The user enters the desired metal tier for the calculation, and the AV Calculator selects the corresponding continuance tables for use in all remaining steps of the calculation.

  • To ensure that the correct continuance table is used for these plans, the Desired Metal Tier depends on the AV level of the variation.

  • Step 9: Calculate AV and Corresponding Metal Tier In the final step, the AV Calculator computes the final AV amount, classifies the plan by metal tier, and determines whether the metal tier matches the desired metal tier input by the user.

  • Metal TierThe Level of Coverage selected for the plan in the Plans & Benefits Template is mapped to the Desired Metal Tier in the AVC.

  • The Desired Metal Tier must be set to Bronze for expanded bronze plans.

  • Note that such adjustments may vary at the plan level and by Metal Tier, but not by rating region.

  • Administrative Expense and Profit values may not vary by plan level, Metal Tier, or rating region.

  • The three options are Issuer Bundle, Metal Tier Bundle, and Single Plan option.

  • The Desired Metal Tier for silver plan variances is set equal to Silver for the 73 percent variation, Gold for the 87 percent variation, and Platinum for the 94 percent variation.

  • Percent Change in Average Marketplace Premiums by Metal Tier, 2018-2023.

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