Affordable Small Business Group Health Insurance
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Standardization of California Available Plans
With the passage of the Affordable Care Act many of the limiting factors of health insurance have been removed. Metal Tiers have been instituted to help simplify the selection process of group health insurance options. ACA designates that all qualifying plans be one of four metals: Bronze, Silver, Gold and Platinum. Each is based on the average amount of healthcare costs the plan will cover shown as a percentage of what is covered by your insurance company and what is paid for by you. All insurers participating in the federal or a state healthcare exchange must offer , at minimum, Silver and Gold plans. All metal plans have a shared maximum out-of-pocket amount that you can be charged in any calendar year.
In addition, for those of you that are under 30 or meet the criteria for a hardship exemption, you can purchase a catastrophic plan that is compliant with ACA requirements.
Premiums charged for any of the qualifying metal plans may be based on:
- Your age
- Tobacco use
- Where you live – determined by rating area
- The number of family members enrolling with you
Under ACA, no one can be denied coverage or charged significantly higher premiums because of past health history (pre-existing conditions) or gender. There can be no look-back or waiting periods imposed. Policies are effective on issue. All coverage is renewable, if you choose to renew it. Plans can only be canceled for non-payment of premiums or fraud. The guaranteed issue provision applies to all non-grandfathered plans.