A plan meets the minimum value (MV) requirement if it has an actuarial value of at least 60%. This means that the plan pays for at least 60% of the total cost of covered benefits. The ACA requires Individual and Family Plans (IFP) and Small Group plans to adopt metal tiers, according to their actuarial value, as follows:
| Metal Tier Name | Actuarial Value |
|---|---|
| Platinum | Plan pays 90% of the costs for covered benefits in-network (Higher premiums, lower out-of-pocket costs) |
| Gold | Plan pays 80% of the costs for covered benefits in-network |
| Silver | Plan pays 70% of the costs for covered benefits in-network |
| Bronze | Plan pays 60% of the costs for covered benefits in-network (lower premiums, higher out-of-pocket costs) |
Actuarial Value: represents the percentage of total average costs for covered benefits that a health plan will pay. For example, a plan with an actuarial value of 60% means that, on average, the plan will cover 60% of healthcare expenses for a standard population, while the insured individuals will be responsible for the remaining 40% through deductibles, copayments, and coinsurance. Actuarial value helps consumers compare different health insurance plans based on the share of healthcare costs covered by the insurer.