Summary Cost Data for Health Plans Available in Florida’s Exchange, 2014: Fact Sheet Page: 3 of 6
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Summary Cost Data for Health Plans Available in Florida's Exchange, 2014: Fact Sheet
Source: CRS analysis of data from Data.HealthCare.gov.
Notes: The listed premiums are pre-subsidy figures; they do not reflect the premium tax credits that will in
effect reduce these prices for many individuals with incomes that fall below 400% of the federal poverty level.
Differences between listed premiums may also be attributed to variables not considered in the table, such as
geographic rating areas within a state. Child-only plans are excluded.
a. A median is the middle value of an ordered sequence. For each median premium, half of the set of
premiums are above its value and half below it. This is in contrast to the arithmetic mean, an alternative
measure of central tendency, which is the sum of a set of values divided by the number of values. Median
premiums were drawn from an ordered list of premiums for all plans offered in all rating areas in the state.
b. Catastrophic plans are available only to individuals under the age of 30 and certain others who are exempt
from the ACA's individual mandate (regardless of age).
The premiums and cost-sharing amounts listed in these tables are based on all plans offered in the
state at the appropriate metal level (AV). Individuals may choose from plans within insurance
rating areas. Individuals in a specific rating area may have a more limited range of plans,
premiums, and cost-sharing options than those shown in these state-level tables.
Table 2.Annual Exchange Cost-Sharing Requirements for Individuals
Maximum Out-of-Pocket
Medical Deductible Expenses
Metal Level Min. Median Max Min. Median Max
Platinum $0 $850 $1,000 $1,000 $2,500 $2,500
Gold $0 $2,500 $3,000 $2,400 $5,000 $6,350
Silver $0 $5,000 $5,750 $3,950 $6,250 $6,350
Bronze $3,500 $6,000 $6,350 $6,250 $6,250 $6,350
Catastrophic $6,350 $6,350 $6,350 $6,350 $6,350 $6,350
Source: CRS analysis of data from Data.HealthCare.gov.
Notes: Some individuals with incomes below 250% of the federal poverty level may be eligible for cost-sharing
subsidies, which would have the effect of reducing the listed cost-sharing burdens.
ACA generally requires exchange plans to limit annual out-of-pocket (OOP) expenses to specific
levels. For 2014, the annual OOP limits for individual and family plans are $6,350 and $12,700,
respectively. Given these limits, exchange plans with lower actuarial values may use the OOP
limits to also establish deductible levels.
Just as an individual may consider premiums and cost-sharing when seeking insurance, a family
may likewise make such a comparison. For example, a family that either expects to use a high
volume of medical services or wants to assume less financial vulnerability to a large medical bill
may prefer to select a higher-tier plan with larger premiums in order to have less burdensome
cost-sharing requirements, such as a low deductible. Table 3 shows the range of premiums for
family insurance plans in the state for hypothetical families at selected ages, and Table 4 shows
the range of selected cost-sharing requirements for those plans.Congressional Research Service
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Summary Cost Data for Health Plans Available in Florida’s Exchange, 2014: Fact Sheet, report, July 29, 2014; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc805532/m1/3/: accessed April 24, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.