What is the minimum value requirement for a plan?

What is the minimum value requirement for a plan?

• A. 70% of covered costs; the employee pays the remaining 30%
• B. The plan must pay 60% of covered costs; the employee pays the remaining 40%
• C. 80% of covered costs; the employee pays the remaining 20%
• D. 50% of covered costs; the employee pays the remaining 50%

Answer: (B)

Minimum value is about how much of the cost of covered benefits the plan must pay for a typical enrollee. In ACA terms, a plan meets minimum value if it pays at least 60% of the costs of covered services (actuarial value), leaving about 40% for the employee to cover through deductibles, copays, and coinsurance. So the required threshold sits at 60% paid by the plan and 40% paid by the employee. Higher-value plans also satisfy minimum value, but anything below 60% would not meet the requirement.

Minimum value is about how much of the cost of covered benefits the plan must pay for a typical enrollee. In ACA terms, a plan meets minimum value if it pays at least 60% of the costs of covered services (actuarial value), leaving about 40% for the employee to cover through deductibles, copays, and coinsurance. So the required threshold sits at 60% paid by the plan and 40% paid by the employee. Higher-value plans also satisfy minimum value, but anything below 60% would not meet the requirement.