Metal Plans for Obamacare

The New Healthcare Marketplace continues to move in record speed, as the government races to meet the October 1st deadline. It remains to be seen if Obamacare will become a reality, if the individual mandate gets delayed another year, or if the Republicans really believe they can shut down the government by not funding the law. What hangs in the balance is the potential legacy of the current president and the hopes of millions of Americans who don’t have health insurance and need coverage.

If the New Marketplace is available October 1st, the plan designs will resemble the periodic table (remember your 8th grade science class); Bronze, Silver, Gold, and Platinum. In this new market, a consumer can purchase the health insurance product of choice either with our without a government subsidy. Government subsidies are at the heart of Obamacare and creates the most contention in political circles.

All health insurers who agree to participate in each state, must offer the same benefits in the metal class. Carriers will now compete based upon price, networks, drug card formularies and consumer familiarity. At some point in the future, the government could issue a Star Rating similar to those offered in the Medicare Advantage market which provides consumer awareness of the differences in vendors.

It is important to understand the metal tiers. Small group policies will change in 2014 to reflect the new government standards. In essence, all small group plans must resemble a bronze or gold plan. Depending upon your current benefit structure, your group plans may change dramatically in 2014 as well as pricing.


Burman S. Clark

Burman S. Clark, RHU, CSA is the President of Muneris Benefits and a licensed insurance broker and consultant. His independent practice and focuses on employee benefits, individual life, disability, medical, and senior products. Burman has traveled extensively and provided guidance to large employer associations with regards to the Affordable Care Act.