Table of Contents
Introduction: The Crossroads of Cost and Care
For millions of American families, the annual ritual of selecting a health insurance plan has become a source of profound anxiety.
Consider the Millers, a hypothetical but entirely representative family of four.
They are gathered around their kitchen table, the glow of a laptop screen illuminating their concerned faces as they navigate the Health Insurance Marketplace.
The screen is a kaleidoscope of options, a dizzying grid of plans with names like “BlueAdvantage Bronze,” “BlueOptions Silver,” and “BlueSelect Gold.” With each click, a new cascade of unfamiliar terms appears: deductibles, copayments, coinsurance, out-of-pocket maximums.
The Millers’ predicament is a familiar one.
They find themselves at a crossroads, grappling with the fundamental questions that define the modern healthcare calculus.
Do they opt for a plan with a lower monthly bill, a tempting proposition for their tight budget, but one that carries the risk of a catastrophic expense if a serious illness or accident occurs? Or do they commit to a higher, more burdensome monthly premium for the peace of mind that comes with lower costs when they actually need to see a doctor or visit a hospital? What do these metallic tiers—Bronze, Silver, Gold—truly signify about the care and coverage they will receive? And what, precisely, are the “extra savings” the website tantalizingly mentions, savings that seem to appear and disappear depending on the plan they select?
This report is designed to be the definitive guide to answering these critical questions.
It will demystify the often-impenetrable language of health insurance by focusing on the most common, and yet most profoundly misunderstood, plan category on the Marketplace: the Silver plan.
The objective here is not merely to define what a Silver plan is, but to uncover its unique and often hidden power as a financial instrument.
This analysis will provide a clear, evidence-based framework to help households like the Millers determine if a Silver plan is not just an option, but the single most financially advantageous choice for their family’s health and economic well-being.
We will navigate the intricate architecture of the Affordable Care Act (ACA), dissect the anatomy of a real-world Blue Cross Blue Shield (BCBS) Silver plan, and reveal the advanced strategies that can unlock tens of thousands of dollars in value, transforming the daunting task of choosing a health plan from a source of anxiety into an act of empowerment.
Chapter 1: Beyond the Metal – Understanding the Insurance Engine
To make an informed decision about any health plan, one must first understand the fundamental mechanics that govern the entire Marketplace.
The ACA established a standardized system of “metal tiers” to help consumers compare plans, but the logic behind these tiers is rooted in a core principle of risk and cost that predates the law itself.1
The Fundamental Trade-Off
At its heart, the choice between a Bronze, Silver, Gold, or Platinum plan is a decision about how to balance two different types of costs: the fixed, predictable cost of the monthly premium and the variable, uncertain cost of out-of-pocket expenses when medical care is needed.
These two costs exist in an inverse relationship, much like two ends of a seesaw.
- Bronze Plans: These plans sit on one end of the spectrum, characterized by the lowest monthly premiums. However, to achieve this low upfront cost, they require the enrollee to bear the highest share of costs when they access care, in the form of high deductibles and other cost-sharing.3 They are designed for individuals who anticipate very few medical needs and are primarily seeking protection against a worst-case scenario, like a major hospitalization.5
- Gold and Platinum Plans: Occupying the other end, these plans feature the highest monthly premiums. In exchange for this significant upfront investment, they offer the most generous coverage, with low deductibles and minimal out-of-pocket costs at the time of service.3 These plans are often the best fit for individuals and families with chronic conditions, who take multiple expensive medications, or who expect to utilize healthcare services frequently throughout the year.4
- Silver Plans: Positioned as the fulcrum of this seesaw, Silver plans are designed to strike a balance. They feature moderate monthly premiums and moderate out-of-pocket costs, offering a middle path between the extremes of Bronze and Gold.7 This balanced approach is a primary reason why Silver plans are the most common choice for shoppers on the Health Insurance Marketplace.7
This structure provides a range of options, but it doesn’t, on its own, provide a standardized way to measure the true value of a plan.
For that, federal regulators embedded a technical concept into the very DNA of the Marketplace: Actuarial Value.
Decoding Actuarial Value (AV): The Blueprint of Your Plan
The term “Actuarial Value,” or AV, is perhaps the single most important and least understood concept for consumers.
It is the invisible engine that drives the metal tier system.
The ACA and the Department of Health and Human Services (HHS) established AV as a standardized metric to measure the relative generosity of a health plan.11
AV represents the average percentage of total allowed medical costs that a plan is expected to pay for a standard population of enrollees.11
The remaining percentage is what the enrollees, on average, will pay out-of-pocket through deductibles, copayments, and coinsurance.
It is crucial to understand that AV is not a guarantee of what any single individual will pay.
A very healthy person in a Silver plan might have 100% of their (preventive) costs covered, while a person with a significant medical event might pay thousands of dollars out-of-pocket, resulting in the plan covering far more or less than the target AV for that specific individual.11
The AV is an aggregate measure across a diverse group of people.
The ACA assigns a specific AV target to each metal tier, creating a clear hierarchy of coverage generosity 1:
- Platinum: 90% AV (The plan pays 90% of average costs; enrollees pay 10%).
- Gold: 80% AV (The plan pays 80%; enrollees pay 20%).
- Silver: 70% AV (The plan pays 70%; enrollees pay 30%).
- Bronze: 60% AV (The plan pays 60%; enrollees pay 40%).
HHS regulations allow for a small variation, or de minimis range, around these targets.
For instance, a Silver plan can have an AV between 68% and 72% and still be categorized as Silver.1
The introduction of AV was a deliberate policy choice designed to solve a fundamental problem in insurance markets: the difficulty of making apples-to-apples comparisons.
Before the ACA, insurers could design plans with wildly different structures, making it nearly impossible for a consumer to determine which one offered better value.
By mandating that all plans cover a core set of 10 Essential Health Benefits (EHBs)—such as hospitalization, prescription drugs, and maternity care—and then categorizing them by AV, the law ensures that the primary difference between metal tiers is not what is covered, but how much the enrollee has to contribute to the cost of that coverage.4
This standardization is empowering.
It means that while two different Silver plans might have slightly different deductibles or copay structures, they are both designed to provide roughly the same overall level of financial protection on average.11
This allows consumers to focus on the trade-offs that matter most to them—premium vs. out-of-pocket cost—with the confidence that they are comparing plans of similar underlying value.
Actuarial Value, therefore, is not merely a technical specification; it is the linchpin of the ACA’s promise of a more transparent and consumer-friendly marketplace.
Chapter 2: The Silver Plan Standard: A Profile of the Benchmark
The Silver plan occupies a unique and central position within the ACA Marketplace.
It is not only the most popular choice among consumers but is also designated as the “benchmark” plan.7
This benchmark status is critical because federal financial assistance, specifically the Premium Tax Credit, is calculated based on the premium of the second-lowest-cost Silver plan available in a consumer’s geographic area.16
This makes understanding the standard, unsubsidized Silver plan the essential first step before exploring the powerful subsidies that can transform its value.
The Middle Path
At its core, a standard Silver plan embodies the 70/30 cost-sharing principle.
On average, for every dollar spent on covered medical care across its entire pool of enrollees, the insurance company pays 70 cents, and the enrollees collectively pay 30 cents.8
This 30% share is paid by individuals through their deductibles, copayments, and coinsurance.
For those who do not qualify for additional financial help, this “middle path” offers a compromise: a monthly premium that is more manageable than a Gold plan’s, coupled with out-of-pocket costs that are less daunting than a Bronze plan’s.6
Anatomy of a BCBS Silver Plan
To move from abstract percentages to concrete financial realities, it is instructive to dissect a representative plan.
The following table details the cost structure of a standard 2025 Blue Cross Blue Shield of Vermont Silver plan, which serves as a clear example of how the 70% Actuarial Value translates into specific dollar amounts for an individual or family.
This represents the “sticker price” of the plan, before any subsidies are applied.
Table 1: Anatomy of a Representative 2025 BCBS Standard Silver Plan
| Feature | Cost Structure & Details |
| Monthly Premium | ~$1,390.77 (Example rate for a specific profile) 19 |
| Annual Medical Deductible | $3,500 per individual. This is the amount an enrollee must pay for most medical services before the plan begins to share costs.19 |
| Annual Prescription Deductible | $500 per individual. This is a separate deductible that applies only to many prescription drugs.19 |
| Annual Out-of-Pocket Maximum | $9,200 per individual. This is the absolute most an enrollee will pay for in-network, covered services in 2025. Once this cap is reached, the plan pays 100% of costs.19 |
| Primary Care & Mental Health Visit | First 3 visits are $0. Subsequent visits are a $40 copay, which applies even before the medical deductible is met.19 |
| Specialist Visit | $90 copay. This fixed fee applies before the medical deductible is met.19 |
| Emergency Room Care | $250 copay applies after the $3,500 medical deductible has been met.19 |
| Inpatient Hospital Stay | 50% coinsurance applies after the $3,500 medical deductible has been met. The enrollee is responsible for half the cost of the stay until the out-of-pocket maximum is reached.19 |
| Generic Prescription Drugs | $15 copay. This applies before and after the prescription deductible is met.19 |
| Preferred Brand Drugs | Full price until the $500 prescription deductible is met, then a $70 copay.19 |
| Non-Preferred Brand Drugs | Full price until the $500 prescription deductible is met, then 50% coinsurance.19 |
| Preventive Care | $0. Services like annual checkups, routine screenings (mammograms, colonoscopies), and immunizations are covered at no cost to the enrollee, as mandated by the ACA.3 |
Note: This table is based on the BlueCross BlueShield of Vermont Standard Silver Plan for 2025 and is for illustrative purposes.
Specific costs and plan structures vary by state and carrier.
This detailed breakdown reveals the reality of a standard Silver plan.
While it offers valuable coverage, the potential for significant out-of-pocket costs is real.
An individual facing a serious medical event that requires hospitalization would first have to pay the $3,500 deductible and then 50% of all subsequent hospital bills until their total spending reached the $9,200 maximum.
For many households, this level of financial exposure remains a significant barrier to care.
It is this exact challenge that the ACA’s most powerful, yet least understood, subsidy is designed to solve.
Chapter 3: The Silver Plan’s Secret: Unlocking Cost-Sharing Reductions (CSRs)
Let us return to the Miller family at their kitchen table.
After entering their household size and estimated annual income into the Marketplace application, a new message appears on their screen: “Based on your income, you qualify for extra savings on out-of-pocket costs if you choose a Silver plan”.21
This message is the key that unlocks the Silver plan’s secret superpower: Cost-Sharing Reductions, or CSRs.
The Game-Changing Subsidy
CSRs are a form of financial assistance, unique to the ACA Marketplace, that is fundamentally different from the more widely understood premium tax credits.
While premium credits lower the monthly bill, CSRs are discounts that directly lower the amount an enrollee must pay at the time they receive medical care.22
They attack the high out-of-pocket costs that can make even insured individuals hesitant to seek care by reducing a plan’s deductible, copayments, and coinsurance.8
The impact of CSRs is transformative.
For example, a standard Silver plan might have a deductible of several thousand dollars.
For an eligible individual, a CSR-enhanced version of that exact same plan could have a deductible of just a few hundred dollars, or even $0.21
This is not a different plan; it is the same plan with a supercharged benefit structure, courtesy of the federal government.
However, there is one ironclad rule that governs this powerful benefit: Cost-Sharing Reductions are only available to eligible consumers who enroll in a Silver-tier plan.7
An individual who qualifies for CSRs but chooses a Bronze plan to save on the monthly premium, or a Gold plan for its perceived higher quality, will forfeit 100% of this assistance.
They will receive their premium tax credit, but the extra savings on their deductible and copays will vanish.
This makes the decision to enroll in a Silver plan a critical gateway to the most substantial cost assistance the ACA offers.
Are You Eligible? The 2025 Federal Poverty Level (FPL) Test
Eligibility for CSRs is determined by a household’s Modified Adjusted Gross Income (MAGI) in relation to the Federal Poverty Level (FPL), a set of income thresholds that vary by household size.25
For 2025 coverage, individuals and families with household incomes between 100% and 250% of the FPL are generally eligible for CSRs.8
(In states that have expanded Medicaid, the lower threshold is typically 138% of FPL, as those below that level qualify for Medicaid).20
The ACA further stratifies the CSR benefit into three tiers.
The lower a household’s income, the more powerful the cost-sharing reductions become.
This is achieved by mandating that insurers increase the Actuarial Value (AV) of the Silver plan for eligible enrollees, effectively turning their 70% AV plan into one that is far more generous.20
The following table outlines the three tiers of CSR benefits for 2025, translating the abstract FPL percentages into concrete income levels and demonstrating the dramatic enhancement of a Silver plan’s value at each level.
Table 2: 2025 Silver Plan Cost-Sharing Reduction (CSR) Tiers & Benefits
| Benefit Level | Income: 100% – 150% FPL | Income: >150% – 200% FPL | Income: >200% – 250% FPL |
| 2025 Annual Income (Individual) | $15,060 – $22,590 | $22,591 – $30,120 | $30,121 – $37,650 |
| 2025 Annual Income (Family of 4) | $31,200 – $46,800 | $46,801 – $62,400 | $62,401 – $78,000 |
| Enhanced Actuarial Value (AV) | 94% | 87% | 73% |
| Effective Plan Level | Better than a Platinum Plan (90% AV) | Better than a Gold Plan (80% AV) | An Enhanced Silver Plan (70% AV) |
| 2025 Max Out-of-Pocket (Individual) | $3,050 | $3,050 | $7,350 |
| 2025 Max Out-of-Pocket (Family) | $6,100 | $6,100 | $14,700 |
Sources: 2025 FPL data from 25; Enhanced AV levels from 20; 2025 CSR Out-of-Pocket Maximums from.20
FPL thresholds are for the 48 contiguous states and d+.C.
and may vary in Alaska and Hawaii.
The implications of this table are staggering.
A family of four with an income of $45,000 (about 144% FPL) who enrolls in a Silver plan does not receive a standard 70% AV plan.
Instead, they are automatically upgraded to a plan with 94% AV.
This plan is, by definition, more generous than the most expensive Platinum plans on the market.
Their maximum annual financial risk is not the standard $18,400 for a family, but is capped at just $6,100—a reduction of two-thirds.20
For this family, choosing a Silver plan is not merely a good decision; it is the only decision that makes financial sense.
They gain access to top-tier coverage for the price of a mid-tier plan, a value proposition that cannot be replicated with any other metal level.
Chapter 4: Putting It All Together: The Miller Family’s Choice
Armed with an understanding of both the standard Silver plan and the transformative power of Cost-Sharing Reductions, the Miller family is now equipped to make a truly informed choice.
Their journey highlights the critical interplay between the ACA’s two distinct forms of financial assistance.
A Tale of Two Subsidies
It is essential to clearly distinguish between the two affordability programs at work:
- Premium Tax Credits (PTCs): These are subsidies that function like an instant discount to lower the monthly premium of a health insurance plan.10 Eligibility is broad, and these credits can be applied to any metal tier—Bronze, Silver, Gold, or Platinum.4 The amount of the credit is designed to ensure that a household pays no more than a certain percentage of its income for the benchmark Silver plan.16
- Cost-Sharing Reductions (CSRs): As detailed previously, these are subsidies that lower the out-of-pocket costs—deductibles, copayments, and coinsurance—when care is received.22 They are a separate form of assistance, and their availability is strictly limited to eligible individuals who enroll in a
Silver plan.21
For the Miller family, assuming their income places them in the 100%-150% FPL range, these two subsidies work in tandem.
The PTC makes the monthly premium for a BCBS Silver plan affordable, perhaps even bringing it down to $0 per month.16
Then, the CSRs step in to fundamentally reshape the plan’s internal cost structure, protecting them from the high point-of-service costs that can lead to medical debt.
The “Before and After” Transformation
To illustrate the profound impact of this one-two punch of affordability, let us compare the financial reality the Millers would face with a standard Silver plan versus the CSR-enhanced Silver plan they are eligible for.
The following table places the plan from Chapter 2 side-by-side with its 94% AV counterpart.
Table 3: The Miller Family’s Financial Protection – Standard Silver vs. CSR-Enhanced Silver (94% AV)
| Cost Metric | Standard Silver Plan (70% AV) | CSR-Enhanced Silver Plan (94% AV) | The Difference |
| Annual Medical Deductible (Family) | $7,000 | Dramatically reduced, often to $0 | Protection from thousands in upfront costs. |
| Primary Care Copay | $40 per visit (after 3 free) | Reduced to a nominal fee, e.g., $5-$15 | Encourages routine care without financial barriers. |
| Specialist Copay | $90 per visit | Reduced to a nominal fee, e.g., $10-$25 | Makes essential specialized care accessible. |
| Inpatient Hospital Stay | 50% Coinsurance after deductible | Reduced to a low copay or small coinsurance, e.g., 10% | Protects against the most expensive form of care. |
| Annual Out-of-Pocket Maximum (Family) | $18,400 | $6,100 | $12,300 reduction in worst-case financial risk. |
Note: This table provides a comparative illustration.
The exact cost-sharing for CSR-enhanced plans varies by insurer and state, but the structure reflects the mandated increase in Actuarial Value to 94%.
The standard plan data is based on the BCBS VT example from Table 1, with the family deductible doubled.
The CSR OOPM is from federal guidelines for 2025.20
The contrast is stark and undeniable.
Under the standard plan, a single major health event could expose the Miller family to over $18,000 in medical bills.
Under the CSR-enhanced plan, their absolute maximum financial exposure for the entire year is capped at $6,100.
The high deductible, a major barrier to care, effectively vanishes.
The cost of seeing a doctor or specialist drops from a significant expense to a minor one.
This side-by-side comparison provides the “aha!” moment for consumers.
It demonstrates that for a CSR-eligible family, the term “Silver plan” is a misnomer.
They are not buying a mid-tier product.
They are using their eligibility as a key to unlock a Platinum-level (or better) product for the price of a Silver one.
The narrative for the Millers is now clear: their choice of a Silver plan is not a compromise, but a calculated move to secure the highest possible value and the strongest possible financial protection available to them under the law.
Chapter 5: The Expert’s Edge: Silver Loading and Advanced Strategy
The strategic imperative for CSR-eligible individuals is clear: choose a Silver plan.
But what about those who are not eligible? Imagine a different version of the Miller family, one whose household income is slightly higher, placing them at 260% of the Federal Poverty Level—just outside the window for Cost-Sharing Reductions.
As they shop on the Marketplace, they notice something peculiar: the monthly premium for a Silver plan seems disproportionately expensive compared to both Bronze and Gold plans.
This is not an anomaly; it is the result of a complex market dynamic known as “Silver Loading,” and understanding it is the key to advanced strategic planning for non-CSR-eligible consumers.
The Ghost in the Machine: Explaining “Silver Loading”
The story of Silver Loading begins with a pivotal policy decision in 2017.
The federal government ceased making direct payments to insurance companies to reimburse them for the cost of providing CSRs.27
However, the ACA’s legal mandate remained in place: insurers were still required to offer the discounted, high-AV plans to all eligible enrollees.27
This created a financial dilemma for insurers.
They were legally obligated to provide billions of dollars in discounts but would no longer be reimbursed by the government.
To solve this, state regulators and insurers devised a workaround.
Since CSRs are only available on Silver plans, they decided to recoup the cost of these discounts by increasing the premiums of only the Silver-tier plans.31
This practice of concentrating the entire cost of the CSR program into the premiums of a single metal tier is what is known as “Silver Loading”.28
The Counterintuitive Ripple Effect
This seemingly simple workaround created a profound and counterintuitive ripple effect that reshaped the entire Marketplace for subsidized consumers.
- Inflated Silver Premiums: The most direct consequence is that the “sticker price” of all Silver plans became artificially inflated to absorb the cost of the CSRs they had to provide.31
- Inflated Premium Subsidies: This is where the strategy deepens. As mentioned earlier, Premium Tax Credits (PTCs) are calculated based on the premium of the benchmark plan, which is the second-lowest-cost Silver plan in a region.16 When Silver Loading drove up the premiums of all Silver plans, it also drove up the value of the benchmark. Consequently, the amount of the PTC available to every eligible individual—regardless of their income or the plan they ultimately choose—increased significantly.31
This chain of events created a market distortion with critical strategic implications.
A consumer who is not eligible for CSRs is still eligible for the much larger PTC that results from Silver Loading.
They are, in effect, handed a larger-than-normal “voucher” to go shopping with.
They are not required to spend this voucher on the artificially expensive Silver plan that generated it.
Instead, they can apply this super-sized subsidy to any other metal tier.
This leads to two powerful strategic alternatives for the non-CSR-eligible consumer:
- The “Free” Bronze Plan: They can take their large PTC and apply it to a low-premium Bronze plan. In many cases, the subsidy is large enough to cover the entire premium of the Bronze plan, resulting in a $0 monthly cost. For a healthy individual who primarily wants catastrophic coverage, this can be an unbeatable value proposition.
- The “Discounted” Gold Plan: Alternatively, they can apply their large PTC to a high-premium, high-coverage Gold plan. The subsidy will not make the Gold plan free, but it will significantly reduce its cost, often making it cheaper per month than the standard Silver plan. This allows the consumer to purchase an 80% AV plan for less than the price of a 70% AV plan, gaining more robust coverage and lower out-of-pocket costs.
For the family at 260% FPL, the “balanced” Silver plan is often the worst of both worlds.
They pay the artificially inflated premium but receive none of the CSR benefits that justify that premium.
Their optimal strategy is not to seek balance in the middle, but to leverage their enhanced subsidy at the extremes of the market—either by minimizing their premium with a Bronze plan or by maximizing their coverage with a Gold plan.
Conclusion: Your Silver Plan Decision Framework
The journey through the intricate world of the Silver health plan, from its foundational role in the metal tier system to the advanced strategies of Silver Loading, culminates in a clear and actionable path forward.
The Miller family, once paralyzed by confusion, can now move forward with confidence, knowing they have selected the optimal financial instrument for their specific circumstances.
Their story provides a model for any household navigating the Marketplace.
The complexity of the system can be distilled into a simple, three-step decision framework.
This checklist is designed to cut through the noise and guide any consumer to their most rational and financially sound choice.
Step 1: Estimate Your 2025 Household Income
Before anything else, you must have a reasonable estimate of your household’s Modified Adjusted Gross Income (MAGI) for the upcoming year.
Use the official calculator on HealthCare.gov or your state’s Marketplace website.
This is the single most important number in your health insurance journey.
Step 2: Determine Your CSR Eligibility
Compare your estimated income and household size to the 2025 Federal Poverty Level (FPL) thresholds outlined in Table 2 of this report.
The critical question is simple: Is your income at or below 250% of the FPL?
Step 3: Follow Your Designated Path
Your answer to the question in Step 2 dictates your entire strategy.
There are two distinct paths, and choosing the correct one is paramount.
- Path A: You ARE Eligible for Cost-Sharing Reductions (Income ≤ 250% FPL)
Your choice is clear and unambiguous: You should enroll in a Silver plan. This is the only way to access the powerful CSR benefits that will dramatically lower your deductible, copayments, and maximum out-of-pocket costs. A Silver plan for you is not a 70% AV plan; depending on your income, it is a 73%, 87%, or even a 94% AV plan—offering value that cannot be matched by any other metal tier. Your task is to compare the various Silver plans offered by carriers like Blue Cross Blue Shield to find the one with the network and specific features that best suit your needs, secure in the knowledge that the Silver tier is your gateway to the best value on the Marketplace. - Path B: You are NOT Eligible for Cost-Sharing Reductions (Income > 250% FPL)
Your task is more complex and requires careful comparison shopping. Do not automatically assume a Silver plan offers the best balance. Due to the effects of Silver Loading, you are likely eligible for a substantial Premium Tax Credit. Your mission is to use this credit strategically.
- First, see what the net, post-subsidy monthly premium is for a Silver plan.
- Next, see what the net premium is for a Bronze plan. It may be extremely low or even $0.
- Finally, see what the net premium is for a Gold plan. It may be surprisingly affordable, potentially even cheaper than the Silver plan.
Your best value likely lies not in the middle, but at one of the ends of the spectrum. You must weigh the low upfront cost of a Bronze plan against the superior coverage and lower out-of-pocket risk of a Gold plan, both of which may be more financially prudent than the overpriced standard Silver plan.
The American health insurance landscape is undeniably complex.
Yet, within that complexity lies a logical structure.
By understanding the engine of Actuarial Value, the secret power of Cost-Sharing Reductions, and the strategic implications of Silver Loading, consumers can transform themselves from passive recipients of a confusing system into active, empowered architects of their own financial security.
Knowledge is the tool that turns anxiety into action, ensuring that families can secure not just a health insurance card, but true peace of mind.
Works cited
- Metal Levels for Qualified Health Plans | The Loop – Fickewirth Benefits Advisors, accessed August 10, 2025, https://www.fickewirth.com/the-loop-detail.php?Metal-Levels-for-Qualified-Health-Plans-26
- Health plans are categorized as Bronze, Silver, Gold, or Catastrophic. What does this mean? – Maryland Health Connection, accessed August 10, 2025, https://www.marylandhealthconnection.gov/faq/health-plans-are-categorized-as-bronze-silver-gold-or-catastrophic-what-does-this-mean/
- Shop Individual Medical Health Insurance | ACA Marketplace | Anthem, accessed August 10, 2025, https://www.anthem.com/individual-and-family/health-insurance
- Health Insurance Metal Levels: Understanding Bronze, Silver, Gold …, accessed August 10, 2025, https://www.anthem.com/individual-and-family/insurance-basics/health-insurance/understanding-metal-health-insurance-plans
- What’s with health insurance metal levels? Is going for the bronze the winning choice?, accessed August 10, 2025, https://www.healthoptions.org/blog/health-insurance-metal-levels
- Gold, Silver, Bronze Health Insurance Levels | Blue Cross and Blue Shield of Texas, accessed August 10, 2025, https://www.bcbstx.com/individual-family-health-insurance/metallic-levels
- Silver health plan – Glossary | HealthCare.gov, accessed August 10, 2025, https://www.healthcare.gov/glossary/silver-health-plan/
- What is a Silver Healthcare Plan? | Anthem, accessed August 10, 2025, https://www.anthem.com/individual-and-family/insurance-basics/health-insurance/what-is-a-silver-health-plan
- What is a Silver Health Insurance Plan? – eHealth, accessed August 10, 2025, https://www.ehealthinsurance.com/resources/affordable-care-act/what-is-a-silver-health-plan
- What Is the Affordable Care Act’s Silver Health Plan? – GoodRx, accessed August 10, 2025, https://www.goodrx.com/insurance/aca/silver-health-plan
- What is “actuarial value”, accessed August 10, 2025, https://actuary.org/wp-content/uploads/2017/11/Actuarial_value_basics_for_NAIC_040113.pdf
- Determining Minimum Value and Actuarial Value under the Affordable Care Act, accessed August 10, 2025, https://www.actuarialstandardsboard.org/wp-content/uploads/2015/10/asop050_182.pdf
- What the Actuarial Values in the Affordable Care Act Mean – KFF, accessed August 10, 2025, https://www.kff.org/wp-content/uploads/2013/01/8177.pdf
- What is Actuarial Value? – PeopleKeep, accessed August 10, 2025, https://www.peoplekeep.com/blog/what-is-actuarial-value
- Patient Protection and Affordable Care Act; Actuarial Value Calculator Methodology – CMS, accessed August 10, 2025, https://www.cms.gov/cciio/resources/files/downloads/av-calculator-methodology.pdf
- Health Insurance Premium Tax Credit and Cost-Sharing Reductions | Congress.gov, accessed August 10, 2025, https://www.congress.gov/crs-product/R44425
- Gold, Silver and Bronze Health Insurance | Blue Cross and Blue Shield of Illinois, accessed August 10, 2025, https://www.bcbsil.com/individual-family-health-insurance/metallic-levels
- Silver Level Insurance in Texas | Blue Cross and Blue Shield of Texas, accessed August 10, 2025, https://www.bcbstx.com/individual-family-health-insurance/metallic-levels/silver-level
- Standard Silver Plan Individual | BlueCross BlueShield of Vermont, accessed August 10, 2025, https://www.bluecrossvt.org/our-plans/find-and-compare-plans/silver-plan-individual
- What is a cost-sharing reduction? | healthinsurance.org, accessed August 10, 2025, https://www.healthinsurance.org/glossary/cost-sharing-reduction/
- Cost-sharing reductions | HealthCare.gov, accessed August 10, 2025, https://www.healthcare.gov/lower-costs/save-on-out-of-pocket-costs/
- Cost sharing reduction (CSR) – Glossary | HealthCare.gov, accessed August 10, 2025, https://www.healthcare.gov/glossary/cost-sharing-reduction/
- Cost-Sharing Reductions Available in NY State of Health – NYC.gov, accessed August 10, 2025, https://www.nyc.gov/assets/ochia/downloads/pdf/fly-927-cost-sharing-reductions-english.pdf
- Cost-Sharing Reductions – MNsure, accessed August 10, 2025, https://www.mnsure.org/financial-help/cost-share/index.jsp
- Federal Poverty Guidelines for FFY 2025 | The LIHEAP Clearinghouse, accessed August 10, 2025, https://liheapch.acf.gov/profiles/povertytables/FY2025/popstate.htm
- 2025 Federal Poverty Level for the 48 Contiguous States (Annual Income), accessed August 10, 2025, https://discover.pbc.gov/youthservices/PDF/SummerCamp/2025%20Federal%20Poverty%20Guideline%20Table.pdf
- Cost-Sharing Reductions: What Are They and Why Do They Need to Be Funded?, accessed August 10, 2025, https://actuary.org/cost-sharing-reductions-what-are-they-and-why-do-they-need-to-be-funded/
- What are metal plans? | healthinsurance.org, accessed August 10, 2025, https://www.healthinsurance.org/glossary/metal-plans/
- How much are the cost-sharing reductions? – KFF, accessed August 10, 2025, https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/how-much-are-the-cost-sharing-subsidies/
- The ACA’s Cost-Sharing Reductions: Protecting Consumers from High Out-of-Pocket Health Costs – Families USA, accessed August 10, 2025, https://www.familiesusa.org/resources/the-acas-cost-sharing-reductions-protecting-consumers-from-high-out-of-pocket-health-costs/
- Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces | KFF, accessed August 10, 2025, https://www.kff.org/policy-watch/explaining-cost-sharing-reductions-and-silver-loading-in-aca-marketplaces/
