You are here

Preview Rate Review and Cost Sharing

Premium Rate Review

As of September 2011, the Affordable Care Act required state or federal governments to review premium rate increases of 10% or more. Since April 2014, 46 states and DC were deemed to have effective review programs in place (including Colorado).

Cost-Sharing

The Affordable Care Act establishes a limit on the amount of cost-sharing consumers can be expected to pay for services covered by the plan. Once this limit is met the plan must pay 100% of the remaining health care costs. The maximum out-of-pocket limit for 2016 is $6,850 per individual and $13,700 for family.These limits are lower for those with incomes below 250% PL who are eligible for cost-sharing reductions.