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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).


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.