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Affordable Care Act Member Level Age Rating

The Affordable Care Act (ACA) changed the rating structure as of January 1, 2014 for health insurance carriers that offer policies to small businesses. Instead of rating health plans at the subscriber or employee age, they will be rated at the member’s age.

  • Children: All children ages 0 to 20, where all rates are the same.
  • Adults: Single-year age bands covering individuals between ages 21 to 63.
  • Older Adults: A single age band covering individuals age 64 and older, where all rates are the same.

Insurance carriers cannot charge their oldest customers more than three times what their youngest customers pay for their rates. This pricing structure is meant to make sure that rates are affordable for everyone, regardless of health status or age.

For subscribers with a policy that includes more than three dependent children under 21, the complete rate will include the fees for all covered adults and a maximum of three of the oldest covered children. Any additional dependent children will have a rate of $0.

For more information about the ACA, contact Save-On Health Insurance Services located in Los Angeles, California.