Navigation Links
Zane Benefits Publishes New Information on Actuarial Value (AV)

Park City, Utah (PRWEB) January 31, 2013

Today, Zane Benefits, Inc. published new information on Actuarial Value (AV) and Health Care Reform. Zane Benefits, which provides comprehensive and flexible alternatives to traditional employer sponsored health benefits, is the leader in defined contribution and health reimbursement accounts.

According to Zane Benefits’ website, beginning in 2014, health care reform requires health insurance plans in the individual and small group markets to meet certain actuarial value (or "metal") levels. These “Metal levels” are intended to allow consumers to compare plans with different levels of coverage for essential health benefits (EHB). The levels include:

  •     Bronze (60% actuarial value)
  •     Silver (70% actuarial value)
  •     Gold (80% actuarial value)
  •     Platinum (90% actuarial value)

What is Actuarial Value (AV)?

According to Zane Benefits’ website, Actuarial value is a measure of the percentage of expected health care costs a specific health plan will cover for the "standard" population. Actuarial value is generally calculated using the ratio of:

the total expected payments by the plan for essential health benefits

divided by:

the total expected costs of the "standard" population for essential health benefits

For example, a plan with a 70 percent actuarial value would be expected to pay, on average, 70 percent of a standard population’s expected medical expenses for essential health benefits. The individuals covered by the plan would be expected to pay, on average, the remaining 30 percent of the expected expenses in the form of deductibles, co-payments, and coinsurance.

The exact process for determining a "standard" actuarial value across multiple plans has yet to be finalized. However, HHS has proposed rules governing the calculation of actuarial value.

Proposed Rules for a Standardized Actuarial Value (AV)

According to Zane Benefits’ website, The Department of Health and Human Services (HHS) has provided information on actuarial value standards in several phases:

  •     On December 16, 2011, HHS released a bulletin that outlined an intended regulatory approach for defining essential health benefits, including a benchmark-based framework.
  •     On January 25, 2012, HHS released a list of the largest three small group market products by state, which were updated on July 2, 2012.
  •     On February 17, 2012, HHS further clarified the approach to essential health benefits through a series of Frequently Asked Questions (FAQs)
  •     On February 24, 2012, HHS published a bulletin outlining an intended regulatory approach to calculations of actuarial value and implementation of cost-sharing reductions
  •     On July 20, 2012, HHS published a final rule authorizing the collection of data to be used under the intended process for states to select from among several benchmark options to define essential health benefits.
  •     On November 20, 2012, HHS published a proposed rule that outlines health insurance issuer standards related to the coverage of essential health benefits and the determination of actuarial value.

To standardize the calculation of actuarial value for health insurance issuers, HHS has proposed utilizing a publicly available "Actuarial Value Calculator". The idea is that health plans can use this calculator to determine actuarial values based on a national, standard population determined by HHS.

Click here to read full article.


About Zane Benefits

Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangement (HRAs) and defined contribution healthcare. The flagship software provides a 100% paperless administration experience to employers and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit

Read the full story at

Source: PRWeb
Copyright©2012 Vocus, Inc.
All rights reserved

Related medicine news :

1. Impotence Drug Cialis Might Have Other Sexual Benefits: Study
2. Coming Out Can Bring Health Benefits, Study Says
3. Study demonstrates health benefits of coming out of the closet
4. Some health benefits of berries may not make it past your mouth
5. Zane Benefits Publishes New Information on Compliant HRA Software
6. New Health Benefits of Water Report Now Available at
7. United Benefit Advisors Celebrates 10th Anniversary and Recognition as One of the Nation's Top 5 Employee Benefits Organizations
8. Physical therapy in the intensive care unit benefits hospitals bottom line
9. Implanted Heart Devices Have Real-World Benefits: Study
10. Sozo Nutritionals Announces Release of Svetol® Based Natural Weight Loss Product Backed By Several Clinical Studies Showing Remarkable Weight Loss Benefits
11. Benefits of higher oxygen, breathing device persist after infancy
Post Your Comments:
(Date:6/25/2016)... ... 2016 , ... As a lifelong Southern Californian, Dr. Omkar Marathe earned his ... David Geffen School of Medicine at UCLA. He trained in Internal Medicine at Scripps ... in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the opportunity to ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June 14 ... The article goes on to state that individuals are now more comfortable seeking to ... operations such as calf and cheek reduction. The Los Angeles area medical group, Beverly ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... and Scientific Sessions in Dallas that it will receive two significant new grants ... grants came as PHA marked its 25th anniversary by recognizing patients, medical professionals ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and ... that call for a minimum wage raise to $12 an hour by 2020 and then ... will restore the lost value of the minimum wage, assure the wage floor does not ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Grove Investment Group (TGIG), has initiated cultivation and processing operations at its production ... and Pahrump, Nevada. , Puradigm is the manufacturer of a complete system of ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... SAN CLEMENTE, Calif. , June 24, 2016  American Respiratory ... testing company, is now able to perform sophisticated lung assessments in ... Medical Technologies , Inc. Patients are no longer ... to ndd,s EasyOne PRO ® , ARL patients like Jeanne R. ... testing done in the comfort of her own home. ...
(Date:6/24/2016)... , June 24, 2016 ... appointment of Dr. Edward Futcher to ... Director, effective June 23, 2016.Dr. Futcher was also ... and Governance Committees.  As a non-executive member of ... expertise and strategic counsel to VolitionRx in connection ...
(Date:6/23/2016)... , June 23, 2016 Any dentist who ... challenges of the current process. Many of them do not ... the technical difficulties and high laboratory costs involved. And those ... offer it at such a high cost that the majority ... Dr. Parsa Zadeh , founder of Dental ...
Breaking Medicine Technology: