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State RegulationsNY specificDifficulty 2/5

A client shopping on New York's exchange wants the lowest monthly premium among the metal-level plans and will accept higher out-of-pocket costs when she uses care. Under the Affordable Care Act, which metal level should the agent point to?

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Answer & full 3-part explanation (select an option above, or peek)

Why B is correct

Under the Affordable Care Act, bronze plans sit at the bottom of the actuarial-value ladder: the plan pays the smallest average share of covered costs, so the monthly premium is the lowest while deductibles and other cost sharing are the highest. Platinum sits at the opposite pole, with gold and silver in between. For a premium-sensitive enrollee who is comfortable with higher point-of-care costs, bronze is the fitting choice.

Why the other options are wrong

  • A) Platinum plans carry the richest coverage and the highest premiums - the opposite of what she wants.
  • C) Gold plans cost more per month than bronze because the plan pays a larger average share of costs.
  • D) Silver plans fall in the middle of the premium range, not at the low end occupied by bronze.

Memory hook

Bronze = bare premium, big deductible; platinum = plush premium, low cost sharing.

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