In 2010, Congress passed the Affordable Care Act, or ACA for short. It completely changed how many Americans get their health insurance by expanding Medicaid (called Medi-Cal here in California) to help low-income individuals, families, and kids get health coverage. It also created new online marketplaces where people and small businesses could shop for health insurance. Today, 19 states and Washington, D.C. run their own marketplaces. California is one of them, with Covered California for individuals and families and Covered California for Small Business for employers. The other 31 states use the federal site, HealthCare.gov.
One of the biggest impacts of the ACA? Insurance companies can’t deny coverage or charge you more just because of your health history. It also lets young adults stay on their parents’ plan until they turn 26, which is a huge help for students and those just starting out.
The ACA was created to help more people get access to quality, affordable health insurance, slow down rising health care costs, and improve overall care for Americans. The Act also laid out 10 essential health benefits (EHBs) that every ACA-compliant plan has to cover. Think of it as a baseline for what your health insurance should include. These are things like doctor’s visits (ambulatory services), emergency care, hospital stays, care for moms and new babies, mental health and addiction services, prescription meds, preventative check-ups, rehab and habilitation services, and even kids’ services like dental and vision care.
How Metal Tiers Work
ACA health plans come in four “Metal Tiers”: Bronze, Silver, Gold, and Platinum. Each tier shows a different way that costs are split between you and the insurance company. The “metal” name doesn’t mean better quality care; it just tells you about your potential out-of-pocket costs for treatment.
| Plan Category/
ACA Metal Tier |
Portion of Covered Services Paid by the Insurance Company | Portion of Health Care Costs Paid by Insured Patient |
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Bronze, Silver, Gold, Platinum — What’s Right for You?
Think of metal tiers like your everyday choices.
☕ Coffee Lovers
If health plans were coffee orders:
- Bronze: A solid cup of drip coffee — gets the job done, no frills.
- Silver: A smooth latte — a little extra comfort without breaking the bank.
- Gold: A barista-crafted cappuccino — premium beans and that fancy foam art.
- Platinum: The single-origin pour-over — artisanal, with a side of biscotti and bragging rights.
🚗 Car Fans
If health plans were cars:
- Bronze: A trusty compact — reliable, efficient, and gets you from A to B.
- Silver: A mid-size SUV — some nice extras, maybe a sunroof.
- Gold: A luxury sedan — sleek, comfy, loaded with tech.
- Platinum: A high-end ride — think electric, hands-free, and park-itself fancy.
🏨 Frequent Travelers
If health plans were hotel stays:
- Bronze: A budget-friendly motel — clean, simple, and practical.
- Silver: A comfy hotel with free breakfast and Wi-Fi that (mostly) works.
- Gold: A resort-style stay with room service and a poolside drink.
- Platinum: The full five-star experience — spa, ocean views, and turn-down chocolates.
📱 Tech Fans
If health plans were smartphones:
- Bronze: The starter phone — texts, calls, and that’s about it.
- Silver: A solid mid-range model — takes great photos and runs fast.
- Gold: The premium phone — sharper camera, bigger screen, longer battery.
- Platinum: The latest flagship model — next-gen everything and VIP features.
Choosing the Right Metal Tier for Your Business
While the ACA’s Metal Tiers are a bit like the choices you make every day, there’s one important detail to keep in mind. What’s best for you might not be best for all your employees. That’s why CaliforniaChoice lets you pick just one tier or multiple. Go with Total Choice, and your employees get access to all four metal tiers. The best part? It costs you nothing extra to offer Total Choice, and there’s no participation requirement for any tier.
Chat with a Health Insurance Broker
When you’re looking for employee benefits, a health insurance broker is your secret weapon. Whether you’re a small startup or a growing enterprise, they will build a custom quote for your business based on your unique needs. If you don’t have a broker, you can connect with one easily at MyCalChoice.com.
