CWA HEALTH CARE REFORM UPDATE: Age Rating for Families

Is the age rating in the health insurance exchanges based just on the primary planholder, or on all family members in a family plan?

The Affordable Care Act mandates many new regulations on health insurance plans sold to individuals and those in the “small group” market (meaning to small businesses). One of these is a new limitation on “age rating.”

Because older people are likely to require more health care and thus be more expensive to cover, insurance companies often charge customers more based on how old they are. Under the ACA, an older adult cannot be charge more the 3 times the price for a younger adult with the same plan.

According to regulations issued in February 2013, the age of each adult covered on a family plan will affect the price of coverage. The 3 times limit will apply to the portion of the final price corresponding to each adult on the plan.