top of page

Glossary – Understand the most used terms during Open Enrollment

Glossary – Understand the most used terms during Open Enrollment


Covered California Open Enrollment is here. Following the same purpose of our series "Back 2 Basics", we've gathered a few important must-know terms of your health insurance plan so you can best choose your policy for 2021.

1) Advanced Premium Tax Credit (APTC)


Financial assistance eligible consumers may receive when enrolling in a Covered California health insurance plan, to assist them in paying their monthly premium costs. The amount of premium assistance an individual may receive is determined based on his or her income as a percentage of the federal poverty level. This tax credit may also be described as “premium assistance.” Tax credits are also available to small businesses with fewer than 25 full-time-equivalent employees to help offset the cost of providing coverage.

符合經濟援助資格的消費者在加入加州健保健康保險計劃時可能會獲得補貼,從而幫助他們支付每月的保費。 個人可獲得的保費補助金額取決於其收入佔聯邦貧困線的百分比。 此稅收抵免也可以稱為“保費援助”。 少於25名全職員工的小型企業也可享受稅收抵免,從而幫助他們支付保險的費用。

2) Affordable Care Act


Enacted in March 2010, the federal Patient Protection and Affordable Care Act (Affordable Care Act), occasionally referred to as “Obamacare,” provides the framework, policies, regulations, and guidelines for implementation of comprehensive health care reform by the states. The Affordable Care Act expands access to quality, affordable insurance, and health care.

聯邦患者保護與平價醫療法案(Affordable Care Act)於2010年3月頒布,有時被稱為“奧巴馬健保”,為各州實施全面醫療改革提供了框架,政策,法規和指南。 平價醫療法案增加了獲得優質,平價的保險和醫療保健的機會。


A federal law (the Consolidated Omnibus Budget Reconciliation Act) that may allow you to temporarily keep health coverage after your employment ends, you lose coverage as a dependent of the covered employee or another qualifying event. If you elect COBRA coverage, you pay 100 percent of the premiums, including the share the employer used to pay, plus a small administrative fee.

聯邦法律(綜合預算和解法案)可能允許您在工作結束後,或您失去作為被保員工的受撫養人的保險覆蓋,或發生其他符合資格的事件,您可以暫時保留健康保險。 如果您選擇COBRA保險,則需支付保險費的100%,包括在工作單位所曾支付的份額以及少量管理費。

4) Minimum Coverage Plan


Covered California health insurance plans — and all health plans in the individual and small-group markets — are sold in four levels of coverage: Bronze, Silver, Gold, and Platinum. In addition to these categories, Covered California offers a “minimum coverage plan,” also known as a “catastrophic plan,” which helps protect a person from financial disaster in the event of a serious and expensive medical emergency. Minimum coverage plans are designed to cover excessive medical bills that occur above the limit that you would be able to manage financially. Covered California offers minimum coverage to those up to age 30 or those individuals who prove they are without affordable coverage options or are experiencing financial hardship.

加州健保的醫療保險計劃以及個人和小型團體市場中的所有醫療計劃均以四種保險級別出售:銅級,銀級,金級和白金級。 除這些類別外,加州健保還提供了“最低覆蓋計劃”,也稱為“災難性計劃”,可在嚴重且昂貴的緊急醫療情況下幫助保護人們免受財務災難的影響。 最低承保計劃旨在承保超出您能夠進行財務管理的限額的醫療費用。加州健保為30歲以下的人或能夠證明自己不能負擔得起保險計劃或面臨財務困難的個人提供最低承保範圍。 

Source 文章來源:

12 views0 comments


bottom of page