2015 Dean Health Plan Individual & Family Plan Book

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Advance Premium Tax Credits (APTC)
Tax credits can lower the amount you pay toward your monthly premium. Tax credits
are available to individuals and families who earn at least 100 percent and not more
than 400 percent of the Federal Poverty Level. Only the Marketplace can determine if
you are eligible for, and how much you can receive in, tax credits.
Cost Sharing Reduction (CSR)
If your income is at least 100 percent and not more than 250 percent of the Federal
Poverty Level, you are eligible for special plans with Cost Sharing Reductions to
lower your out-of-pocket costs, in addition to the Advanced Premium Tax Credits.
Only the Marketplace can determine if you are eligible for, and how much you can
receive in, Cost Sharing Reductions.
Cost-sharing Maximums
The plan you purchase will include a limit on the out-of-pocket expenses you have
to pay for health care per year, after which point your health insurance plan begins
to pay 100 percent of the cost. This maximum cost sharing amount is lower for
some plans, so be sure to take a look at the plan’s maximum out-of-pocket level,
as well as deductible, coinsurance and copays when selecting a plan. Cost-sharing
maximums do not account for monthly premiums or payments for out-of-network
care that is not prior authorized.
How You Can Use Your Tax Credit
You can use your tax credit on any Marketplace plan. The Marketplace, also known as
alculates your tax credit allowance. Your monthly premium will be
personalized for you based on the plan you select, but the credit will stay the same.
Example: You have a $250 tax credit per month and have income of less than 400
percent of the Federal Poverty Level.
• If you buy a Silver plan with a premium payment of $400 per
month, you will lower your monthly premium payment to $150.
• If you buy a Bronze plan with a premium payment of $260
per month, you will lower your monthly premium to $10.