Individual & Family
Group health
Medicare Supplement


Free Assistance 800-320-6269

California health insurance  -  Health Reform Questions  -  cost sharing benefit

What Is The Cost Sharing Benefit?
Real Answers for Real Californian's
Questions on Covered California


Many people have heard about the Health Subsidy which helps qualified individuals and families that make between 138% and 400% of the Federal Poverty Level with subsidies they can use towards their health premiums.  Not as many know about the cost sharing benefits that are available to individuals/families that make between 138% and 250% of the FPL.  It's equally beneficial so let's take a look at how it works.

Better benefits if you qualify for cost sharing

People who make between 138% and 250% of the FPL will be able to get richer benefits at the same premium (reduced by separate health subsidy) on a sliding scale.  They must purchase a Silver level health plan in the Exchange in order to get the Cost sharing benefit although the separate health subsidy can be applied towards any metallic plan in the Exchange.  If you're between 138% and 250%, definitely consider a Silver health plan in the Exchange.  So what are the levels.

Benefit Sharing improvement to Actuarial Value

Basically, the Silver plan is a 70% AV.  This means that for the average person, the plan will pay 70% of the health care costs and the average will pay 30% (aside from premium).  If you qualify for Cost Sharing Benefits, you're AV will increase (as will your benefits) but you will pay the same Silver rate (minus subsidies applied). 

Here are the levels:

  • Tier 1:   138%  - 150% of FPL:  95% AV

  • Tier 2:   150% - 200% of FPL =  87% AV

  • Tier 3:  200% - 250% of FPL = 73% AV

The Tier 1 level is a very rich plan (richer even than the Platinum metallic plan).  A person who qualifies for this can expect to have very little out of pocket.  The Tier 2 plan is 3% than the standard Silver plan which also helps reduce out of pocket expenses.

How to get your cost sharing benefit

Take a look at the FPL Grid on the right column.  Estimate your current year's household gross income (MAGI explanation on right).  If you fall in the 138%-250% range, contact us and we can help you enroll on a plan that will offer you the best value at the maximum subsidy.  You can run your quote here or contact us below with the following information:

  1. # of people in household

  2. best estimate for 2013 gross household income

  3. dates of birth and zip code of household members



You can run your Covered California with Cost Sharing quote to view rates and plans side by side from the major carriers...Free.

Again, there is absolutely no cost to you for our services.  Call 800-320-6269 Today!


In just 15 minutes:

  • - Get the most tax credit available
  • - Find the best plan for your needs
  • - Enroll right over the phone!

Call 800-320-6269

Our Services are FREE to You!

Need Help
With Existing Account

We can help you:

  • -Get required docs to covered Ca.
  • -Make changes to income and other info
  • -Choose and finalize plan enrollment
  • -Make sure you get right tax credit
  • -Payment/membership issues with carriers

Call to Enroll over the Phone in 15 Minutes

If Your Income
Is In This Range

Current Years Estimate; All those that file together on one 1040:

Single Person: $16k - $47k
2 People $22k - $64k
3 People $27k - $80k
4 People $33k - $97k

Call 800-320-6269
Anthem Blue Cross California
Blue Shield of California under Covered California
Kaiser of California
Health Net of California
and more
Thousands of Californians
Hundreds of California Companies
Thousands of Californians
Hundreds of California Companies

from SC

"My sincere thanks for making a miracle happen- 2014 health insurance !! Many thanks for your expertise and advice yesterday !!"

from SD

"Thanks again for your help - I had absolutely no idea how to get this done when I got up this morning. You've made it remarkably easier than I expected. I hope you're not stuck at the office all night..."

from KV

"Anyway, I hope you got some time off this past week! Thank you again for your help and efforts on my behalf! I was very lucky to find you."

from EK

"I thank you very much for the time that you have invested in handling everything

from SR

"I truly appreciate the quick response and will think of you in the future if I need to make any changes to my insurance plans."

from VH

"You are awesome... takes a huge worry off my back, thank you for your kind. thanks for your time and kindness. !!"

from SA

"Wow, I can't thank you guys enough for your help...I couldn't imagine trying to tackle this on my own!"

from LM

"You are my new best friend. A HUGE thank you again.

Find out what customers are saying about our services

20 years of experience in the California health insurance market has taught us one thing...Competent and experienced guidance is Invaluable

We can quickly (very important) size up your health insurance needs and clearly explain the options available to you. Our focus is finding the most coverage at the best cost to you.

We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and tax credits.

Call will be Pleasantly Surprised.  800-320-6269

Request a 10 Minute Health Plan Check-up

We'll quickly see if you have the best priced plan available and if you qualify for a tax credit

calhealth website

Our Services are FREE to You is a Goodacre Insurance Services Website

This website is owned and operated by Goodacre Insurance Services, which is solely responsible for its content. This site is not maintained by or associated with Covered California, and Covered California bears no responsibility for its content. The email address and phone numbers that appear throughout the site belong to Goodacre Insurance Services, and cannot be used to contact Covered California.