Actuarial value: The average worth of a health plan to a person.

Affordable Care Act (ACA): A law passed in March 2010. Also called the health care reform law and Obamacare. It contains hundreds of provisions, but most importantly, it requires all Americans to have health insurance coverage, most employers to provide coverage, and changes the structure of insurance plans in terms of what they have to cover.

Affordable coverage: The amount you pay for health care must meet very specific rules. First, your plan must pay for at least 60 percent of a group of health care services, also known as minimum essential coverage. Second, your premium for single coverage (not the cost to cover your family — that’s important) cannot be more than 9.5 percent of your total household income.

UC offers you affordable coverage because UC’s least expensive plan, Core Medical, provides minimum coverage and is free to employees. However, if you decide to explore the marketplace options, this notice provides more information. Important: If you’re eligible for UC insurance (regardless of whether or not you enroll), you are not eligible for a premium tax credit if you purchase insurance in the marketplace.

Essential health benefits: A list of health services that all plans must cover. Essential benefits include (but are not limited to) emergency care, prescription drugs, maternity and newborn care, mental health and substance abuse services, preventive and wellness care and pediatric services including dental and vision care. UC’s plans help you pay for essential health benefits and also cover other valuable medical services.

Individual mandate: Part of the Affordable Care Act that requires all Americans to have health insurance or pay a fine. The rule went into effect Jan. 1, 2014. There are specific rules about what kind of plan you’re required to have, whether or not you can get help paying for your plan and the fine for not having one. If you have UC-sponsored coverage, you’ve met the requirement — no worries!

Minimum essential coverage: Your plan must help pay for at least 60 percent of a specific list of health care services, also called essential health benefits. This is also sometimes referred to as minimum essential value. This term is one rule of affordable coverage.

Premium tax credit: A cash advance to help cover part of the cost of health insurance through a state exchange. An American who does not have affordable coverage through their employer and has a total household income below 400 percent of the poverty level, is eligible for a premium tax credit. The credit amount is determined by family size, household income and the cost of plans in the individual’s state exchanges like Covered California. If you’re eligible for UC benefits, you have access to affordable coverage through UC and therefore you’re not eligible for a premium tax credit. If you’re not enrolled in UC benefits, check with your local benefits office to make sure you’re not eligible. If you’re not eligible for UC benefits, you can start by visiting

Qualified health plan: State exchanges must review and certify all plans sold in their marketplace. These are referred to as qualified health plans. All plans must cover the minimum essential benefits. Plans may have different features — like the amount of the deductible or the copay, but the overall value of the plan must equal one of the four standard levels of coverage:

Lastly, a qualified health plan must also maintain a network of providers that has enough hospitals, doctors, mental health providers and other health care providers, and make sure that all services are "accessible without reasonable delay."

If UC’s plans were available through the marketplace, all of them would meet the minimum legal requirements under health care reform. In fact, we offer plans that are equivalent to platinum plans.

State exchange: A marketplace where people can shop for and purchase health insurance online. Think of a mall, but where all the stores sell health insurance. (See more about what state exchanges can do.) Behind the scenes, the marketplace is managed by a board that makes decisions about how to run it, including bringing in outside partners who can perform some functions of the marketplace. One member of each board must be a consumer advocate.

Subsidy: See premium tax credit.