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Silver Plan

The second lowest actuarial level health plans available through the insurance exchanges, equal to a 70 percent actuarial value. An individual’s subsidy is based on the second lowest cost silver plan in their region. Bronze, Gold, and Platinum plans offer varying actuarial values.

Utilization Review (UR)

Refers to the evaluation of the efficiency and need of health care services, including procedures and facilities, according to established criteria of the provisions of…