ACA Age Band Rate Auto Fill

When you enter current rates for a medical plan that is rated by age, MonarkHQ can fill in the whole age table from a single number. Enter the plan's age 21 rate, and Monark calculates every other age using the ACA age-rating multipliers. This saves you from typing 50+ individual rates from a carrier rate sheet.

What Are ACA Age-Band Rates?

For ACA-compliant fully insured medical plans, a member's rate is the plan's age 21 rate multiplied by a standard factor for their age. The federal table (45 CFR §147.102) sets these factors for ages 21–64, and the age 64 rate is always 3× the age 21 rate. For children (ages 0–20), carriers may use their own factors: the federal default is a flat 0.635 for every age, while some carriers, such as Anthem, use their own under-21 schedule.

When brokers enter current rates on a renewal RFP, the age-rates section needs these per-age values so carrier representatives get an accurate picture of the group's existing cost structure.

How Auto-Fill Works

Auto-fill appears in the Rates section when the Rate Tier Type is set to All Ages (0-65). An ACA Rate Auto-fill box sits above the age-rate fields with two inputs:

Under-21 rates — Which schedule to use for ages 0–20: ACA federal default (flat 0.635), Anthem Blue Cross, Kaiser Permanente, or Other carrier. Monark pre-selects Anthem or Kaiser when the plan name includes that carrier; otherwise it starts on the ACA federal default. You can change it before applying.
Age 21 Rate — The plan's monthly rate for a 21-year-old, from the carrier rate sheet.

Click Apply ACA Rates and Monark fills:

Ages 21–64 from the federal ACA multipliers (the same for every carrier)
Age 65 at the age 64 rate
Ages 0–20 from the under-21 schedule you selected

If the age-rate fields already contain values, Monark asks you to confirm before overwriting them. Every filled cell stays editable.

Auto-fill applies only to the All Ages (0-65) rate tier type. It does not appear for tier-rated (3-tier or 4-tier) or 5- and 10-year banded rate entry.

Reviewing and Editing Auto-Filled Rates

Open the medical renewal configuration for the group
In the Rates section, set Rate Tier Type to All Ages (0-65)
In the ACA Rate Auto-fill box, confirm the Under-21 rates selection and enter the Age 21 Rate
Click Apply ACA Rates — the age-rate fields fill in immediately
Review the rates against your carrier rate sheet and edit any that differ
Save the configuration

Always verify auto-filled rates against your carrier documentation. Auto-fill uses the standard multiplier tables and may not reflect carrier-specific adjustments, participation discounts, or negotiated rates.

Age 64 check: If the age 64 rate is not exactly 3.00× the age 21 rate (within $0.01) — for example after you edit individual ages — Monark shows a warning that the carrier may be using non-standard multipliers for upper ages. It's a reminder to double-check, not an error, and doesn't block saving.

When Under-21 Auto-Fill Is Not Available

Monark has under-21 schedules for the ACA federal default and Anthem Blue Cross. If you select Kaiser Permanente or Other carrier, auto-fill covers ages 21–65 only, and a note asks you to enter ages 0–20 manually from the carrier's rate documents. The age-rate fields remain fully editable in every case.

Age-Band Rates in Proposal Exports

The Full Proposal Excel export includes a Medical Rate Table tab for medical options:

Age-banded plans show an age grid built from the plan's actual rates. Any age the carrier did not provide is estimated from the ACA age curve and marked with "*", with a footnote noting that these values are derived and aren't carrier-published rates.
Community-rated plans (for example, in New York) are not age-banded. They show the carrier's tier rates in a TIER RATES section instead of an age curve.

Next Steps

After confirming the age-band rates, complete the renewal configuration and send the RFP to carrier representatives. See Obtaining Quotes for the full renewal RFP workflow.