July 23, The Honorable Orrin G. Hatch Ranking Member Committee on Finance United States Senate

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1 441 G St. N.W. Washington, DC July 23, 2013 The Honorable Orrin G. Hatch Ranking Member Committee on Finance United States Senate Subject: Private Health Insurance: The Range of Base Premiums in the Individual Market by State in January 2013 Dear Senator Hatch: Millions of Americans obtain health coverage by purchasing private health insurance, 1 including over 11 million individuals who purchased individual market plans in These Americans may be purchasing individual health insurance for a variety of reasons, including being selfemployed or a small business owner, or because their own employer does not offer insurance. Currently, in most states, under applicable law, individual health insurance market rates may vary on the basis of age, gender, health status, and other factors. In addition, states vary in their specific requirements for what insurers can consider in underwriting, which is the process of assessing the health status of the insurance applicant and setting the according to the health risk of that individual. 3 With certain exceptions, when individuals purchasing coverage in the individual market undergo underwriting, they can have their coverage denied, offered at a higher-than-average, or offered with a rider that excludes coverage of a preexisting condition. 4 The Center for Consumer Information and Insurance Oversight (CCIIO) within the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) currently maintains an online portal the HealthCare.gov Plan Finder that displays insurers base s prior to underwriting to assist consumers in comparing health insurance coverage options in the individual market. 5 The Patient Protection and Affordable Care Act (PPACA) included a number of provisions that could affect private health insurance requirements and the resulting cost of individual health insurance s. For example, insurers will no longer be able to use gender and health 1 Private health insurance includes individual and group market plans. Participants in the individual market purchase health insurance coverage directly from a carrier. Group market participants generally obtain health insurance coverage through a group health plan, usually offered by an employer. 2 Centers for Medicare & Medicaid Services, The 80/20 Rule: How Insurers Spend Your Health Insurance Premiums (Baltimore, Md.: Feb. 15, 2013). 3 Bernadette Fernandez, Congressional Research Service, Drivers of Premium Increases and Review of Health Insurance Rates (Washington, D.C.: January 20, 2012). In any given state, s may vary according to the rating factors allowed by the state. For example, a state may prohibit s in the individual market from varying based on health factors, but may allow s to vary based on age, gender, or other risk factors. 4 A preexisting condition is a health condition that exists before someone applies for or enrolls in a new health insurance coverage. 5 This online portal was established pursuant to a requirement in the Patient Protection and Affordable Care Act (PPACA), Pub. L. No , 1103(a), 10102(b), 124 Stat. 119, 146, 892 (2010). The Plan Finder can be found at Page 1 GAO R Range of Health Insurance Premiums in 2013

2 status to set rates and will be restricted in the amount they can vary s based on age and tobacco use, among other provisions. 6 PPACA also included an individual mandate that will require most individuals to have health insurance. 7 While some of the PPACA provisions have been implemented, others will not take effect until January As a result, beginning in 2014, the way insurers may calculate base s prior to underwriting may change. 8 You asked us to examine amounts that existed prior to the full implementation of the PPACA provisions. This report examines the range of base s for health insurance in the individual market that were displayed on the HealthCare.gov Plan Finder in the month of January To examine the range of base s displayed on the HealthCare.gov Plan Finder, we analyzed data maintained by CCIIO. The data included insurers base s for health plans that were publically available to consumers through the Plan Finder in the month of 9 January The base amounts and supporting plan information were self-reported by each insurance company, and each company was required to comply with a data validation and attestation process. However, our analysis may not reflect the entire universe of insurers base s because roughly 20 percent of all insurance companies did not submit data. In addition, our analysis may include plans with little or no enrollment because enrollment data were not available at the plan level. 10 Because insurers may impose different rates on individuals for a variety of factors, the data represent base amounts prior to underwriting, rather than the actual amount an individual may have been charged, which could be higher than the base rates because the actual amounts would have been determined after more complete underwriting for health conditions and other factors. We calculated an annual based on monthly amounts submitted by insurers. We developed base ranges for each of the 50 states and the District of Columbia for different types of consumers. Our state-wide ranges do not represent the range of base s that would have been displayed for all individuals in the state, because individuals search the Plan Finder on the basis of their zip codes and insurers may have offered some plans only in specific regions of a state. We also developed ranges for an urban and a rural zip code in four select states Illinois, Nevada, Pennsylvania, and Texas to illustrate how base s can vary within randomly selected urban and rural locations. While we selected zip codes within each state randomly, states were selected on the basis of geographic location and included one 6 See, Pub. L. No , 1201, 124 Stat In March 2012, GAO reported that there were 5 states with protections similar to PPACA. We classified states as having protections similar to PPACA if the state prohibited the denial of coverage to individuals on the basis of preexisting conditions, or if the state had rating restrictions that affected insurers ability to adjust an individual s health insurance s on the basis of an individual s health status. 7 Pub. L. No , 1501, 10106, 124 Stat. 242, 907, as amended by Pub. L. No , 1002, 1004, 124 Stat. 1029, In addition, beginning January 1, 2014, tax credits and cost-sharing subsidies subsidies that will help individuals pay for out-of-pocket expenses such as deductibles and copays will become available under PPACA. 9 Insurance companies may offer multiple health insurance products in each state, and multiple health plans may be available for each product. For example, the same product may have plans with different cost sharing features. In addition, insurance companies can vary s on the basis of county or zip code, and each variation represents a different health plan in the Plan Finder. Therefore, in some states there can be a high number of plans available statewide. 10 HealthCare.gov data include enrollment information at the product level. However, multiple plans may be associated with a single product; therefore, plan-level enrollment data were not available. Page 2 GAO R Range of Health Insurance Premiums in 2013

3 state from each of the four census regions. 11 To assess the reliability of these data for the purpose of our study, we: reviewed the requirements for the data validation and attestation process; reviewed documentation on the database that houses the information submitted to CCIIO, including the user manual and the business rules that govern how rates are rendered to consumers through the Plan Finder; and interviewed key CCIIO officials responsible for overseeing the submission and maintenance of the data. We determined that the 2013 data were sufficiently reliable for our purposes. We conducted our work from March 2013 to July 2013 in accordance with all sections of GAO s Quality Assurance Framework that are relevant to our objectives. The framework requires that we plan and perform the engagement to obtain sufficient and appropriate evidence to meet our stated objectives and to discuss any limitations in our work. We believe that the information and data obtained, and the analysis conducted, provide a reasonable basis for any findings and conclusions. The range of base s in the individual market displayed on the HealthCare.gov Plan Finder as of January 2013 in each of the 50 states and the District of Columbia are reported in enclosure I. Enclosure II shows the range of base s for the same categories of individuals for urban and rural zip codes in four states. Agency Comments We provided the Department of Health and Human Services (HHS) with a draft of this report for review; it had no comments. We are sending copies of this report to the Secretary of Health and Human Services and other interested parties. In addition, the report will be available at no charge on GAO s website at If you or your staff have any questions about this information, please contact me at (202) or Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. Major contributors to this report were Gerardine Brennan, Assistant Director; Todd D. Anderson; George Bogart; Erin Henderson; and Laurie Pachter. Sincerely yours, John E. Dicken Director, Health Care Enclosures 2 11 Urban and rural classifications were based on the Rural-Urban Commuting Area (RUCA) codes developed by the Department of Agriculture s Economic Research Service which are based on patterns of urbanization, population density, and daily commuting patterns. Page 3 GAO R Range of Health Insurance Premiums in 2013

4 Base Premiums Prior to Underwriting in Each State, for Selected Consumers Table 1: In Alabama, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 849 1,435 3,228 Annual deductible (dollars) 10,000 7,500 2,000 Out-of-pocket maximum (dollars) 16,000 12,000 6,000 Coinsurance (percent) plans available Premium amount (dollars) 948 1,808 4,085 Annual deductible (dollars) 3,250 5,000 2,000 Out-of-pocket maximum (dollars) 5,000 6,000 6,000 Coinsurance (percent) plans available Premium amount (dollars) 948 1,961 4,341 Annual deductible (dollars) 3,250 6,000 2,000 Out-of-pocket maximum (dollars) 5,000 6,000 6,000 Coinsurance (percent) plans available Premium amount (dollars) 948 2,415 5,407 Annual deductible (dollars) 3,250 4,000 2,000 Out-of-pocket maximum (dollars) 5,000 6,000 6,000 Coinsurance (percent) plans available Premium amount (dollars) 3,120 6,691 14,388 Family annual deductible (dollars) 6,450 22,500 6,000 Family out-of-pocket maximum (dollars) 10,000 31,500 18,000 Coinsurance (percent) plans available Premium amount (dollars) 4,452 7,551 17,378 Family annual deductible (dollars) 6,450 12,000 6,000 Family out-of-pocket maximum (dollars) 10,000 18,000 18,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 4 GAO R Range of Health Insurance Premiums in 2013

5 Table 2: In Alaska, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 1,027 1,835 3,972 Annual deductible (dollars) 5,000 5,000 1,000 Out-of-pocket maximum (dollars) 5,000 7,000 4,000 Coinsurance (percent) plans available Premium amount (dollars) 1,181 2,110 4,584 Annual deductible (dollars) 5,000 5,000 1,000 Out-of-pocket maximum (dollars) 5,000 7,000 4,000 Coinsurance (percent) plans available Premium amount (dollars) 1,242 2,229 6,792 Annual deductible (dollars) 5,000 1,500 1,000 Out-of-pocket maximum (dollars) 5,000 5,150 4,000 Coinsurance (percent) plans available Premium amount (dollars) 1,429 2,564 7,824 Annual deductible (dollars) 5,000 1,500 1,000 Out-of-pocket maximum (dollars) 5,000 5,150 4,000 Coinsurance (percent) plans available Premium amount (dollars) 4,723 8,681 32,304 Family annual deductible (dollars) N/A 15,000 2,000 Family out-of-pocket maximum (dollars) N/A 21,000 4,000 Coinsurance (percent) plans available Premium amount (dollars) 6,176 10,681 31,812 Family annual deductible (dollars) N/A 15,000 2,000 Family out-of-pocket maximum (dollars) N/A 21,000 4,000 Coinsurance (percent) Legend: N/A=Not applicable (value was not reported by the insurer) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 5 GAO R Range of Health Insurance Premiums in 2013

6 Table 3: In Arizona, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 456 1,046 6,815 Annual deductible (dollars) 10,000 5,000 3,900 Out-of-pocket maximum (dollars) 5,000 9,500 5,900 Coinsurance (percent) plans available Premium amount (dollars) 501 1,267 9,490 Annual deductible (dollars) 10,000 5,000 3,900 Out-of-pocket maximum (dollars) 5,000 2,500 5,900 Coinsurance (percent) plans available Premium amount (dollars) 624 1,424 9,708 Annual deductible (dollars) 10,000 2,500 3,500 Out-of-pocket maximum (dollars) 5,000 6,500 3,500 Coinsurance (percent) plans available Premium amount (dollars) 686 1,716 13,840 Annual deductible (dollars) 10,000 4,000 3,900 Out-of-pocket maximum (dollars) 5,000 No Maximum 5,900 Coinsurance (percent) plans available Premium amount (dollars) 2,691 4,408 10,115 Family annual deductible (dollars) 30,000 6,000 6,000 Family out-of-pocket maximum (dollars) 48,000 18,000 18,000 Coinsurance (percent) plans available Premium amount (dollars) 2,496 5,578 41,559 Family annual deductible (dollars) 20,000 22,500 11,700 Family out-of-pocket maximum (dollars) N/A 31,500 No Maximum Coinsurance (percent) Legend: N/A=Not applicable (value was not reported by the insurer) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 6 GAO R Range of Health Insurance Premiums in 2013

7 Table 4: In Arkansas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) ,201 Annual deductible (dollars) 25,000 5,000 1,000 Out-of-pocket maximum (dollars) 25,000 9,000 4,000 Coinsurance (percent) plans available Premium amount (dollars) 437 1,132 2,531 Annual deductible (dollars) 25,000 7,500 1,000 Out-of-pocket maximum (dollars) 25,000 12,000 4,000 Coinsurance (percent) plans available Premium amount (dollars) 681 1,240 2,971 Annual deductible (dollars) 25,000 5,000 1,000 Out-of-pocket maximum (dollars) 25,000 9,000 4,000 Coinsurance (percent) plans available Premium amount (dollars) 681 1,505 3,417 Annual deductible (dollars) 25,000 5,000 1,000 Out-of-pocket maximum (dollars) 25,000 9,000 4,000 Coinsurance (percent) plans available Premium amount (dollars) 2,278 4,256 7,449 Family annual deductible (dollars) 50,000 6,000 6,000 Family out-of-pocket maximum (dollars) 50,000 18,000 18,000 Coinsurance (percent) plans available Premium amount (dollars) 578 4,630 8,997 Family annual deductible (dollars) 15,000 15,000 6,000 Family out-of-pocket maximum (dollars) 33,000 33,000 18,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 7 GAO R Range of Health Insurance Premiums in 2013

8 Table 5: In California, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 672 2,232 13,836 Annual deductible (dollars) 6,500 2,500 2,000 Out-of-pocket maximum (dollars) 9,500 7,500 3,000 Coinsurance (percent) N/A 617 plans available Premium amount (dollars) 672 2,472 13,836 Annual deductible (dollars) 6,500 3,400 2,000 Out-of-pocket maximum (dollars) 9,500 3,400 3,000 Coinsurance (percent) 50 0 N/A 617 plans available Premium amount (dollars) 672 2,232 13,836 Annual deductible (dollars) 6,500 2,500 2,000 Out-of-pocket maximum (dollars) 9,500 7,500 3,000 Coinsurance (percent) N/A 617 plans available Premium amount (dollars) 672 2,472 13,836 Annual deductible (dollars) 6,500 3,400 2,000 Out-of-pocket maximum (dollars) 9,500 3,400 3,000 Coinsurance (percent) 50 0 N/A 314 plans available Premium amount (dollars) 2,832 8,841 43,632 Family annual deductible (dollars) 13,000 15,000 4,000 Family out-of-pocket maximum (dollars) 19,000 21,000 6,000 Coinsurance (percent) N/A 599 plans available Premium amount (dollars) 2,880 10,020 36,780 Family annual deductible (dollars) 13,000 5,000 4,000 Family out-of-pocket maximum (dollars) 19,000 15,000 6,000 Coinsurance (percent) N/A Legend: N/A=Not applicable (value was not reported by the insurer) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 8 GAO R Range of Health Insurance Premiums in 2013

9 Table 6: In Colorado, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January ,571 plans available Premium amount (dollars) 673 2,424 11,439 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 17,500 5,950 3,000 Coinsurance (percent) ,571 plans available Premium amount (dollars) 918 2,935 13,270 Annual deductible (dollars) 10,000 10, Out-of-pocket maximum (dollars) 17,500 3,000 3,000 Coinsurance (percent) ,571 plans available Premium amount (dollars) 673 2,424 11,439 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 17,500 5,950 3,000 Coinsurance (percent) ,571 plans available Premium amount (dollars) 918 2,935 13,270 Annual deductible (dollars) 10,000 10, Out-of-pocket maximum (dollars) 17,500 3,000 3,000 Coinsurance (percent) ,266 plans available Premium amount (dollars) 2,394 7,573 19,684 Family annual deductible (dollars) 20,000 N/A 3,000 Family out-of-pocket maximum (dollars) 35,000 N/A 9,000 Coinsurance (percent) ,930 plans available Premium amount (dollars) 2,981 9,528 36,826 Family annual deductible (dollars) 20,000 7,000 1,500 Family out-of-pocket maximum (dollars) 35,000 14,000 6,500 Coinsurance (percent) Legend: N/A=Not applicable (value was not reported by the insurer) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 9 GAO R Range of Health Insurance Premiums in 2013

10 Table 7: In Connecticut, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 936 1,910 4,511 Annual deductible (dollars) 10,000 4, Out-of-pocket maximum (dollars) 12,500 4,000 3,500 Coinsurance (percent) plans available Premium amount (dollars) 936 2,265 5,639 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 12,500 5,000 3,500 Coinsurance (percent) plans available Premium amount (dollars) 1,188 2,381 5,075 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 12,500 5,000 3,500 Coinsurance (percent) plans available Premium amount (dollars) 1,188 2,763 6,907 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 12,500 7,000 3,500 Coinsurance (percent) plans available Premium amount (dollars) 4,980 9,404 22,719 Family annual deductible (dollars) 24,000 15,000 1,000 Family out-of-pocket maximum (dollars) 24,000 21,000 7,000 Coinsurance (percent) plans available Premium amount (dollars) 4,068 10,454 24,037 Family annual deductible (dollars) 20,000 7,500 1,000 Family out-of-pocket maximum (dollars) 25,000 13,500 7,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 10 GAO R Range of Health Insurance Premiums in 2013

11 Table 8: In Delaware, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 623 1,379 2,648 Annual deductible (dollars) 10,000 10,000 1,000 Out-of-pocket maximum (dollars) 3, ,000 Coinsurance (percent) plans available Premium amount (dollars) 747 1,661 3,318 Annual deductible (dollars) 10,000 7,500 2,000 Out-of-pocket maximum (dollars) 3,000 10,500 6,000 Coinsurance (percent) plans available Premium amount (dollars) 826 1,735 3,527 Annual deductible (dollars) 10,000 3,500 2,000 Out-of-pocket maximum (dollars) 3,000 9,500 6,000 Coinsurance (percent) plans available Premium amount (dollars) 991 2,097 4,393 Annual deductible (dollars) 10,000 5,000 2,000 Out-of-pocket maximum (dollars) 3,000 5,000 6,000 Coinsurance (percent) plans available Premium amount (dollars) 4,022 6,275 11,689 Family annual deductible (dollars) 30,000 22,500 6,000 Family out-of-pocket maximum (dollars) 48,000 31,500 18,000 Coinsurance (percent) plans available Premium amount (dollars) 3,391 7,246 14,797 Family annual deductible (dollars) 20,000 2,000 2,000 Family out-of-pocket maximum (dollars) 3,000 3,000 3,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 11 GAO R Range of Health Insurance Premiums in 2013

12 Table 9: In District of Columbia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 643 1,749 12,056 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 17,500 7,000 2,500 Coinsurance (percent) plans available Premium amount (dollars) 1,006 2,112 12,056 Annual deductible (dollars) 10,000 3, Out-of-pocket maximum (dollars) 17,500 7,000 2,500 Coinsurance (percent) plans available Premium amount (dollars) 643 2,112 12,056 Annual deductible (dollars) 10,000 2, Out-of-pocket maximum (dollars) 17,500 5,000 2,500 Coinsurance (percent) plans available Premium amount (dollars) 1,006 2,518 12,056 Annual deductible (dollars) 10,000 1, Out-of-pocket maximum (dollars) 17,500 4,500 2,500 Coinsurance (percent) plans available Premium amount (dollars) 2,338 7,656 43,952 Family annual deductible (dollars) 20,000 N/A 200 Family out-of-pocket maximum (dollars) 35,000 5,000 5,000 Coinsurance (percent) plans available Premium amount (dollars) 2,642 9,593 57,412 Family annual deductible (dollars) 20,000 30, Family out-of-pocket maximum (dollars) 35,000 30,000 5,000 Coinsurance (percent) Legend: N/A=Not applicable (value was not reported by the insurer) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 12 GAO R Range of Health Insurance Premiums in 2013

13 Table 10: In Florida, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January ,669 plans available Premium amount (dollars) 624 1,704 6,921 Annual deductible (dollars) 10,000 2,600 1,000 Out-of-pocket maximum (dollars) 12,500 5,000 3,000 Coinsurance (percent) ,669 plans available Premium amount (dollars) 624 2,088 7,959 Annual deductible (dollars) 10,000 3,500 1,000 Out-of-pocket maximum (dollars) 12,500 7,000 3,000 Coinsurance (percent) ,669 plans available Premium amount (dollars) 792 2,547 8,367 Annual deductible (dollars) 2,500 1,500 1,000 Out-of-pocket maximum (dollars) 7,500 5,150 3,000 Coinsurance (percent) ,669 plans available Premium amount (dollars) 828 3,024 9,623 Annual deductible (dollars) 2,500 1,500 1,000 Out-of-pocket maximum (dollars) 7,500 6,000 3,000 Coinsurance (percent) ,140 plans available Premium amount (dollars) 3,984 9,826 32,744 Family annual deductible (dollars) 22,500 7,500 3,000 Family out-of-pocket maximum (dollars) 31,500 7,500 9,000 Coinsurance (percent) ,877 plans available Premium amount (dollars) 2,868 8,364 40,287 Family annual deductible (dollars) 20,000 7,500 3,000 Family out-of-pocket maximum (dollars) 25,000 10,000 9,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 13 GAO R Range of Health Insurance Premiums in 2013

14 Table 11: In Georgia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January ,209 plans available Premium amount (dollars) 363 1,293 8,526 Annual deductible (dollars) 10,000 3, Out-of-pocket maximum (dollars) 17,500 7,000 3,000 Coinsurance (percent) ,196 plans available Premium amount (dollars) 495 1,573 9,142 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 17,500 8,000 3,000 Coinsurance (percent) ,209 plans available Premium amount (dollars) 467 1,712 10,164 Annual deductible (dollars) 10,000 3, Out-of-pocket maximum (dollars) 17,500 11,000 3,000 Coinsurance (percent) ,196 plans available Premium amount (dollars) 638 2,065 11,458 Annual deductible (dollars) 10,000 5, Out-of-pocket maximum (dollars) 17,500 5,000 3,000 Coinsurance (percent) ,973 plans available Premium amount (dollars) 1,869 5,386 26,671 Family annual deductible (dollars) 20,000 4,000 1,500 Family out-of-pocket maximum (dollars) 35,000 19,000 7,000 Coinsurance (percent) ,161 plans available Premium amount (dollars) 2,252 6,975 32,137 Family annual deductible (dollars) 20,000 10,000 1,500 Family out-of-pocket maximum (dollars) 35,000 15,000 7,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 14 GAO R Range of Health Insurance Premiums in 2013

15 Table 12: In Hawaii, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 770 5,175 7,339 Annual deductible (dollars) N/A 0 0 Out-of-pocket maximum (dollars) 5,000 2,500 2,500 Coinsurance (percent) N/A plans available Premium amount (dollars) 770 5,175 7,339 Annual deductible (dollars) N/A 0 0 Out-of-pocket maximum (dollars) 5,000 2,500 2,500 Coinsurance (percent) N/A plans available Premium amount (dollars) 864 5,296 7,339 Annual deductible (dollars) 2, Out-of-pocket maximum (dollars) 3,500 2,500 2,500 Coinsurance (percent) plans available Premium amount (dollars) 864 5,296 7,339 Annual deductible (dollars) 2, Out-of-pocket maximum (dollars) 3,500 2,500 2,500 Coinsurance (percent) plans available Premium amount (dollars) 2,592 17,485 23,088 Family annual deductible (dollars) 5, Family out-of-pocket maximum (dollars) 7,000 7,500 7,500 Coinsurance (percent) plans available Premium amount (dollars) 2,862 20,804 29,009 Family annual deductible (dollars) 5, Family out-of-pocket maximum (dollars) 7,000 7,500 7,500 Coinsurance (percent) Legend: N/A=Not applicable (value was not reported by the insurer) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 15 GAO R Range of Health Insurance Premiums in 2013

16 Table 13: In Idaho, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January plans available Premium amount (dollars) 702 1,466 3,922 Annual deductible (dollars) 5,000 5,000 2,850 Out-of-pocket maximum (dollars) 2,000 8,500 2,850 Coinsurance (percent) plans available Premium amount (dollars) 738 1,768 5,352 Annual deductible (dollars) 10,000 10,000 2,850 Out-of-pocket maximum (dollars) 4,000 13,500 2,850 Coinsurance (percent) plans available Premium amount (dollars) 936 1,966 4,657 Annual deductible (dollars) 10,000 5,000 2,850 Out-of-pocket maximum (dollars) 12,500 10,000 2,850 Coinsurance (percent) plans available Premium amount (dollars) 996 2,347 6,355 Annual deductible (dollars) 7,500 10,000 2,850 Out-of-pocket maximum (dollars) 10,000 10,000 2,850 Coinsurance (percent) plans available Premium amount (dollars) 3,192 7,170 16,073 Family annual deductible (dollars) 20,000 6,000 5,700 Family out-of-pocket maximum (dollars) 25,000 10,000 5,700 Coinsurance (percent) plans available Premium amount (dollars) 3,600 8,444 19,656 Family annual deductible (dollars) 20,000 7,000 5,700 Family out-of-pocket maximum (dollars) 25,000 10,000 5,700 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 16 GAO R Range of Health Insurance Premiums in 2013

17 Table 14: In Illinois, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January ,854 plans available Premium amount (dollars) 573 1,451 5,632 Annual deductible (dollars) 10,000 6,000 0 Out-of-pocket maximum (dollars) 16,000 6,000 1,000 Coinsurance (percent) ,854 plans available Premium amount (dollars) 661 1,722 7,040 Annual deductible (dollars) 7,500 2,500 0 Out-of-pocket maximum (dollars) 22,500 7,000 1,000 Coinsurance (percent) ,854 plans available Premium amount (dollars) 816 2,170 14,578 Annual deductible (dollars) 10,000 4,000 0 Out-of-pocket maximum (dollars) 16,000 6,000 1,000 Coinsurance (percent) ,854 plans available Premium amount (dollars) 900 2,518 18,223 Annual deductible (dollars) 7,500 2,000 0 Out-of-pocket maximum (dollars) 22,500 6,000 1,000 Coinsurance (percent) ,262 plans available Premium amount (dollars) 2,694 6,224 31,536 Family annual deductible (dollars) 30,000 18,000 0 Family out-of-pocket maximum (dollars) 48,000 18,000 3,000 Coinsurance (percent) ,374 plans available Premium amount (dollars) 3,028 7,519 37,790 Family annual deductible (dollars) 30,000 18,000 0 Family out-of-pocket maximum (dollars) 48,000 18,000 3,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 17 GAO R Range of Health Insurance Premiums in 2013

18 Table 15: In Indiana, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January ,278 plans available Premium amount (dollars) 513 1,593 4,422 Annual deductible (dollars) N/A 1,500 1,000 Out-of-pocket maximum (dollars) N/A 5,000 3,000 Coinsurance (percent) ,278 plans available Premium amount (dollars) 667 1,957 5,542 Annual deductible (dollars) N/A 1,000 1,000 Out-of-pocket maximum (dollars) N/A 4,500 3,000 Coinsurance (percent) ,278 plans available Premium amount (dollars) 746 2,156 8,662 Annual deductible (dollars) N/A 6, Out-of-pocket maximum (dollars) N/A 8,000 2,500 Coinsurance (percent) ,278 plans available Premium amount (dollars) 970 2,719 9,844 Annual deductible (dollars) N/A 6, Out-of-pocket maximum (dollars) N/A 8,000 2,500 Coinsurance (percent) plans available Premium amount (dollars) 3,757 7,366 17,112 Family annual deductible (dollars) 22,500 15,000 3,000 Family out-of-pocket maximum (dollars) 31,500 15,000 9,000 Coinsurance (percent) ,130 plans available Premium amount (dollars) 3,210 8,958 22,110 Family annual deductible (dollars) 12,000 7,500 2,000 Family out-of-pocket maximum (dollars) 12,000 13,500 6,000 Coinsurance (percent) Legend: N/A=Not applicable (value was not reported by the insurer) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 18 GAO R Range of Health Insurance Premiums in 2013

19 Table 16: In Iowa, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January ,404 plans available Premium amount (dollars) 442 1,341 3,215 Annual deductible (dollars) 5,000 2, Out-of-pocket maximum (dollars) 10,000 2,600 1,500 Coinsurance (percent) ,404 plans available Premium amount (dollars) 597 1,548 3,722 Annual deductible (dollars) 5,000 2,600 1,500 Out-of-pocket maximum (dollars) 10,000 5,000 4,000 Coinsurance (percent) ,404 plans available Premium amount (dollars) 678 1,656 6,171 Annual deductible (dollars) 5,000 10, Out-of-pocket maximum (dollars) 10,000 3,000 1,500 Coinsurance (percent) ,404 plans available Premium amount (dollars) 916 1,953 7,080 Annual deductible (dollars) 5,000 5, Out-of-pocket maximum (dollars) 10,000 8,000 1,500 Coinsurance (percent) ,170 plans available Premium amount (dollars) 3,408 6,595 17,946 Family annual deductible (dollars) 22,500 4,500 1,500 Family out-of-pocket maximum (dollars) 31,500 13,500 4,500 Coinsurance (percent) ,404 plans available Premium amount (dollars) 1,807 7,707 16,892 Family annual deductible (dollars) 10,000 7,500 3,000 Family out-of-pocket maximum (dollars) 20,000 13,500 9,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 19 GAO R Range of Health Insurance Premiums in 2013

20 Table 17: In Kansas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January ,727 plans available Premium amount (dollars) 405 1,497 9,804 Annual deductible (dollars) 10,000 2,000 2,500 Out-of-pocket maximum (dollars) 17,500 4,000 5,000 Coinsurance (percent) ,727 plans available Premium amount (dollars) 452 1,847 9,804 Annual deductible (dollars) 10,000 5,000 2,500 Out-of-pocket maximum (dollars) 11,000 7,000 5,000 Coinsurance (percent) ,727 plans available Premium amount (dollars) 459 1,900 11,016 Annual deductible (dollars) 10,000 2,500 2,500 Out-of-pocket maximum (dollars) 17,500 4,500 5,000 Coinsurance (percent) ,727 plans available Premium amount (dollars) 626 2,270 11,016 Annual deductible (dollars) 10,000 2,600 2,500 Out-of-pocket maximum (dollars) 17,500 5,000 5,000 Coinsurance (percent) ,278 plans available Premium amount (dollars) 1,875 7,049 17,970 Family annual deductible (dollars) 20,000 5,000 3,000 Family out-of-pocket maximum (dollars) 35,000 5,000 9,000 Coinsurance (percent) ,715 plans available Premium amount (dollars) 230 7,916 25,356 Family annual deductible (dollars) 20,000 5,800 5,000 Family out-of-pocket maximum (dollars) 30, ,000 Coinsurance (percent) Notes: Because insurers can impose different s on individuals on the basis of a variety of factors, the data represent the base amount, rather than the actual amount an individual would be charged. Actual s could be higher plans may vary in the base or in the plan details, such as network and cost-sharing options. Page 20 GAO R Range of Health Insurance Premiums in 2013

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