skip to Main Content

Avalere Analysis: 2016 Exchange Premiums

  • This page as PDF


New analysis from Avalere Health examines the 2016 Federal Exchange Premium File. According to HHS, more than 8 in 10 (86 percent) of current enrollees can find a lower premium plan in the same metal level by returning to the exchange and shopping for 2016. As a result, tables and figures below examine the lowest cost options in two metal levels:
Please note: This is an archived post. Some of the information and data discussed in this article may be out of date. It is preserved here for historical reference but should not be used as the basis for business decisions. Please see our main Insights section for more recent posts.
    Average lowest cost Bronze premium by state: 2015 vs. 2016 and percent change
    Average lowest cost Silver premium by state: 2015 vs. 2016 and percent change

    As shown in Figure 1, the average lowest silver plan in states with a federal exchange increased by 13.0 percent from 2015 to 2016, compared to 3.2 percent from 2014 to 2015.

    {embed=”embeds/_article_slideshow” group_name=”EData1″}

    “While premiums have increased dramatically in many markets, the vast majority of exchange enrollees receive premium subsidies that can protect them from these increased costs,” said Caroline Pearson, senior vice president. “However, most consumers will need to return to the exchange to shop and may need to select a new plan to avoid higher premiums.”

    “In addition to monthly premiums, it is important to also look at benefit design,” said Elizabeth Carpenter, vice president at Avalere. “Factors like deductibles, out-of-pocket limits, and provider networks can add significant costs for some patients.”

    “Today’s findings underscore that the exchange market varies widely depending on where you live,” said Chris Sloan, manager at Avalere. “For example, while lowest cost silver plans increased 44 percent in Oklahoma, they decreased 14 percent in Indiana.”

    2016 Exchange Premiums: Changes in 2016 premiums vary widely by geography and regional market dynamics. When considering premium impact, note that over two-thirds of exchange consumers picked silver plans in 2015. Exchange plan enrollment is often concentrated in the lower priced plans in a particular metal level. As such, changes in the lowest priced plans in markets will have a larger impact on the average exchange consumer than the average premium for the entire market.

    {embed=”embeds/_article_slideshow” group_name=”EData2″}


    Premium data based on the 2014 HHS Individual Market Landscape file, updated as of August 2014, the 2015 HHS Individual Market Landscape file, updated as of October 2015, and the 2016 HHS Individual Market Landscape file, updated as of October 30, 2015. The 2016 Landscape file is accurate as of October 16, 2015, after which several co-ops and other issuers may have exited the market. Analysis excludes state-based exchanges. All premiums are based on a 50-yr old non-smoker. Averages are not enrollment weighted.

Sign up to receive more insights about
Please enter your email address to be notified when new insights are published.

Back To Top