Silver Exchange Premiums Rise 34% on Average in 2018

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New analysis from Avalere finds that the 2018 exchange market will see silver premiums rise by an average of 34%. According to Avalere's analysis of filings from states, exchange premiums for the most popular type of exchange plan (silver) will be 34% higher, on average, compared to last year.
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 Some of the information and data discussed in this article may be out of date. It is preserved here for historical reference but should not be used as the basis for business decisions.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.

“Plans are raising premiums in 2018 to account for market uncertainty and the federal government’s failure to pay for cost-sharing reductions,” said Caroline Pearson, senior vice president at Avalere. “These premium increases may allow insurers to remain in the market and enrollees in all regions to have access to coverage.”

Avalere experts attribute premium increases to a number of factors, including elimination of cost-sharing reduction (CSR) payments, lower than anticipated enrollment in the marketplace, limited insurer participation, insufficient action by the government to reimburse plans that cover higher cost enrollees (e.g., via risk corridors), and general volatility around the policies governing the exchanges. The vast majority of exchange enrollees are subsidized and can avoid premium increases, if they select the lowest or second lowest cost silver plan in their region. However, some unsubsidized consumers who pay the full premium cost may choose not to enroll for 2018 due to premium increases.

Average exchange plan premiums

Average premium increases will vary significantly by state. For example, Iowa will see the highest jump in average silver premium, 69%, over 2017, while Alaska will see a decrease in premiums for 2018, at -22% (Table 1). Exact premium amounts consumers can expect to pay will vary depending on their location and selected plan. Notably, in states with limited plan participation, the average silver premium maybe lower than the second lowest cost silver.

Average silver and second lowest cost silver premiums

Additional Context

Importantly, these rates reflect the data current displayed on These rates may change prior to open enrollment depending on how states respond to the elimination of CSR funding for the 2018 plan year. States where health plans were not permitted to provide an amended or second set of rates assuming the loss of CSRs may permit health plans to refile their rates prior to 2018 open enrollment, due to the elimination of the CSR payments. In states where this occurs, it is expected that the newly updated rates will be substantially higher for the 2018 plan year.


To conduct the analysis, Avalere utilized the recently released 2018 Individual Market HHS Landscape Files of 2018 exchange plan premiums in states. Avalere then compared the average unweighted premiums within each state by metal level to prior years analysis of the Individual Market HHS Landscape files. To calculate the average premiums, Avalere deduped the files to unique plans in each rating region in each state. Avalere used premiums for a 50 year old individual to calculate the averages.

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