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Personal Health Insurance - Base Premium Rates in the Individual Market (2013)

Studies show that up to 15 million Americans (6%) have a personal health insurance plan (also called an individual or family health insurance plan). This includes the self-employed, small business owners, employees with a pure defined contribution health plan, and employees without access to employer-sponsored health insurance.

With major provisions of health reform taking effect in 2014, many experts agree the landscape of health insurance is rapidly changing for both employers and employees. One of the most significant changes is a shift toward the individual health insurance market. For example, of the 48 million currently uninsured, it's expected that 19 million individuals will be eligible for the new health insurance premium subsidies available through the state health insurance marketplaces.

Starting in 2014, insurers will no longer be able to use gender and health status to set personal health insurance plan premium rates and will be restricted in the amount they can vary premiums based on age, tobacco use, and location. 

Personal Health Insurance Rates 2013
With the opening of the state health insurance marketplaces, the individual mandate, and all personal health insurance plans becoming guaranteed-issue in 2014, employers, employees, and health insurance brokers have been eagerly waiting to see what will happen to premium rates for personal health insurance plans in 2014.

To provide a baseline of premium rates in 2013, the Government Accountability Office (GAO) examined base premium rates for health insurance on the individual market.

The GAO used individual market rates displayed on healthcare.gov "Plan Finder" in January 2013. Here are their findings.

Personal Health Insurance Base Rates - 2013

GAO reported the range of base premiums prior to underwriting for health insurance in the individual market that were displayed on the HealthCare.gov "Plan Finder" in the month of January 2013 for each of the 50 states and the District of Columbia.

The study provided state by state rates, by age of consumer, and type of plan.

30-Year Old Single Female Base Premium Rates

For a 30-year old single female, nonsmoker, the national average is $222/month. Here is the breakdown for this demographic, by state. These average monthly rates represent plans with median premiums.

State

 

State

 

State

 

Alabama

$163

Kentucky

$140

North Dakota

$112

Alaska

$186

Louisiana

$163

Ohio

$166

Arizona

$119

Maine

$774

Oklahoma

$183

Arkansas

$103

Maryland

$223

Oregon

$139

California

$186

Massachusetts

$287

Pennsylvania

$201

Colorado

$202

Michigan

$118

Rhode Island

$291

Connecticut

$198

Minnesota

$128

South Carolina

$227

Delaware

$145

Mississippi

$172

South Dakota

$228

District of Columbia

$176

Missouri

$171

Tennessee

$182

Florida

$129

Montana

$119

Texas

$153

Georgia

$143

Nebraska

$178

Utah

$141

Hawaii

$441

Nevada

$160

Vermont

$208

Idaho

$164

New Hampshire

$176

Virginia

$154

Illinois

$181

New Jersey

$1,436

Washington

$168

Indiana

$180

New Mexico

$135

West Virginia

$152

Iowa

$138

New York

$479

Wisconsin

$144

Kansas

$158

North Carolina

$161

Wyoming

$208

Source: GAO.

 

55-Year Old Couple Base Premium Rates

For a 55-year old couple (two non-smoking adults), the national average is $815/month. Here is the breakdown for this demographic, by state. These average monthly rates represent plans with median premiums.

State

 

State

 

State

 

Alabama

$629

Kentucky

$524

North Dakota

$553

Alaska

$890

Louisiana

$657

Ohio

$703

Arizona

$465

Maine

$2,138

Oklahoma

$832

Arkansas

$386

Maryland

$679

Oregon

$624

California

$835

Massachusetts

$1,103

Pennsylvania

$856

Colorado

$794

Michigan

$463

Rhode Island

$871

Connecticut

$871

Minnesota

$547

South Carolina

$954

Delaware

$604

Mississippi

$693

South Dakota

$1,031

District of Columbia

$799

Missouri

$655

Tennessee

$785

Florida

$697

Montana

$521

Texas

$612

Georgia

$581

Nebraska

$841

Utah

$571

Hawaii

$1,734

Nevada

$675

Vermont

$565

Idaho

$704

New Hampshire

$842

Virginia

$635

Illinois

$627

New Jersey

$2,926

Washington

$794

Indiana

$747

New Mexico

$567

West Virginia

$702

Iowa

$642

New York

$828

Wisconsin

$586

Kansas

$660

North Carolina

$702

Wyoming

$1,021

Source: GAO.

Study Methodology

The GAO examined the range of premiums for the individual market that were displayed on the HealthCare.gov "Plan Finder", which reflected insurers' base premiums prior to underwriting.

The data included insurers’ base premiums for health plans that were publicly available to consumers through the Plan Finder in the month of January 2013. The base premium 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, the analysis may not reflect the entire universe of insurers’ base premiums because roughly 20 percent of all insurance companies did not submit data. 

The base premiums displayed on the HealthCare.gov Plan Finder reflected information from data submitted by insurers to the Center for Consumer Information and Insurance Oversight (CCIIO) within the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS).

Read the full GAO study and methodology notes here.

What do you think? Are these rates found in the GAO study reflective of personal health insurance rates in the individual market? Let us know in the comments below.