Page 1 GAO-14-263R Range of Health Insurance Premiums in 2013

441 G St. N.W.

Washington, DC 20548

January 31, 2014

The Honorable Orrin G. Hatch

Ranking Member

Committee on Finance

United States Senate

Private Health Insurance: The Range of Base Premiums for Individuals Age 19 and 64 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 2011.2 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. 

In 2013, in most states, under applicable law, individual health insurance market premium rates 

could have varied on the basis of age, gender, health status, and other factors. In addition, 

states could have varied in their specific requirements for what insurers could consider in 

underwriting—the process of assessing the health status of the insurance applicant and setting 

the premium according to the health risk of that individual.3 Historically, with certain exceptions, 

when individuals purchasing coverage in the individual market went through the underwriting 

process, their coverage could have been denied, offered at a higher-than-average premium, or 

offered with a rider that excluded coverage of a preexisting condition.4

The Patient Protection and Affordable Care Act (PPACA) included a number of provisions that 

changed private health insurance requirements, and these changes could affect the cost of 

individual market health insurance premiums. For example, under PPACA, insurers may not 

deny coverage to individuals based on preexisting conditions or use gender or health status to 

set premium rates, and they are restricted in the amount they can vary premiums based on age

and tobacco use.5 PPACA also included an individual mandate that requires most individuals to 

have health insurance coverage or pay a tax penalty.6

 

1

Private health insurance includes individual and group market plans. Participants in the individual market purchase 

health insurance coverage directly from an insurance carrier. Group market participants generally obtain health 

insurance coverage through a group health plan, usually offered by an employer.

These PPACA provisions were not 

2

Centers for Medicare & Medicaid Services, The 80/20 Rule: How Insurers Spend Your Health Insurance Premiums

(Baltimore, Md.: February 15, 2013).

3

Bernadette Fernandez, Congressional Research Service, Drivers of Premium Increases and Review of Health 

Insurance Rates (Washington, D.C.: January 20, 2012).

4

A preexisting condition is a health condition that exists before someone applies for or enrolls in new health insurance 

coverage.

5

See the Patient Protection and Affordable Care Act (PPACA), Pub. L. No. 111-148, § 1201, 124 Stat. 119, 154 

(2010) (codified at 42 U.S.C. § 300gg(a)(1)(A)). 

6

Pub. L. No. 111-148, §§ 1501, 10106, 124 Stat. 242, 907, as amended by the Health Care and Education 

Reconciliation Act of 2010, Pub. L. No. 111-152, §§ 1002, 1004, 124 Stat. 1029, 1032, 1034 (codified as amended at 

26 U.S.C. § 5000A).
Page 2 GAO-14-263R Range of Health Insurance Premiums in 2013

required to be met until 2014. As a result, beginning in January 2014, the way insurers calculate 

base premiums may change.7

The Center for Consumer Information and Insurance Oversight (CCIIO) within the Department 

of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) 

maintains an online portal—the HealthCare.gov Plan Finder—that displays insurers’ premiums 

to assist consumers in comparing health insurance coverage options in the individual market.8

In July 2013, we reported the range of base premiums for private health insurance coverage 

options for different categories of individuals in each of the 50 states and the District of 

Columbia as they were displayed for individuals on the HealthCare.gov Plan Finder in January 

of 2013.

In January 2013, the data displayed on the HealthCare.gov Plan Finder included insurers’ base 

premiums prior to underwriting. These premium amounts were not subject to the PPACA 

provisions that took effect in 2014. They represented the lowest premium amounts that would 

have been available to different categories of individuals at that time, and were subject to an 

underwriting process that could have resulted in higher premiums depending on an individual’s 

health status, for example the presence of a preexisting condition.

9

To examine the range of base premiums that was displayed on the HealthCare.gov Plan Finder, 

we analyzed data maintained by CCIIO. The data included insurers’ base premiums for health 

plans that were publically available to consumers through the Plan Finder in the month of

January 2013.

You asked us to expand our analysis to include ranges of base premiums for 

additional categories of individuals that would represent individuals whose premiums would be 

among the lowest and highest based on age. In the enclosures to this letter, we are reporting 

the range of base premiums that were displayed for young adults (age 19), and older adults not 

yet eligible for Medicare (age 64). For both age categories, we are reporting the range of base 

premiums displayed for nonsmoking and smoking individuals in each of the 50 states and the 

District of Columbia on the HealthCare.gov Plan Finder in the month of January 2013.

10

 

7

In addition, beginning January 1, 2014, premium tax credits and cost-sharing subsidies became available under 

PPACA for qualified individuals. Premium tax credits may be used to reduce monthly premiums, and cost-sharing 

subsidies decrease out-of-pocket expenses such as deductibles and copays.

Because insurers may have established different rates for individuals for a 

variety of factors, the data represent base premium amounts prior to underwriting, rather than 

the actual premium amount an individual may have been charged. Actual premium amounts 

could have been higher than the base rates, as they would have been determined after more 

complete underwriting for health conditions and other factors, and some individuals could have 

8

This online portal was established pursuant to a requirement in PPACA, Pub. L. No. 111–148, §§ 1103(a), 10102(b), 

124 Stat. 119, 146, 892 (codified at 42 U.S.C. § 18003). The Plan Finder can be found at http://finder.healthcare.gov/

(accessed December 23, 2013).

9

See GAO, Private Health Insurance: The Range of Base Premiums in the Individual Market by State in January 

2013, GAO-13-712R (Washington, D.C.: July 23, 2013). We reported the range of premiums for six categories of 

individuals, including 30-year-old nonsmoking and smoking males and females, a family of four, and a 55-year-old 

couple.

10Insurance 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 premiums 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.
Page 3 GAO-14-263R Range of Health Insurance Premiums in 2013

been denied coverage, for example because of pre-existing conditions.11 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, 

our analysis may not reflect the entire universe of insurers’ base premiums 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.12

We calculated an annual premium based on monthly amounts submitted by insurers. We 

developed base premium ranges for each of the 50 states and the District of Columbia for 

different categories of consumers. Our state-wide premium ranges do not represent the range of 

base premiums 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 premium ranges for an urban 

and a rural zip code in four select states—Illinois, Nevada, Pennsylvania, and Texas—to 

illustrate how base premiums can vary within randomly selected urban and rural locations. 

Although we selected zip codes within each state randomly, states were selected on the basis 

of geographic location and included one state from each of the four census regions.13

We conducted our work from November 2013 to January 2014 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.

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.

The range of base premiums for 19- and 64-year-old individuals in the individual market that 

was displayed on the HealthCare.gov Plan Finder as of January 2013 in each of the 50 states 

and the District of Columbia is reported in enclosure I. Enclosure II shows the range of base 

premiums for the same categories of individuals for urban and rural zip codes in four states.

Agency Comments

The Department of Health and Human Services reviewed a draft of this report and provided 

technical comments, which we incorporated as appropriate. 

 

11For example, GAO previously reported that, based on national data from the first quarter of 2010, on average, 

19 percent of applicants for individual insurance coverage were denied coverage. See GAO, Private Health 

Insurance: Data on Application and Coverage Denials, GAO-11-268 (Washington, D.C.: March 16, 2011).

12HealthCare.gov data included enrollment information at the product level. However, multiple plans may be 

associated with a single product; therefore, plan-level enrollment data were not available.

13Urban 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 4 GAO-14-263R Range of Health Insurance Premiums in 2013

– – – – – 

As arranged with your office, unless you publicly announce its contents earlier, we plan no 

further distribution of this report until 30 days after its issue date. At that time we will send

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 

http://www.gao.gov. If you or your staff have any questions about this information, please 

contact me at (202) 512-7114 or dickenj@gao.gov. 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 
Enclosure I

Page 5 GAO-14-263R Range of Health Insurance Premiums in 2013

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 Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 512 plans available

Premium amount (dollars) 719 1,226 2,683

Annual deductible (dollars) 10,000 5,000 2,000

Out-of-pocket maximum (dollars) 16,000 9,500 6,000

Coinsurance (percent) 30 30 20

Single male, smoker, age 19 512 plans available

Premium amount (dollars) 780 1,516 3,318

Annual deductible (dollars) 3,250 5,000 2,000

Out-of-pocket maximum (dollars) 5,000 9,500 6,000

Coinsurance (percent) 20 30 20

Single female, nonsmoker, age 19 512 plans available

Premium amount (dollars) 780 1,532 3,331

Annual deductible (dollars) 3,250 5,000 2,000

Out-of-pocket maximum (dollars) 5,000 6,000 6,000

Coinsurance (percent) 20 30 20

Single female, smoker, age 19 512 plans available

Premium amount (dollars) 780 1,840 4,036

Annual deductible (dollars) 3,250 5,000 2,000

Out-of-pocket maximum (dollars) 5,000 6,000 6,000

Coinsurance (percent) 20 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 6 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 2: In Alabama, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 512 plans available

Premium amount (dollars) 2,340 6,273 14,752

Annual deductible (dollars) 3,250 2,500 2,000

Out-of-pocket maximum (dollars) 5,000 6,500 6,000

Coinsurance (percent) 20 20 20

Single male, smoker, age 64 512 plans available

Premium amount (dollars) 2,340 9,322 21,942

Annual deductible (dollars) 3,250 2,500 2,000

Out-of-pocket maximum (dollars) 5,000 6,500 6,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 64 512 plans available

Premium amount (dollars) 2,340 5,508 12,853

Annual deductible (dollars) 3,250 2,500 2,000

Out-of-pocket maximum (dollars) 5,000 6,500 6,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 64 512 plans available

Premium amount (dollars) 2,340 8,099 18,930

Annual deductible (dollars) 3,250 2,500 2,000

Out-of-pocket maximum (dollars) 5,000 6,500 6,000

Coinsurance (percent) 20 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 7 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 3: In Alaska, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 178 plans available

Premium amount (dollars) 911 1,635 4,128

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 5,000 5,150 4,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 19 178 plans available

Premium amount (dollars) 1,048 1,872 4,128

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 7,000 4,000

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 19 178 plans available

Premium amount (dollars) 969 1,734 4,128

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 7,000 4,000

Coinsurance (percent) 0 20 20

Single female, smoker, age 19 178 plans available

Premium amount (dollars) 1,114 1,995 4,128

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 7,000 4,000

Coinsurance (percent) 0 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 8 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 4: In Alaska, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 178 plans available

Premium amount (dollars) 5,062 8,667 19,908

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 7,000 4,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 64 178 plans available

Premium amount (dollars) 5,822 9,967 22,908

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 7,000 4,000

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 64 178 plans available

Premium amount (dollars) 4,849 8,312 17,640

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 7,000 4,000

Coinsurance (percent) 0 20 20

Single female, smoker, age 64 178 plans available

Premium amount (dollars) 5,576 9,559 20,328

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 7,000 4,000

Coinsurance (percent) 0 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 9 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 5: In Arizona, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 736 plans available

Premium amount (dollars) 384 892 6,643

Annual deductible (dollars) 10,000 2,000 3,900

Out-of-pocket maximum (dollars) 5,000 6,000 5,900

Coinsurance (percent) 40 20 20

Single male, smoker, age 19 736 plans available

Premium amount (dollars) 422 1,069 7,612

Annual deductible (dollars) 10,000 5,000 3,900

Out-of-pocket maximum (dollars) 5,000 8,000 5,900

Coinsurance (percent) 40 20 20

Single female, nonsmoker, age 19 736 plans available

Premium amount (dollars) 516 1,142 8,364

Annual deductible (dollars) 10,000 7,500 3,500

Out-of-pocket maximum (dollars) 5,000 10,500 3,500

Coinsurance (percent) 40 20 30

Single female, smoker, age 19 736 plans available

Premium amount (dollars) 567 1,341 10,378

Annual deductible (dollars) 10,000 2,000 3,900

Out-of-pocket maximum (dollars) 5,000 6,000 5,900

Coinsurance (percent) 40 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 10 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 6: In Arizona, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 736 plans available

Premium amount (dollars) 1,896 4,534 27,511

Annual deductible (dollars) 10,000 2,500 3,900

Out-of-pocket maximum (dollars) 5,000 6,500 5,900

Coinsurance (percent) 40 20 20

Single male, smoker, age 64 731 plans available

Premium amount (dollars) 2,568 6,442 30,927

Annual deductible (dollars) 10,000 3,500 5,200

Out-of-pocket maximum (dollars) 3,000 9,500 7,200

Coinsurance (percent) 30 30 20

Single female, nonsmoker, age 64 736 plans available

Premium amount (dollars) 1,716 3,982 27,870

Annual deductible (dollars) 10,000 2,500 3,900

Out-of-pocket maximum (dollars) 5,000 6,500 5,900

Coinsurance (percent) 40 20 20

Single female, smoker, age 64 736 plans available

Premium amount (dollars) 2,136 5,644 36,381

Annual deductible (dollars) 10,000 3,500 3,900

Out-of-pocket maximum (dollars) 3,000 5,500 5,900

Coinsurance (percent) 30 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 11 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 7: In Arkansas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 386 plans available

Premium amount (dollars) 301 769 1,952

Annual deductible (dollars) 25,000 2,000 1,000

Out-of-pocket maximum (dollars) 25,000 6,000 4,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 19 386 plans available

Premium amount (dollars) 301 938 2,050

Annual deductible (dollars) 25,000 10,000 1,000

Out-of-pocket maximum (dollars) 25,000 13,000 4,000

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 19 386 plans available

Premium amount (dollars) 479 971 2,458

Annual deductible (dollars) 25,000 7,500 1,000

Out-of-pocket maximum (dollars) 25,000 12,000 4,000

Coinsurance (percent) 0 30 20

Single female, smoker, age 19 386 plans available

Premium amount (dollars) 479 1,161 2,581

Annual deductible (dollars) 25,000 10,000 1,000

Out-of-pocket maximum (dollars) 25,000 13,000 4,000

Coinsurance (percent) 0 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 12 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 8: In Arkansas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 386 plans available

Premium amount (dollars) 1,923 3,893 9,150

Annual deductible (dollars) 25,000 7,500 1,000

Out-of-pocket maximum (dollars) 25,000 10,500 4,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 64 386 plans available

Premium amount (dollars) 1,923 5,749 12,353

Annual deductible (dollars) 25,000 3,000 1,000

Out-of-pocket maximum (dollars) 25,000 6,000 4,000

Coinsurance (percent) 0 30 20

Single female, nonsmoker, age 64 386 plans available

Premium amount (dollars) 1,811 3,434 8,816

Annual deductible (dollars) 25,000 10,000 1,000

Out-of-pocket maximum (dollars) 25,000 13,000 4,000

Coinsurance (percent) 0 20 20

Single female, smoker, age 64 386 plans available

Premium amount (dollars) 1,811 5,016 11,902

Annual deductible (dollars) 25,000 5,000 1,000

Out-of-pocket maximum (dollars) 25,000 9,000 4,000

Coinsurance (percent) 0 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 13 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 9: In California, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 617 plans available

Premium amount (dollars) 672 1,704 11,664

Annual deductible (dollars) 6,500 1,000 2,000

Out-of-pocket maximum (dollars) 9,500 2,000 3,000

Coinsurance (percent) 50 30 N/A

Single male, smoker, age 19 617 plans available

Premium amount (dollars) 672 1,920 11,664

Annual deductible (dollars) 6,500 5,000 2,000

Out-of-pocket maximum (dollars) 9,500 0 3,000

Coinsurance (percent) 50 0 N/A

Single female, nonsmoker, age 19 617 plans available

Premium amount (dollars) 672 1,704 11,664

Annual deductible (dollars) 6,500 1,000 2,000

Out-of-pocket maximum (dollars) 9,500 2,000 3,000

Coinsurance (percent) 50 30 N/A

Single female, smoker, age 19 617 plans available

Premium amount (dollars) 672 1,920 11,664

Annual deductible (dollars) 6,500 5,000 2,000

Out-of-pocket maximum (dollars) 9,500 0 3,000

Coinsurance (percent) 50 0 N/A

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 14 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 10: In California, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 617 plans available

Premium amount (dollars) 3,096 6,988 26,928

Annual deductible (dollars) 6,500 5,000 2,000

Out-of-pocket maximum (dollars) 9,500 7,000 3,000

Coinsurance (percent) 50 20 N/A

Single male, smoker, age 64 617 plans available

Premium amount (dollars) 3,096 7,584 26,928

Annual deductible (dollars) 6,500 2,750 2,000

Out-of-pocket maximum (dollars) 9,500 7,500 3,000

Coinsurance (percent) 50 30 N/A

Single female, nonsmoker, age 64 617 plans available

Premium amount (dollars) 3,096 6,988 26,928

Annual deductible (dollars) 6,500 5,000 2,000

Out-of-pocket maximum (dollars) 9,500 7,000 3,000

Coinsurance (percent) 50 20 N/A

Single female, smoker, age 64 617 plans available

Premium amount (dollars) 3,096 7,584 26,928

Annual deductible (dollars) 6,500 2,750 2,000

Out-of-pocket maximum (dollars) 9,500 7,500 3,000

Coinsurance (percent) 50 30 N/A

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 15 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 11: In Colorado, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 2,571 plans available

Premium amount (dollars) 581 1,930 9,908

Annual deductible (dollars) 10,000 2,000 500

Out-of-pocket maximum (dollars) 17,500 3,750 3,000

Coinsurance (percent) 50 30 20

Single male, smoker, age 19 2,571 plans available

Premium amount (dollars) 684 2,241 10,898

Annual deductible (dollars) 10,000 3,250 500

Out-of-pocket maximum (dollars) 17,500 3,250 3,000

Coinsurance (percent) 50 0 20

Single female, nonsmoker, age 19 2,571 plans available

Premium amount (dollars) 581 1,930 9,908

Annual deductible (dollars) 10,000 2,000 500

Out-of-pocket maximum (dollars) 17,500 3,750 3,000

Coinsurance (percent) 50 30 20

Single female, smoker, age 19 2,571 plans available

Premium amount (dollars) 684 2,241 10,898

Annual deductible (dollars) 10,000 3,250 500

Out-of-pocket maximum (dollars) 17,500 3,250 3,000

Coinsurance (percent) 50 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 16 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 12: In Colorado, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 2,567 plans available

Premium amount (dollars) 2,111 7,145 24,739

Annual deductible (dollars) 10,000 10,000 500

Out-of-pocket maximum (dollars) 17,500 3,000 3,000

Coinsurance (percent) 50 20 20

Single male, smoker, age 64 2,567 plans available

Premium amount (dollars) 3,276 9,396 39,583

Annual deductible (dollars) 7,500 N/A 500

Out-of-pocket maximum (dollars) 11,000 N/A 3,000

Coinsurance (percent) 50 0 20

Single female, nonsmoker, age 64 2,567 plans available

Premium amount (dollars) 2,111 7,145 24,739

Annual deductible (dollars) 10,000 10,000 500

Out-of-pocket maximum (dollars) 17,500 3,000 3,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 64 2,567 plans available

Premium amount (dollars) 3,276 9,396 39,583

Annual deductible (dollars) 7,500 N/A 500

Out-of-pocket maximum (dollars) 11,000 N/A 3,000

Coinsurance (percent) 50 0 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 17 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 13: In Connecticut, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 470 plans available

Premium amount (dollars) 876 1,662 3,800

Annual deductible (dollars) 10,000 1,000 500

Out-of-pocket maximum (dollars) 12,500 10,000 3,500

Coinsurance (percent) 20 0 20

Single male, smoker, age 19 470 plans available

Premium amount (dollars) 876 1,965 4,750

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 12,500 6,500 3,500

Coinsurance (percent) 20 50 20

Single female, nonsmoker, age 19 470 plans available

Premium amount (dollars) 972 1,879 5,094

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 12,500 7,000 3,500

Coinsurance (percent) 20 20 20

Single female, smoker, age 19 470 plans available

Premium amount (dollars) 972 2,227 6,368

Annual deductible (dollars) 10,000 1,500 500

Out-of-pocket maximum (dollars) 12,500 5,150 3,500

Coinsurance (percent) 20 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 18 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 14: In Connecticut, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 470 plans available

Premium amount (dollars) 3,672 8,482 16,820

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 12,500 4,500 3,500

Coinsurance (percent) 20 20 20

Single male, smoker, age 64 470 plans available

Premium amount (dollars) 3,672 9,755 21,025

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 12,500 4,500 3,500

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 64 470 plans available

Premium amount (dollars) 2,676 7,844 16,122

Annual deductible (dollars) 10,000 2,600 1,000

Out-of-pocket maximum (dollars) 12,500 5,000 3,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 64 470 plans available

Premium amount (dollars) 2,676 9,356 19,605

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 12,500 4,500 3,500

Coinsurance (percent) 20 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 19 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 15: In Delaware, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 123 plans available

Premium amount (dollars) 550 1,176 2,180

Annual deductible (dollars) 10,000 2,000 2,000

Out-of-pocket maximum (dollars) 3,000 6,000 6,000

Coinsurance (percent) 20 20 20

Single male, smoker, age 19 123 plans available

Premium amount (dollars) 660 1,401 2,696

Annual deductible (dollars) 10,000 7,500 2,000

Out-of-pocket maximum (dollars) 3,000 10,500 6,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 19 123 plans available

Premium amount (dollars) 565 1,338 2,706

Annual deductible (dollars) 10,000 3,500 2,000

Out-of-pocket maximum (dollars) 3,000 0 6,000

Coinsurance (percent) 20 0 20

Single female, smoker, age 19 123 plans available

Premium amount (dollars) 678 1,596 3,279

Annual deductible (dollars) 10,000 7,500 2,000

Out-of-pocket maximum (dollars) 3,000 12,000 6,000

Coinsurance (percent) 20 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 20 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 16: In Delaware, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 123 plans available

Premium amount (dollars) 3,536 6,420 13,952

Annual deductible (dollars) 10,000 2,400 1,250

Out-of-pocket maximum (dollars) 3,000 4,400 600

Coinsurance (percent) 20 20 30

Single male, smoker, age 64 123 plans available

Premium amount (dollars) 5,304 9,385 20,928

Annual deductible (dollars) 10,000 2,500 1,250

Out-of-pocket maximum (dollars) 3,000 6,500 600

Coinsurance (percent) 20 20 30

Single female, nonsmoker, age 64 123 plans available

Premium amount (dollars) 2,637 5,164 10,442

Annual deductible (dollars) 10,000 3,000 2,000

Out-of-pocket maximum (dollars) 3,000 6,000 6,000

Coinsurance (percent) 20 30 20

Single female, smoker, age 64 123 plans available

Premium amount (dollars) 3,956 7,591 15,379

Annual deductible (dollars) 10,000 5,000 2,000

Out-of-pocket maximum (dollars) 3,000 9,500 6,000

Coinsurance (percent) 20 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 21 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 17: In District of Columbia, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 309 plans available

Premium amount (dollars) 614 1,617 12,056

Annual deductible (dollars) 10,000 2,850 100

Out-of-pocket maximum (dollars) 17,500 4,850 2,500

Coinsurance (percent) 50 20 10

Single male, smoker, age 19 309 plans available

Premium amount (dollars) 961 1,957 12,056

Annual deductible (dollars) 10,000 2,500 100

Out-of-pocket maximum (dollars) 17,500 4,500 2,500

Coinsurance (percent) 50 20 10

Single female, nonsmoker, age 19 309 plans available

Premium amount (dollars) 614 1,653 12,056

Annual deductible (dollars) 10,000 5,000 100

Out-of-pocket maximum (dollars) 17,500 7,000 2,500

Coinsurance (percent) 50 20 10

Single female, smoker, age 19 309 plans available

Premium amount (dollars) 961 2,020 12,056

Annual deductible (dollars) 10,000 1,500 100

Out-of-pocket maximum (dollars) 17,500 3,000 2,500

Coinsurance (percent) 50 0 10

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 22 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 18: In District of Columbia, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 309 plans available

Premium amount (dollars) 1,842 7,715 36,120

Annual deductible (dollars) 10,000 2,500 100

Out-of-pocket maximum (dollars) 17,500 4,500 2,500

Coinsurance (percent) 50 20 10

Single male, smoker, age 64 309 plans available

Premium amount (dollars) 2,883 8,872 36,120

Annual deductible (dollars) 10,000 2,500 100

Out-of-pocket maximum (dollars) 17,500 4,500 2,500

Coinsurance (percent) 50 20 10

Single female, nonsmoker, age 64 309 plans available

Premium amount (dollars) 1,842 7,428 36,120

Annual deductible (dollars) 10,000 2,500 100

Out-of-pocket maximum (dollars) 17,500 4,500 2,500

Coinsurance (percent) 50 20 10

Single female, smoker, age 64 309 plans available

Premium amount (dollars) 2,883 8,542 36,120

Annual deductible (dollars) 10,000 2,500 100

Out-of-pocket maximum (dollars) 17,500 4,500 2,500

Coinsurance (percent) 50 20 10

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 23 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 19: In Florida, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 7,669 plans available

Premium amount (dollars) 540 1,248 6,141

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 15,000 3,000

Coinsurance (percent) 20 30 20

Single male, smoker, age 19 7,669 plans available

Premium amount (dollars) 564 1,512 7,063

Annual deductible (dollars) 2,500 3,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,000 3,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 19 7,669 plans available

Premium amount (dollars) 588 1,812 6,580

Annual deductible (dollars) 2,500 500 500

Out-of-pocket maximum (dollars) 7,500 4,000 3,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 19 7,669 plans available

Premium amount (dollars) 612 2,128 7,524

Annual deductible (dollars) 2,500 1,000 1,000

Out-of-pocket maximum (dollars) 7,500 10,000 3,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 24 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 20: In Florida, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 7,669 plans available

Premium amount (dollars) 2,280 5,496 32,688

Annual deductible (dollars) 10,000 250 1,000

Out-of-pocket maximum (dollars) 20,000 2,500 3,000

Coinsurance (percent) 20 10 20

Single male, smoker, age 64 7,669 plans available

Premium amount (dollars) 2,568 6,768 37,591

Annual deductible (dollars) 10,000 10,000 1,000

Out-of-pocket maximum (dollars) 12,500 0 3,000

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 64 7,669 plans available

Premium amount (dollars) 1,800 5,916 31,352

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 12,500 15,000 3,000

Coinsurance (percent) 20 30 20

Single female, smoker, age 64 7,669 plans available

Premium amount (dollars) 1,800 7,104 36,054

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 12,500 3,500 3,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 25 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 21: In Georgia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 4,209 plans available

Premium amount (dollars) 363 1,145 7,866

Annual deductible (dollars) 10,000 2,000 500

Out-of-pocket maximum (dollars) 17,500 9,500 3,000

Coinsurance (percent) 40 40 20

Single male, smoker, age 19 4,196 plans available

Premium amount (dollars) 422 1,317 8,351

Annual deductible (dollars) 10,000 7,500 500

Out-of-pocket maximum (dollars) 5,000 5,000 3,000

Coinsurance (percent) 30 25 20

Single female, nonsmoker, age 19 4,209 plans available

Premium amount (dollars) 383 1,327 8,960

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 17,500 7,500 3,000

Coinsurance (percent) 40 30 20

Single female, smoker, age 19 4,196 plans available

Premium amount (dollars) 450 1,533 9,853

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 17,500 10,000 3,000

Coinsurance (percent) 40 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 26 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 22: In Georgia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 4,209 plans available

Premium amount (dollars) 1,481 5,168 22,832

Annual deductible (dollars) 10,000 6,000 1,000

Out-of-pocket maximum (dollars) 17,500 6,000 2,500

Coinsurance (percent) 40 0 20

Single male, smoker, age 64 4,196 plans available

Premium amount (dollars) 2,615 7,717 31,964

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 17,500 7,000 2,500

Coinsurance (percent) 40 20 20

Single female, nonsmoker, age 64 4,209 plans available

Premium amount (dollars) 1,635 4,943 20,529

Annual deductible (dollars) 10,000 4,000 1,000

Out-of-pocket maximum (dollars) 17,500 4,000 2,500

Coinsurance (percent) 40 0 20

Single female, smoker, age 64 4,196 plans available

Premium amount (dollars) 2,196 7,397 30,748

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 12,500 3,000 3,000

Coinsurance (percent) 30 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 27 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 23: In Hawaii, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 37 plans available

Premium amount (dollars) 570 3,540 4,938

Annual deductible (dollars) 2,500 N/A 0 

Out-of-pocket maximum (dollars) 3,500 2,500 2,500

Coinsurance (percent) 20 N/A 20

Single male, smoker, age 19 37 plans available

Premium amount (dollars) 570 3,540 4,938

Annual deductible (dollars) 2,500 N/A 0 

Out-of-pocket maximum (dollars) 3,500 2,500 2,500

Coinsurance (percent) 20 N/A 20

Single female, nonsmoker, age 19 37 plans available

Premium amount (dollars) 570 3,643 4,938

Annual deductible (dollars) 2,500 0 0 

Out-of-pocket maximum (dollars) 3,500 2,500 2,500

Coinsurance (percent) 20 10 20

Single female, smoker, age 19 37 plans available

Premium amount (dollars) 570 3,643 4,938

Annual deductible (dollars) 2,500 0 0 

Out-of-pocket maximum (dollars) 3,500 2,500 2,500

Coinsurance (percent) 20 10 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 28 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 24: In Hawaii, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 36 plans available

Premium amount (dollars) 1,428 11,729 17,279

Annual deductible (dollars) 2,500 N/A 0 

Out-of-pocket maximum (dollars) 3,500 2,500 2,500

Coinsurance (percent) 20 N/A 20

Single male, smoker, age 64 36 plans available

Premium amount (dollars) 1,428 11,729 17,279

Annual deductible (dollars) 2,500 N/A 0 

Out-of-pocket maximum (dollars) 3,500 2,500 2,500

Coinsurance (percent) 20 N/A 20

Single female, nonsmoker, age 64 36 plans available

Premium amount (dollars) 1,428 11,602 17,279

Annual deductible (dollars) 2,500 300 0 

Out-of-pocket maximum (dollars) 3,500 3,000 2,500

Coinsurance (percent) 20 20 20

Single female, smoker, age 64 36 plans available

Premium amount (dollars) 1,428 11,602 17,279

Annual deductible (dollars) 2,500 300 0 

Out-of-pocket maximum (dollars) 3,500 3,000 2,500

Coinsurance (percent) 20 20 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 29 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 25: In Idaho, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 245 plans available

Premium amount (dollars) 552 1,320 3,901

Annual deductible (dollars) 5,000 1,500 2,850

Out-of-pocket maximum (dollars) 2,000 5,000 2,850

Coinsurance (percent) 20 20 0 

Single male, smoker, age 19 245 plans available

Premium amount (dollars) 613 1,524 4,590

Annual deductible (dollars) 5,000 10,000 2,850

Out-of-pocket maximum (dollars) 2,000 13,500 2,850

Coinsurance (percent) 20 50 0 

Single female, nonsmoker, age 19 245 plans available

Premium amount (dollars) 660 1,416 3,692

Annual deductible (dollars) 10,000 10,000 2,850

Out-of-pocket maximum (dollars) 12,500 10,000 2,850

Coinsurance (percent) 40 0 0 

Single female, smoker, age 19 245 plans available

Premium amount (dollars) 718 1,603 4,344

Annual deductible (dollars) 10,000 10,000 2,850

Out-of-pocket maximum (dollars) 4,000 13,500 2,850

Coinsurance (percent) 30 50 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 30 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 26: In Idaho, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 245 plans available

Premium amount (dollars) 2,694 5,916 14,632

Annual deductible (dollars) 5,000 10,000 2,850

Out-of-pocket maximum (dollars) 2,000 12,000 2,850

Coinsurance (percent) 20 50 0 

Single male, smoker, age 64 245 plans available

Premium amount (dollars) 2,992 8,136 25,822

Annual deductible (dollars) 5,000 2,500 2,850

Out-of-pocket maximum (dollars) 2,000 8,000 2,850

Coinsurance (percent) 20 30 0 

Single female, nonsmoker, age 64 245 plans available

Premium amount (dollars) 2,451 5,772 15,552

Annual deductible (dollars) 5,000 3,500 2,850

Out-of-pocket maximum (dollars) 2,000 5,000 2,850

Coinsurance (percent) 20 20 0 

Single female, smoker, age 64 245 plans available

Premium amount (dollars) 2,723 8,023 27,446

Annual deductible (dollars) 5,000 10,000 2,850

Out-of-pocket maximum (dollars) 2,000 17,500 2,850

Coinsurance (percent) 20 30 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 31 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 27: In Illinois, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,854 plans available

Premium amount (dollars) 485 1,170 4,091

Annual deductible (dollars) 10,000 5,000 0 

Out-of-pocket maximum (dollars) 16,000 8,000 1,000

Coinsurance (percent) 30 20 0 

Single male, smoker, age 19 1,854 plans available

Premium amount (dollars) 535 1,377 5,114

Annual deductible (dollars) 7,500 2,500 0 

Out-of-pocket maximum (dollars) 22,500 5,500 1,000

Coinsurance (percent) 0 20 0 

Single female, nonsmoker, age 19 1,854 plans available

Premium amount (dollars) 646 1,614 14,184

Annual deductible (dollars) 10,000 6,000 0 

Out-of-pocket maximum (dollars) 16,000 6,000 3,000

Coinsurance (percent) 30 0 0 

Single female, smoker, age 19 1,854 plans available

Premium amount (dollars) 684 1,859 17,430

Annual deductible (dollars) 7,500 0 0 

Out-of-pocket maximum (dollars) 22,500 3,000 1,000

Coinsurance (percent) 0 0 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 32 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 28: In Illinois, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,854 plans available

Premium amount (dollars) 2,478 5,916 21,212

Annual deductible (dollars) 10,000 2,000 0 

Out-of-pocket maximum (dollars) 16,000 6,000 1,000

Coinsurance (percent) 30 0 0 

Single male, smoker, age 64 1,854 plans available

Premium amount (dollars) 2,690 7,464 26,515

Annual deductible (dollars) 7,500 3,000 0 

Out-of-pocket maximum (dollars) 22,500 6,000 1,000

Coinsurance (percent) 0 20 0 

Single female, nonsmoker, age 64 1,854 plans available

Premium amount (dollars) 2,052 5,313 23,733

Annual deductible (dollars) 7,500 2,000 0 

Out-of-pocket maximum (dollars) 22,500 6,000 1,000

Coinsurance (percent) 0 20 0 

Single female, smoker, age 64 1,854 plans available

Premium amount (dollars) 2,052 6,564 29,667

Annual deductible (dollars) 7,500 500 0 

Out-of-pocket maximum (dollars) 22,500 2,000 1,000

Coinsurance (percent) 0 0 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 33 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 29: In Indiana, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 2,278 plans available

Premium amount (dollars) 476 1,474 4,290

Annual deductible (dollars) N/A 1,500 1,000

Out-of-pocket maximum (dollars) N/A 5,150 3,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 19 2,278 plans available

Premium amount (dollars) 619 1,768 4,841

Annual deductible (dollars) N/A 3,500 1,000

Out-of-pocket maximum (dollars) N/A 7,000 3,000

Coinsurance (percent) 0 30 20

Single female, nonsmoker, age 19 2,278 plans available

Premium amount (dollars) 587 1,775 7,515

Annual deductible (dollars) N/A 1,500 500

Out-of-pocket maximum (dollars) N/A 3,500 2,500

Coinsurance (percent) 0 30 20

Single female, smoker, age 19 2,278 plans available

Premium amount (dollars) 763 2,204 8,393

Annual deductible (dollars) N/A 2,500 500

Out-of-pocket maximum (dollars) N/A 6,000 2,500

Coinsurance (percent) 0 50 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 34 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 30: In Indiana, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 2,278 plans available

Premium amount (dollars) 2,666 6,628 17,082

Annual deductible (dollars) N/A 5,000 1,000

Out-of-pocket maximum (dollars) N/A 7,000 3,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 64 2,278 plans available

Premium amount (dollars) 3,465 8,195 20,237

Annual deductible (dollars) N/A N/A 1,000

Out-of-pocket maximum (dollars) N/A N/A 3,000

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 64 2,278 plans available

Premium amount (dollars) 2,108 6,488 16,384

Annual deductible (dollars) N/A 5,000 1,000

Out-of-pocket maximum (dollars) N/A 7,000 3,000

Coinsurance (percent) 0 20 20

Single female, smoker, age 64 2,278 plans available

Premium amount (dollars) 2,740 7,987 19,002

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 4,500 3,000

Coinsurance (percent) 0 20 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 35 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 31: In Iowa, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,404 plans available

Premium amount (dollars) 272 1,174 2,575

Annual deductible (dollars) 5,000 2,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 20 20

Single male, smoker, age 19 1,404 plans available

Premium amount (dollars) 368 1,357 2,961

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 30 20

Single female, nonsmoker, age 19 1,404 plans available

Premium amount (dollars) 306 1,251 2,743

Annual deductible (dollars) 5,000 2,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 20 20

Single female, smoker, age 19 1,404 plans available

Premium amount (dollars) 413 1,455 3,154

Annual deductible (dollars) 5,000 2,600 1,000

Out-of-pocket maximum (dollars) 10,000 2,600 3,000

Coinsurance (percent) 40 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 36 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 32: In Iowa, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,404 plans available

Premium amount (dollars) 1,412 6,253 13,706

Annual deductible (dollars) 5,000 2,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 20 20

Single male, smoker, age 64 1,404 plans available

Premium amount (dollars) 1,907 7,280 15,762

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 30 20

Single female, nonsmoker, age 64 1,404 plans available

Premium amount (dollars) 1,277 5,985 13,145

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 30 20

Single female, smoker, age 64 1,404 plans available

Premium amount (dollars) 1,724 6,897 15,117

Annual deductible (dollars) 5,000 2,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 37 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 33: In Kansas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,727 plans available

Premium amount (dollars) 289 1,343 9,684

Annual deductible (dollars) 10,000 1,000 2,500

Out-of-pocket maximum (dollars) 11,000 10,000 5,000

Coinsurance (percent) 20 0 20

Single male, smoker, age 19 1,727 plans available

Premium amount (dollars) 289 1,573 9,684

Annual deductible (dollars) 10,000 3,000 2,500

Out-of-pocket maximum (dollars) 11,000 3,000 5,000

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 19 1,727 plans available

Premium amount (dollars) 387 1,466 10,416

Annual deductible (dollars) 10,000 2,850 2,500

Out-of-pocket maximum (dollars) 17,500 4,850 5,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 19 1,727 plans available

Premium amount (dollars) 456 1,732 10,416

Annual deductible (dollars) 10,000 2,850 2,500

Out-of-pocket maximum (dollars) 17,500 5,350 5,000

Coinsurance (percent) 50 50 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include

plans with little or no enrollment.
Enclosure I

Page 38 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 34: In Kansas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,727 plans available

Premium amount (dollars) 1,453 6,374 17,939

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 17,500 6,500 3,000

Coinsurance (percent) 50 30 20

Single male, smoker, age 64 1,727 plans available

Premium amount (dollars) 1,666 8,411 24,172

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 11,000 7,000 2,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 64 1,727 plans available

Premium amount (dollars) 1,382 6,137 17,206

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 15,000 6,500 3,000

Coinsurance (percent) 20 30 20

Single female, smoker, age 64 1,727 plans available

Premium amount (dollars) 1,448 8,066 21,271

Annual deductible (dollars) 10,000 2,000 1,000

Out-of-pocket maximum (dollars) 11,000 3,250 3,000

Coinsurance (percent) 20 50 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 39 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 35: In Kentucky, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 2,222 plans available

Premium amount (dollars) 395 1,167 3,189

Annual deductible (dollars) 10,000 N/A 500

Out-of-pocket maximum (dollars) 17,500 N/A 3,000

Coinsurance (percent) 50 50 20

Single male, smoker, age 19 2,222 plans available

Premium amount (dollars) 464 1,542 4,295

Annual deductible (dollars) 10,000 500 500

Out-of-pocket maximum (dollars) 17,500 4,000 3,000

Coinsurance (percent) 50 50 20

Single female, nonsmoker, age 19 2,222 plans available

Premium amount (dollars) 417 1,420 6,342

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 17,500 5,000 2,500

Coinsurance (percent) 50 20 20

Single female, smoker, age 19 2,222 plans available

Premium amount (dollars) 490 1,889 6,988

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 17,500 5,000 2,500

Coinsurance (percent) 50 20 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 40 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 36: In Kentucky, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 2,222 plans available

Premium amount (dollars) 1,619 4,294 11,553

Annual deductible (dollars) 10,000 1,000 1,000

Out-of-pocket maximum (dollars) 17,500 4,500 2,000

Coinsurance (percent) 50 30 20

Single male, smoker, age 64 2,222 plans available

Premium amount (dollars) 2,276 6,455 17,329

Annual deductible (dollars) 7,500 N/A 1,000

Out-of-pocket maximum (dollars) 12,500 N/A 2,000

Coinsurance (percent) 30 0 20

Single female, nonsmoker, age 64 2,222 plans available

Premium amount (dollars) 1,784 4,361 10,641

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 17,500 5,000 3,000

Coinsurance (percent) 50 0 20

Single female, smoker, age 64 2,222 plans available

Premium amount (dollars) 2,418 6,642 15,670

Annual deductible (dollars) 7,500 500 1,000

Out-of-pocket maximum (dollars) 12,500 4,000 2,000

Coinsurance (percent) 30 30 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 41 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 37: In Louisiana, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,931 plans available

Premium amount (dollars) 332 1,329 3,913

Annual deductible (dollars) 5,000 7,500 500

Out-of-pocket maximum (dollars) 1,000 7,500 3,000

Coinsurance (percent) 20 0 20

Single male, smoker, age 19 1,931 plans available

Premium amount (dollars) 365 1,541 4,304

Annual deductible (dollars) 5,000 5,000 500

Out-of-pocket maximum (dollars) 1,000 12,500 3,000

Coinsurance (percent) 20 30 20

Single female, nonsmoker, age 19 1,931 plans available

Premium amount (dollars) 468 1,528 7,383

Annual deductible (dollars) 5,000 500 500

Out-of-pocket maximum (dollars) 1,000 1,000 2,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 19 1,931 plans available

Premium amount (dollars) 515 1,793 7,737

Annual deductible (dollars) 5,000 5,000 500

Out-of-pocket maximum (dollars) 1,000 7,500 2,000

Coinsurance (percent) 20 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 42 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 38: In Louisiana, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,931 plans available

Premium amount (dollars) 1,689 5,961 17,928

Annual deductible (dollars) 5,000 5,000 500

Out-of-pocket maximum (dollars) 1,000 8,500 1,500

Coinsurance (percent) 20 50 20

Single male, smoker, age 64 1,931 plans available

Premium amount (dollars) 2,067 9,554 25,894

Annual deductible (dollars) 5,000 3,500 1,250

Out-of-pocket maximum (dollars) 1,000 8,500 600

Coinsurance (percent) 20 50 30

Single female, nonsmoker, age 64 1,879 plans available

Premium amount (dollars) 1,446 5,791 15,510

Annual deductible (dollars) 5,000 2,500 500

Out-of-pocket maximum (dollars) 1,000 5,000 1,500

Coinsurance (percent) 20 20 20

Single female, smoker, age 64 1,905 plans available

Premium amount (dollars) 1,773 9,305 21,333

Annual deductible (dollars) 5,000 5,000 2,850

Out-of-pocket maximum (dollars) 1,000 8,500 2,850

Coinsurance (percent) 20 50 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 43 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 39: In Maine, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 11 plans available

Premium amount (dollars) 1,287 9,286 20,582

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Single male, smoker, age 19 11 plans available

Premium amount (dollars) 1,287 9,286 20,582

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Single female, nonsmoker, age 19 11 plans available

Premium amount (dollars) 1,287 9,286 20,582

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Single female, smoker, age 19 11 plans available

Premium amount (dollars) 1,287 9,286 20,582

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 44 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 40: In Maine, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 11 plans available

Premium amount (dollars) 3,860 13,929 29,124

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Single male, smoker, age 64 11 plans available

Premium amount (dollars) 3,860 13,929 29,124

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Single female, nonsmoker, age 64 11 plans available

Premium amount (dollars) 3,860 13,929 29,124

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Single female, smoker, age 64 11 plans available

Premium amount (dollars) 3,860 13,929 29,124

Annual deductible (dollars) 12,000 N/A N/A

Out-of-pocket maximum (dollars) 14,000 2,000 N/A

Coinsurance (percent) 20 0 0 

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 45 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 41: In Maryland, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 55 plans available

Premium amount (dollars) 636 1,680 5,208

Annual deductible (dollars) 5,000 2,500 100

Out-of-pocket maximum (dollars) 6,050 4,000 2,500

Coinsurance (percent) 0 20 10

Single male, smoker, age 19 55 plans available

Premium amount (dollars) 636 1,680 5,208

Annual deductible (dollars) 5,000 2,500 100

Out-of-pocket maximum (dollars) 6,050 4,000 2,500

Coinsurance (percent) 0 20 10

Single female, nonsmoker, age 19 55 plans available

Premium amount (dollars) 648 2,160 5,208

Annual deductible (dollars) 10,000 10,000 100

Out-of-pocket maximum (dollars) 10,000 10,000 2,500

Coinsurance (percent) 0 0 10

Single female, smoker, age 19 55 plans available

Premium amount (dollars) 648 2,160 5,208

Annual deductible (dollars) 10,000 10,000 100

Out-of-pocket maximum (dollars) 10,000 10,000 2,500

Coinsurance (percent) 0 0 10

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 46 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 42: In Maryland, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 55 plans available

Premium amount (dollars) 1,908 6,624 17,556

Annual deductible (dollars) 10,000 2,700 100

Out-of-pocket maximum (dollars) 10,000 3,200 2,500

Coinsurance (percent) 20 0 10

Single male, smoker, age 64 55 plans available

Premium amount (dollars) 1,908 6,624 17,556

Annual deductible (dollars) 10,000 2,700 100

Out-of-pocket maximum (dollars) 10,000 3,200 2,500

Coinsurance (percent) 20 0 10

Single female, nonsmoker, age 64 55 plans available

Premium amount (dollars) 1,908 6,060 17,556

Annual deductible (dollars) 10,000 2,500 100

Out-of-pocket maximum (dollars) 10,000 5,000 2,500

Coinsurance (percent) 20 30 10

Single female, smoker, age 64 55 plans available

Premium amount (dollars) 1,908 6,060 17,556

Annual deductible (dollars) 10,000 2,500 100

Out-of-pocket maximum (dollars) 10,000 5,000 2,500

Coinsurance (percent) 20 30 10

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 47 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 43: In Massachusetts, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 128 plans available

Premium amount (dollars) 2,032 3,022 5,069

Annual deductible (dollars) 2,000 2,000 N/A

Out-of-pocket maximum (dollars) 5,000 5,000 No Maximum

Coinsurance (percent) 20 0 0 

Single male, smoker, age 19 128 plans available

Premium amount (dollars) 2,032 3,022 5,069

Annual deductible (dollars) 2,000 2,000 N/A

Out-of-pocket maximum (dollars) 5,000 5,000 No Maximum

Coinsurance (percent) 20 0 0 

Single female, nonsmoker, age 19 128 plans available

Premium amount (dollars) 2,032 3,022 5,069

Annual deductible (dollars) 2,000 2,000 N/A

Out-of-pocket maximum (dollars) 5,000 5,000 No Maximum

Coinsurance (percent) 20 0 0 

Single female, smoker, age 19 128 plans available

Premium amount (dollars) 2,032 3,022 5,069

Annual deductible (dollars) 2,000 2,000 N/A

Out-of-pocket maximum (dollars) 5,000 5,000 No Maximum

Coinsurance (percent) 20 0 0 

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state- wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 48 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 44: In Massachusetts, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 96 plans available

Premium amount (dollars) 5,128 6,877 10,138

Annual deductible (dollars) 2,000 1,500 N/A

Out-of-pocket maximum (dollars) 5,000 3,000 No Maximum

Coinsurance (percent) 20 0 0 

Single male, smoker, age 64 96 plans available

Premium amount (dollars) 5,128 6,877 10,138

Annual deductible (dollars) 2,000 1,500 N/A

Out-of-pocket maximum (dollars) 5,000 3,000 No Maximum

Coinsurance (percent) 20 0 0 

Single female, nonsmoker, age 64 96 plans available

Premium amount (dollars) 5,128 6,877 10,138

Annual deductible (dollars) 2,000 1,500 N/A

Out-of-pocket maximum (dollars) 5,000 3,000 No Maximum

Coinsurance (percent) 20 0 0 

Single female, smoker, age 64 96 plans available

Premium amount (dollars) 5,128 6,877 10,138

Annual deductible (dollars) 2,000 1,500 N/A

Out-of-pocket maximum (dollars) 5,000 3,000 No Maximum

Coinsurance (percent) 20 0 0 

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment. 
Enclosure I

Page 49 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 45: In Michigan, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 722 plans available

Premium amount (dollars) 436 907 6,006

Annual deductible (dollars) 5,000 2,500 N/A

Out-of-pocket maximum (dollars) 10,000 6,500 1,000

Coinsurance (percent) 20 20 20

Single male, smoker, age 19 722 plans available

Premium amount (dollars) 436 1,051 6,006

Annual deductible (dollars) 5,000 2,500 N/A

Out-of-pocket maximum (dollars) 10,000 6,500 1,000

Coinsurance (percent) 20 30 20

Single female, nonsmoker, age 19 722 plans available

Premium amount (dollars) 504 1,074 6,006

Annual deductible (dollars) 10,000 3,000 N/A

Out-of-pocket maximum (dollars) 12,000 6,000 1,000

Coinsurance (percent) 20 30 20

Single female, smoker, age 19 722 plans available

Premium amount (dollars) 504 1,237 6,006

Annual deductible (dollars) 10,000 7,500 N/A

Out-of-pocket maximum (dollars) 12,000 10,500 1,000

Coinsurance (percent) 20 20 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 50 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 46: In Michigan, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 734 plans available

Premium amount (dollars) 2,088 4,390 13,356

Annual deductible (dollars) 10,000 4,000 1,500

Out-of-pocket maximum (dollars) 12,000 6,000 4,000

Coinsurance (percent) 20 20 20

Single male, smoker, age 64 734 plans available

Premium amount (dollars) 2,088 5,765 16,663

Annual deductible (dollars) 10,000 10,000 1,500

Out-of-pocket maximum (dollars) 12,000 13,000 5,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 64 734 plans available

Premium amount (dollars) 1,980 3,885 13,356

Annual deductible (dollars) 10,000 5,000 1,500

Out-of-pocket maximum (dollars) 12,500 9,500 4,000

Coinsurance (percent) 20 30 20

Single female, smoker, age 64 734 plans available

Premium amount (dollars) 1,980 5,113 15,374

Annual deductible (dollars) 10,000 10,000 1,500

Out-of-pocket maximum (dollars) 12,500 13,000 5,000

Coinsurance (percent) 20 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 51 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 47: In Minnesota, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,098 plans available

Premium amount (dollars) 632 1,438 6,926

Annual deductible (dollars) 15,000 5,000 150

Out-of-pocket maximum (dollars) 17,500 7,000 1,650

Coinsurance (percent) 20 50 20

Single male, smoker, age 19 1,098 plans available

Premium amount (dollars) 832 1,903 9,235

Annual deductible (dollars) 12,600 4,000 150

Out-of-pocket maximum (dollars) 13,600 4,000 1,650

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 19 1,098 plans available

Premium amount (dollars) 632 1,438 6,926

Annual deductible (dollars) 15,000 5,000 150

Out-of-pocket maximum (dollars) 17,500 7,000 1,650

Coinsurance (percent) 20 50 20

Single female, smoker, age 19 1,098 plans available

Premium amount (dollars) 832 1,903 9,235

Annual deductible (dollars) 12,600 4,000 150

Out-of-pocket maximum (dollars) 13,600 4,000 1,650

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 52 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 48: In Minnesota, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,098 plans available

Premium amount (dollars) 1,851 4,182 20,289

Annual deductible (dollars) 15,000 4,000 150

Out-of-pocket maximum (dollars) 17,500 4,000 1,650

Coinsurance (percent) 20 0 20

Single male, smoker, age 64 1,098 plans available

Premium amount (dollars) 2,422 5,580 27,052

Annual deductible (dollars) 12,600 10,000 150

Out-of-pocket maximum (dollars) 13,600 12,000 1,650

Coinsurance (percent) 20 50 20

Single female, nonsmoker, age 64 1,098 plans available

Premium amount (dollars) 1,851 4,182 20,289

Annual deductible (dollars) 15,000 4,000 150

Out-of-pocket maximum (dollars) 17,500 4,000 1,650

Coinsurance (percent) 20 0 20

Single female, smoker, age 64 1,098 plans available

Premium amount (dollars) 2,422 5,580 27,052

Annual deductible (dollars) 12,600 10,000 150

Out-of-pocket maximum (dollars) 13,600 12,000 1,650

Coinsurance (percent) 20 50 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 53 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 49: In Mississippi, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 578 plans available

Premium amount (dollars) 607 1,394 5,593

Annual deductible (dollars) 10,000 2,000 500

Out-of-pocket maximum (dollars) 10,000 6,000 3,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 19 578 plans available

Premium amount (dollars) 665 1,624 6,149

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 10,000 8,000 3,000

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 19 578 plans available

Premium amount (dollars) 747 1,674 7,381

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 10,000 6,500 3,000

Coinsurance (percent) 0 20 20

Single female, smoker, age 19 578 plans available

Premium amount (dollars) 818 1,954 8,117

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 10,000 8,500 3,000

Coinsurance (percent) 0 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 54 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 50: In Mississippi, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 578 plans available

Premium amount (dollars) 2,396 6,377 18,382

Annual deductible (dollars) 7,500 5,000 500

Out-of-pocket maximum (dollars) 12,500 8,000 3,000

Coinsurance (percent) 30 20 20

Single male, smoker, age 64 578 plans available

Premium amount (dollars) 3,817 9,809 29,394

Annual deductible (dollars) 7,500 2,500 500

Out-of-pocket maximum (dollars) 12,500 7,500 3,000

Coinsurance (percent) 30 30 20

Single female, nonsmoker, age 64 578 plans available

Premium amount (dollars) 2,460 5,968 17,485

Annual deductible (dollars) 7,500 5,000 500

Out-of-pocket maximum (dollars) 12,500 7,500 3,000

Coinsurance (percent) 30 20 20

Single female, smoker, age 64 578 plans available

Premium amount (dollars) 3,919 8,974 27,959

Annual deductible (dollars) 7,500 2,000 500

Out-of-pocket maximum (dollars) 12,500 6,000 3,000

Coinsurance (percent) 30 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 55 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 51: In Missouri, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,547 plans available

Premium amount (dollars) 293 1,310 3,512

Annual deductible (dollars) 10,000 3,000 5,000

Out-of-pocket maximum (dollars) 11,000 6,000 6,000

Coinsurance (percent) 20 30 30

Single male, smoker, age 19 1,547 plans available

Premium amount (dollars) 293 1,590 4,039

Annual deductible (dollars) 10,000 4,000 5,000

Out-of-pocket maximum (dollars) 11,000 6,000 6,000

Coinsurance (percent) 20 20 30

Single female, nonsmoker, age 19 1,547 plans available

Premium amount (dollars) 536 1,637 6,048

Annual deductible (dollars) N/A 2,000 500

Out-of-pocket maximum (dollars) N/A 6,000 3,000

Coinsurance (percent) 0 20 10

Single female, smoker, age 19 1,547 plans available

Premium amount (dollars) 572 1,954 7,320

Annual deductible (dollars) 10,000 1,500 500

Out-of-pocket maximum (dollars) 11,000 2,000 3,000

Coinsurance (percent) 20 0 10

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 56 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 52: In Missouri, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,547 plans available

Premium amount (dollars) 1,673 5,909 19,503

Annual deductible (dollars) 10,000 4,000 5,000

Out-of-pocket maximum (dollars) 11,000 6,000 6,000

Coinsurance (percent) 20 20 30

Single male, smoker, age 64 1,547 plans available

Premium amount (dollars) 1,673 7,186 22,429

Annual deductible (dollars) 10,000 500 5,000

Out-of-pocket maximum (dollars) 11,000 5,500 6,000

Coinsurance (percent) 20 30 30

Single female, nonsmoker, age 64 1,547 plans available

Premium amount (dollars) 1,438 5,709 18,681

Annual deductible (dollars) 10,000 2,500 5,000

Out-of-pocket maximum (dollars) 11,000 2,500 6,000

Coinsurance (percent) 20 0 30

Single female, smoker, age 64 1,547 plans available

Premium amount (dollars) 1,438 6,942 21,483

Annual deductible (dollars) 10,000 1,500 5,000

Out-of-pocket maximum (dollars) 11,000 3,000 6,000

Coinsurance (percent) 20 10 30

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 57 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 53: In Montana, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 176 plans available

Premium amount (dollars) 696 1,284 3,686

Annual deductible (dollars) 10,000 3,500 2,850

Out-of-pocket maximum (dollars) 15,000 8,500 2,850

Coinsurance (percent) 40 50 0 

Single male, smoker, age 19 176 plans available

Premium amount (dollars) 696 1,508 4,337

Annual deductible (dollars) 10,000 5,000 2,850

Out-of-pocket maximum (dollars) 15,000 8,500 2,850

Coinsurance (percent) 40 20 0 

Single female, nonsmoker, age 19 176 plans available

Premium amount (dollars) 696 1,284 3,686

Annual deductible (dollars) 10,000 3,500 2,850

Out-of-pocket maximum (dollars) 15,000 8,500 2,850

Coinsurance (percent) 40 50 0 

Single female, smoker, age 19 176 plans available

Premium amount (dollars) 696 1,508 4,337

Annual deductible (dollars) 10,000 5,000 2,850

Out-of-pocket maximum (dollars) 15,000 8,500 2,850

Coinsurance (percent) 40 20 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 58 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 54: In Montana, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 176 plans available

Premium amount (dollars) 2,382 4,194 11,920

Annual deductible (dollars) 10,000 3,500 2,850

Out-of-pocket maximum (dollars) 17,500 8,500 2,850

Coinsurance (percent) 50 50 0 

Single male, smoker, age 64 176 plans available

Premium amount (dollars) 2,592 7,193 21,036

Annual deductible (dollars) 10,000 5,000 2,850

Out-of-pocket maximum (dollars) 15,000 7,000 2,850

Coinsurance (percent) 40 50 0 

Single female, nonsmoker, age 64 176 plans available

Premium amount (dollars) 2,382 4,194 11,920

Annual deductible (dollars) 10,000 3,500 2,850

Out-of-pocket maximum (dollars) 17,500 8,500 2,850

Coinsurance (percent) 50 50 0 

Single female, smoker, age 64 176 plans available

Premium amount (dollars) 2,592 7,193 21,036

Annual deductible (dollars) 10,000 5,000 2,850

Out-of-pocket maximum (dollars) 15,000 7,000 2,850

Coinsurance (percent) 40 50 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 59 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 55: In Nebraska, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,071 plans available

Premium amount (dollars) 288 1,507 3,449

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 20 30 20

Single male, smoker, age 19 1,071 plans available

Premium amount (dollars) 361 1,780 3,967

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 10,000 5,000 3,000

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 19 1,071 plans available

Premium amount (dollars) 323 1,684 4,028

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 19 1,071 plans available

Premium amount (dollars) 404 2,001 5,086

Annual deductible (dollars) 5,000 3,500 1,000

Out-of-pocket maximum (dollars) 10,000 3,500 3,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 60 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 56: In Nebraska, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,071 plans available

Premium amount (dollars) 1,635 7,939 18,361

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 20 30 20

Single male, smoker, age 64 1,071 plans available

Premium amount (dollars) 2,044 9,474 21,115

Annual deductible (dollars) 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 10,000 5,000 3,000

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 64 1,071 plans available

Premium amount (dollars) 1,585 7,643 17,610

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 20 30 20

Single female, smoker, age 64 1,071 plans available

Premium amount (dollars) 1,982 9,029 20,252

Annual deductible (dollars) 5,000 10,000 1,000

Out-of-pocket maximum (dollars) 10,000 3,000 3,000

Coinsurance (percent) 20 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 61 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 57: In Nevada, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 209 plans available

Premium amount (dollars) 318 1,219 7,124

Annual deductible (dollars) 2,000 1,500 1,500

Out-of-pocket maximum (dollars) 4,000 1,500 4,500

Coinsurance (percent) 50 0 30

Single male, smoker, age 19 192 plans available

Premium amount (dollars) 382 1,452 9,622

Annual deductible (dollars) 2,000 3,000 1,500

Out-of-pocket maximum (dollars) 4,000 3,000 4,500

Coinsurance (percent) 50 0 30

Single female, nonsmoker, age 19 209 plans available

Premium amount (dollars) 408 1,539 10,763

Annual deductible (dollars) 2,000 6,000 1,500

Out-of-pocket maximum (dollars) 4,000 8,000 4,500

Coinsurance (percent) 50 20 30

Single female, smoker, age 19 192 plans available

Premium amount (dollars) 490 1,777 14,535

Annual deductible (dollars) 2,000 4,000 1,500

Out-of-pocket maximum (dollars) 4,000 4,000 4,500

Coinsurance (percent) 50 0 30

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 62 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 58: In Nevada, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 209 plans available

Premium amount (dollars) 2,484 6,399 27,065

Annual deductible (dollars) 3,000 3,000 1,500

Out-of-pocket maximum (dollars) 7,000 600 4,500

Coinsurance (percent) 30 30 30

Single male, smoker, age 64 192 plans available

Premium amount (dollars) 3,392 8,076 36,540

Annual deductible (dollars) 2,000 2,500 1,500

Out-of-pocket maximum (dollars) 4,000 5,000 4,500

Coinsurance (percent) 50 20 30

Single female, nonsmoker, age 64 209 plans available

Premium amount (dollars) 2,096 5,237 24,461

Annual deductible (dollars) 10,000 3,000 1,500

Out-of-pocket maximum (dollars) 3,000 0 4,500

Coinsurance (percent) 20 0 30

Single female, smoker, age 64 192 plans available

Premium amount (dollars) 2,652 6,634 33,020

Annual deductible (dollars) 3,000 5,000 1,500

Out-of-pocket maximum (dollars) 5,000 0 4,500

Coinsurance (percent) 20 0 30

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 63 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 59: In New Hampshire, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 136 plans available

Premium amount (dollars) 833 1,870 14,915

Annual deductible (dollars) 10,000 3,500 500

Out-of-pocket maximum (dollars) 17,500 7,000 2,500

Coinsurance (percent) 50 20 20

Single male, smoker, age 19 136 plans available

Premium amount (dollars) 1,225 2,751 22,372

Annual deductible (dollars) 10,000 3,500 500

Out-of-pocket maximum (dollars) 17,500 7,000 2,500

Coinsurance (percent) 50 20 20

Single female, nonsmoker, age 19 136 plans available

Premium amount (dollars) 833 1,870 14,915

Annual deductible (dollars) 10,000 3,500 500

Out-of-pocket maximum (dollars) 17,500 7,000 2,500

Coinsurance (percent) 50 20 20

Single female, smoker, age 19 136 plans available

Premium amount (dollars) 1,225 2,751 22,372

Annual deductible (dollars) 10,000 3,500 500

Out-of-pocket maximum (dollars) 17,500 7,000 2,500

Coinsurance (percent) 50 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 64 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 60: In New Hampshire, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 136 plans available

Premium amount (dollars) 3,285 7,193 23,718

Annual deductible (dollars) 10,000 4,000 500

Out-of-pocket maximum (dollars) 17,500 4,000 2,500

Coinsurance (percent) 50 0 20

Single male, smoker, age 64 136 plans available

Premium amount (dollars) 4,831 10,617 35,577

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 17,500 5,000 2,500

Coinsurance (percent) 50 0 20

Single female, nonsmoker, age 64 136 plans available

Premium amount (dollars) 3,285 7,193 23,718

Annual deductible (dollars) 10,000 4,000 500

Out-of-pocket maximum (dollars) 17,500 4,000 2,500

Coinsurance (percent) 50 0 20

Single female, smoker, age 64 136 plans available

Premium amount (dollars) 4,831 10,617 35,577

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 17,500 5,000 2,500

Coinsurance (percent) 50 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 65 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 61: In New Jersey, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 65 plans available

Premium amount (dollars) 1,776 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Single male, smoker, age 19 65 plans available

Premium amount (dollars) 1,776 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Single female, nonsmoker, age 19 65 plans available

Premium amount (dollars) 1,992 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Single female, smoker, age 19 65 plans available

Premium amount (dollars) 1,992 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 66 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 62: In New Jersey, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 65 plans available

Premium amount (dollars) 5,304 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Single male, smoker, age 64 65 plans available

Premium amount (dollars) 5,304 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Single female, nonsmoker, age 64 65 plans available

Premium amount (dollars) 5,040 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Single female, smoker, age 64 65 plans available

Premium amount (dollars) 5,040 17,556 43,284

Annual deductible (dollars) N/A 2,500 1,000

Out-of-pocket maximum (dollars) N/A 2,500 1,000

Coinsurance (percent) 0 40 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 67 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 63: In New Mexico, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 828 plans available

Premium amount (dollars) 410 1,301 2,852

Annual deductible (dollars) 7,500 2,500 1,500

Out-of-pocket maximum (dollars) 7,500 4,500 1,500

Coinsurance (percent) 0 20 0 

Single male, smoker, age 19 828 plans available

Premium amount (dollars) 456 1,462 3,280

Annual deductible (dollars) 7,500 3,500 1,500

Out-of-pocket maximum (dollars) 7,500 3,000 1,500

Coinsurance (percent) 0 15 0 

Single female, nonsmoker, age 19 828 plans available

Premium amount (dollars) 430 1,301 2,852

Annual deductible (dollars) 7,500 2,500 1,500

Out-of-pocket maximum (dollars) 7,500 4,500 1,500

Coinsurance (percent) 0 20 0 

Single female, smoker, age 19 828 plans available

Premium amount (dollars) 467 1,496 3,280

Annual deductible (dollars) 10,000 2,500 1,500

Out-of-pocket maximum (dollars) 4,500 4,500 1,500

Coinsurance (percent) 30 20 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 68 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 64: In New Mexico, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 828 plans available

Premium amount (dollars) 1,136 3,934 8,680

Annual deductible (dollars) 7,500 3,500 1,500

Out-of-pocket maximum (dollars) 7,500 3,000 1,500

Coinsurance (percent) 0 15 0 

Single male, smoker, age 64 828 plans available

Premium amount (dollars) 1,238 4,481 9,982

Annual deductible (dollars) 5,000 5,000 1,500

Out-of-pocket maximum (dollars) 3,000 3,000 1,500

Coinsurance (percent) 20 15 0 

Single female, nonsmoker, age 64 828 plans available

Premium amount (dollars) 1,132 3,934 8,680

Annual deductible (dollars) 7,500 3,500 1,500

Out-of-pocket maximum (dollars) 7,500 3,000 1,500

Coinsurance (percent) 0 15 0 

Single female, smoker, age 64 828 plans available

Premium amount (dollars) 1,238 4,461 9,982

Annual deductible (dollars) 5,000 1,200 1,500

Out-of-pocket maximum (dollars) 3,000 2,500 1,500

Coinsurance (percent) 20 20 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 69 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 65: In New York, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Single male, smoker, age 19 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Single female, nonsmoker, age 19 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Single female, smoker, age 19 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment. 
Enclosure I

Page 70 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 66: In New York, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Single male, smoker, age 64 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Single female, nonsmoker, age 64 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Single female, smoker, age 64 120 plans available

Premium amount (dollars) 1,986 5,750 24,324

Annual deductible (dollars) N/A No Maximum N/A

Out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0 

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 71 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 67: In North Carolina, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 2,062 plans available

Premium amount (dollars) 505 1,368 6,618

Annual deductible (dollars) 10,000 1,500 3,000

Out-of-pocket maximum (dollars) 17,500 5,000 5,000

Coinsurance (percent) 50 0 20

Single male, smoker, age 19 2,062 plans available

Premium amount (dollars) 595 1,617 7,431

Annual deductible (dollars) 10,000 2,000 3,000

Out-of-pocket maximum (dollars) 17,500 7,000 5,000

Coinsurance (percent) 50 50 20

Single female, nonsmoker, age 19 2,062 plans available

Premium amount (dollars) 537 1,495 7,585

Annual deductible (dollars) 10,000 2,850 3,000

Out-of-pocket maximum (dollars) 17,500 5,350 5,000

Coinsurance (percent) 50 50 20

Single female, smoker, age 19 2,062 plans available

Premium amount (dollars) 632 1,767 9,919

Annual deductible (dollars) 10,000 2,600 3,000

Out-of-pocket maximum (dollars) 17,500 5,000 5,000

Coinsurance (percent) 50 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 72 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 68: In North Carolina, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 2,062 plans available

Premium amount (dollars) 2,043 6,263 27,707

Annual deductible (dollars) 10,000 3,500 3,000

Out-of-pocket maximum (dollars) 17,500 5,500 5,000

Coinsurance (percent) 50 20 20

Single male, smoker, age 64 2,062 plans available

Premium amount (dollars) 3,024 8,746 37,283

Annual deductible (dollars) 10,000 3,500 3,000

Out-of-pocket maximum (dollars) 12,500 11,000 5,000

Coinsurance (percent) 30 50 20

Single female, nonsmoker, age 64 2,062 plans available

Premium amount (dollars) 2,112 6,159 27,787

Annual deductible (dollars) 10,000 5,000 3,000

Out-of-pocket maximum (dollars) 12,500 5,000 5,000

Coinsurance (percent) 30 0 20

Single female, smoker, age 64 2,062 plans available

Premium amount (dollars) 2,112 8,700 36,659

Annual deductible (dollars) 10,000 1,000 3,000

Out-of-pocket maximum (dollars) 12,500 5,000 5,000

Coinsurance (percent) 30 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 73 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 69: In North Dakota, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 250 plans available

Premium amount (dollars) 490 1,233 3,271

Annual deductible (dollars) 7,500 2,850 250

Out-of-pocket maximum (dollars) 10,000 5,350 2,000

Coinsurance (percent) 30 50 20

Single male, smoker, age 19 250 plans available

Premium amount (dollars) 490 1,342 3,271

Annual deductible (dollars) 7,500 3,500 250

Out-of-pocket maximum (dollars) 10,000 11,000 2,000

Coinsurance (percent) 30 30 20

Single female, nonsmoker, age 19 250 plans available

Premium amount (dollars) 490 1,233 3,271

Annual deductible (dollars) 7,500 2,850 250

Out-of-pocket maximum (dollars) 10,000 5,350 2,000

Coinsurance (percent) 30 50 20

Single female, smoker, age 19 250 plans available

Premium amount (dollars) 490 1,342 3,271

Annual deductible (dollars) 7,500 3,500 250

Out-of-pocket maximum (dollars) 10,000 11,000 2,000

Coinsurance (percent) 30 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 74 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 70: In North Dakota, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 248 plans available

Premium amount (dollars) 2,064 4,329 8,745

Annual deductible (dollars) 7,500 3,650 250

Out-of-pocket maximum (dollars) 10,000 3,650 2,000

Coinsurance (percent) 30 0 20

Single male, smoker, age 64 248 plans available

Premium amount (dollars) 2,064 6,430 13,562

Annual deductible (dollars) 7,500 5,000 2,850

Out-of-pocket maximum (dollars) 10,000 12,500 2,850

Coinsurance (percent) 30 30 0 

Single female, nonsmoker, age 64 248 plans available

Premium amount (dollars) 2,064 4,329 8,745

Annual deductible (dollars) 7,500 3,650 250

Out-of-pocket maximum (dollars) 10,000 3,650 2,000

Coinsurance (percent) 30 0 20

Single female, smoker, age 64 248 plans available

Premium amount (dollars) 2,064 6,430 13,562

Annual deductible (dollars) 7,500 5,000 2,850

Out-of-pocket maximum (dollars) 10,000 12,500 2,850

Coinsurance (percent) 30 30 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 75 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 71: In Ohio, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 2,440 plans available

Premium amount (dollars) 444 1,368 6,872

Annual deductible (dollars) 7,500 N/A 750

Out-of-pocket maximum (dollars) 7,500 N/A 3,750

Coinsurance (percent) 0 0 20

Single male, smoker, age 19 2,440 plans available

Premium amount (dollars) 444 1,646 6,872

Annual deductible (dollars) 7,500 10,000 750

Out-of-pocket maximum (dollars) 7,500 10,000 3,750

Coinsurance (percent) 0 0 20

Single female, nonsmoker, age 19 2,440 plans available

Premium amount (dollars) 552 1,609 8,044

Annual deductible (dollars) 7,500 5,000 750

Out-of-pocket maximum (dollars) 7,500 5,000 3,750

Coinsurance (percent) 0 0 20

Single female, smoker, age 19 2,440 plans available

Premium amount (dollars) 552 1,973 8,044

Annual deductible (dollars) 7,500 2,600 750

Out-of-pocket maximum (dollars) 7,500 2,600 3,750

Coinsurance (percent) 0 0 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 76 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 72: In Ohio, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 2,440 plans available

Premium amount (dollars) 2,207 6,364 30,759

Annual deductible (dollars) N/A 1,500 750

Out-of-pocket maximum (dollars) N/A 4,500 3,750

Coinsurance (percent) 0 20 20

Single male, smoker, age 64 2,440 plans available

Premium amount (dollars) 2,268 7,860 30,759

Annual deductible (dollars) 7,500 2,500 750

Out-of-pocket maximum (dollars) 7,500 4,500 3,750

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 64 2,440 plans available

Premium amount (dollars) 2,148 6,264 28,919

Annual deductible (dollars) 7,500 500 750

Out-of-pocket maximum (dollars) 7,500 4,000 3,750

Coinsurance (percent) 0 30 20

Single female, smoker, age 64 2,440 plans available

Premium amount (dollars) 2,148 7,650 28,919

Annual deductible (dollars) 7,500 500 750

Out-of-pocket maximum (dollars) 7,500 4,000 3,750

Coinsurance (percent) 0 50 20

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 77 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 73: In Oklahoma, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,101 plans available

Premium amount (dollars) 504 1,528 4,584

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) No Maximum 4,500 3,000

Coinsurance (percent) 30 20 20

Single male, smoker, age 19 1,087 plans available

Premium amount (dollars) 600 1,800 5,191

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) No Maximum 5,000 3,000

Coinsurance (percent) 30 20 20

Single female, nonsmoker, age 19 1,101 plans available

Premium amount (dollars) 612 1,718 8,760

Annual deductible (dollars) 10,000 1,000 200

Out-of-pocket maximum (dollars) No Maximum 10,000 1,000

Coinsurance (percent) 30 0 20

Single female, smoker, age 19 1,087 plans available

Premium amount (dollars) 732 2,033 10,404

Annual deductible (dollars) 10,000 5,000 200

Out-of-pocket maximum (dollars) No Maximum 5,000 1,000

Coinsurance (percent) 30 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 78 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 74: In Oklahoma, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,101 plans available

Premium amount (dollars) 3,060 7,959 19,812

Annual deductible (dollars) 10,000 2,600 200

Out-of-pocket maximum (dollars) No Maximum 5,000 1,000

Coinsurance (percent) 30 20 20

Single male, smoker, age 64 1,087 plans available

Premium amount (dollars) 3,636 9,559 23,544

Annual deductible (dollars) 10,000 2,600 200

Out-of-pocket maximum (dollars) No Maximum 5,000 1,000

Coinsurance (percent) 30 20 20

Single female, nonsmoker, age 64 1,101 plans available

Premium amount (dollars) 2,616 7,624 17,098

Annual deductible (dollars) 10,000 2,600 1,000

Out-of-pocket maximum (dollars) No Maximum 5,000 3,000

Coinsurance (percent) 30 20 20

Single female, smoker, age 64 1,087 plans available

Premium amount (dollars) 2,868 9,104 21,561

Annual deductible (dollars) 5,000 1,500 1,500

Out-of-pocket maximum (dollars) 12,500 4,500 1,500

Coinsurance (percent) 20 30 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 79 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 75: In Oregon, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 725 plans available

Premium amount (dollars) 432 1,325 2,832

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 7,500 11,000 5,000

Coinsurance (percent) 30 30 20

Single male, smoker, age 19 131 plans available

Premium amount (dollars) 432 1,140 2,832

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 5,000

Coinsurance (percent) 30 30 20

Single female, nonsmoker, age 19 725 plans available

Premium amount (dollars) 432 1,325 2,832

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 7,500 11,000 5,000

Coinsurance (percent) 30 30 20

Single female, smoker, age 19 131 plans available

Premium amount (dollars) 432 1,140 2,832

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 5,000

Coinsurance (percent) 30 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 80 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 76: In Oregon, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 725 plans available

Premium amount (dollars) 1,956 4,928 11,964

Annual deductible (dollars) 10,000 5,000 1,000

Out-of-pocket maximum (dollars) 15,000 6,250 5,000

Coinsurance (percent) 40 50 20

Single male, smoker, age 64 131 plans available

Premium amount (dollars) 1,956 5,472 11,964

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 15,000 5,000 5,000

Coinsurance (percent) 40 20 20

Single female, nonsmoker, age 64 725 plans available

Premium amount (dollars) 1,956 4,928 11,964

Annual deductible (dollars) 10,000 5,000 1,000

Out-of-pocket maximum (dollars) 15,000 6,250 5,000

Coinsurance (percent) 40 50 20

Single female, smoker, age 64 131 plans available

Premium amount (dollars) 1,956 5,472 11,964

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 15,000 5,000 5,000

Coinsurance (percent) 40 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 81 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 77: In Pennsylvania, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 2,128 plans available

Premium amount (dollars) 535 1,512 9,105

Annual deductible (dollars) 5,000 5,000 1,500

Out-of-pocket maximum (dollars) 10,000 5,000 5,500

Coinsurance (percent) 20 0 20

Single male, smoker, age 19 2,114 plans available

Premium amount (dollars) 535 1,726 9,105

Annual deductible (dollars) 5,000 5,000 1,500

Out-of-pocket maximum (dollars) 10,000 6,000 5,500

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 19 2,128 plans available

Premium amount (dollars) 597 1,746 9,105

Annual deductible (dollars) 5,000 2,500 1,500

Out-of-pocket maximum (dollars) 1,050 3,500 5,500

Coinsurance (percent) 0 20 20

Single female, smoker, age 19 2,114 plans available

Premium amount (dollars) 597 1,896 9,105

Annual deductible (dollars) 5,000 2,000 1,500

Out-of-pocket maximum (dollars) 1,050 No Maximum 5,500

Coinsurance (percent) 0 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 82 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 78: In Pennsylvania, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 2,128 plans available

Premium amount (dollars) 1,761 7,763 29,045

Annual deductible (dollars) 0 5,000 500

Out-of-pocket maximum (dollars) 0 6,000 1,500

Coinsurance (percent) 0 20 15

Single male, smoker, age 64 2,114 plans available

Premium amount (dollars) 1,761 8,711 29,045

Annual deductible (dollars) 0 10,000 500

Out-of-pocket maximum (dollars) 0 10,000 1,500

Coinsurance (percent) 0 0 15

Single female, nonsmoker, age 64 2,128 plans available

Premium amount (dollars) 1,761 7,280 27,075

Annual deductible (dollars) 0 10,000 500

Out-of-pocket maximum (dollars) 0 10,000 1,500

Coinsurance (percent) 0 0 15

Single female, smoker, age 64 2,114 plans available

Premium amount (dollars) 1,761 8,293 27,075

Annual deductible (dollars) 0 10,000 500

Out-of-pocket maximum (dollars) 0 10,000 1,500

Coinsurance (percent) 0 0 15

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 83 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 79: In Rhode Island, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 6 plans available

Premium amount (dollars) 1,151 1,853 2,350

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Single male, smoker, age 19 6 plans available

Premium amount (dollars) 3,023 4,866 6,172

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Single female, nonsmoker, age 19 6 plans available

Premium amount (dollars) 1,609 2,591 3,286

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 19 6 plans available

Premium amount (dollars) 3,023 4,866 6,172

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 84 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 80: In Rhode Island, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 6 plans available

Premium amount (dollars) 3,725 5,996 7,605

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Single male, smoker, age 64 6 plans available

Premium amount (dollars) 4,535 7,300 9,258

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Single female, nonsmoker, age 64 6 plans available

Premium amount (dollars) 3,725 5,996 7,605

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 64 6 plans available

Premium amount (dollars) 4,535 7,300 9,258

Annual deductible (dollars) 2,500 2,500 1,000

Out-of-pocket maximum (dollars) 7,500 7,500 3,000

Coinsurance (percent) 50 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 85 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 81: In South Carolina, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,103 plans available

Premium amount (dollars) 546 1,584 4,782

Annual deductible (dollars) 10,000 5,000 1,000

Out-of-pocket maximum (dollars) 3,000 5,000 3,000

Coinsurance (percent) 30 0 20

Single male, smoker, age 19 1,103 plans available

Premium amount (dollars) 546 1,728 5,425

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 3,000 12,500 3,000

Coinsurance (percent) 30 20 20

Single female, nonsmoker, age 19 1,103 plans available

Premium amount (dollars) 674 1,905 5,800

Annual deductible (dollars) 10,000 3,500 1,000

Out-of-pocket maximum (dollars) 3,000 3,500 3,000

Coinsurance (percent) 30 0 20

Single female, smoker, age 19 1,103 plans available

Premium amount (dollars) 674 2,063 7,331

Annual deductible (dollars) 10,000 5,000 1,000

Out-of-pocket maximum (dollars) 3,000 7,000 3,000

Coinsurance (percent) 30 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 86 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 82: In South Carolina, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,103 plans available

Premium amount (dollars) 2,338 8,556 22,471

Annual deductible (dollars) 250 5,000 1,000

Out-of-pocket maximum (dollars) 5,000 5,000 3,000

Coinsurance (percent) 20 20 20

Single male, smoker, age 64 1,103 plans available

Premium amount (dollars) 2,338 10,714 25,841

Annual deductible (dollars) 250 2,000 1,000

Out-of-pocket maximum (dollars) 5,000 1,500 3,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 64 1,103 plans available

Premium amount (dollars) 2,376 7,699 21,552

Annual deductible (dollars) 10,000 4,000 1,000

Out-of-pocket maximum (dollars) 12,500 4,000 3,000

Coinsurance (percent) 20 0 20

Single female, smoker, age 64 1,103 plans available

Premium amount (dollars) 2,376 9,667 24,784

Annual deductible (dollars) 10,000 5,000 1,000

Out-of-pocket maximum (dollars) 12,500 5,000 3,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 87 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 83: In South Dakota, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 626 plans available

Premium amount (dollars) 316 1,946 4,044

Annual deductible (dollars) 5,000 3,500 1,000

Out-of-pocket maximum (dollars) 10,000 11,000 3,000

Coinsurance (percent) 40 30 20

Single male, smoker, age 19 626 plans available

Premium amount (dollars) 380 2,290 4,651

Annual deductible (dollars) 5,000 3,500 1,000

Out-of-pocket maximum (dollars) 10,000 11,000 3,000

Coinsurance (percent) 40 30 20

Single female, nonsmoker, age 19 626 plans available

Premium amount (dollars) 355 2,148 6,511

Annual deductible (dollars) 5,000 2,500 500

Out-of-pocket maximum (dollars) 10,000 4,500 1,500

Coinsurance (percent) 40 20 10

Single female, smoker, age 19 626 plans available

Premium amount (dollars) 426 2,471 7,162

Annual deductible (dollars) 5,000 2,500 500

Out-of-pocket maximum (dollars) 10,000 4,500 1,500

Coinsurance (percent) 40 20 10

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include

plans with little or no enrollment.
Enclosure I

Page 88 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 84: In South Dakota, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type 

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 626 plans available

Premium amount (dollars) 1,507 9,144 20,224

Annual deductible (dollars) 5,000 2,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 20 20

Single male, smoker, age 64 626 plans available

Premium amount (dollars) 1,808 11,734 23,258

Annual deductible (dollars) 5,000 1,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 30 20

Single female, nonsmoker, age 64 626 plans available

Premium amount (dollars) 1,507 9,144 20,224

Annual deductible (dollars) 5,000 2,500 1,000

Out-of-pocket maximum (dollars) 10,000 4,500 3,000

Coinsurance (percent) 40 20 20

Single female, smoker, age 64 626 plans available

Premium amount (dollars) 1,808 11,922 24,007

Annual deductible (dollars) 5,000 7,500 2,850

Out-of-pocket maximum (dollars) 10,000 15,000 2,850

Coinsurance (percent) 40 30 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 89 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 85: In Tennessee, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,161 plans available

Premium amount (dollars) 469 1,505 4,790

Annual deductible (dollars) 7,500 1,500 3,000

Out-of-pocket maximum (dollars) 10,500 6,500 5,000

Coinsurance (percent) 20 30 20

Single male, smoker, age 19 1,161 plans available

Premium amount (dollars) 587 1,750 5,389

Annual deductible (dollars) 7,500 1,500 3,000

Out-of-pocket maximum (dollars) 10,500 1,500 5,000

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 19 1,161 plans available

Premium amount (dollars) 599 1,735 5,512

Annual deductible (dollars) 7,500 5,000 3,000

Out-of-pocket maximum (dollars) 10,500 7,500 5,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 19 1,161 plans available

Premium amount (dollars) 749 2,012 7,236

Annual deductible (dollars) 7,500 3,500 3,000

Out-of-pocket maximum (dollars) 10,500 3,500 5,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 90 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 86: In Tennessee, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,161 plans available

Premium amount (dollars) 1,869 7,320 21,304

Annual deductible (dollars) 7,500 3,000 1,000

Out-of-pocket maximum (dollars) 10,500 4,000 3,000

Coinsurance (percent) 20 20 20

Single male, smoker, age 64 1,161 plans available

Premium amount (dollars) 2,804 9,259 26,610

Annual deductible (dollars) 7,500 2,500 3,000

Out-of-pocket maximum (dollars) 10,500 4,500 5,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 64 1,161 plans available

Premium amount (dollars) 1,752 6,924 20,433

Annual deductible (dollars) 7,500 1,000 1,000

Out-of-pocket maximum (dollars) 10,500 10,000 3,000

Coinsurance (percent) 20 0 20

Single female, smoker, age 64 1,161 plans available

Premium amount (dollars) 2,629 8,866 26,324

Annual deductible (dollars) 7,500 1,000 3,000

Out-of-pocket maximum (dollars) 10,500 10,000 5,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include

plans with little or no enrollment.
Enclosure I

Page 91 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 87: In Texas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 5,422 plans available

Premium amount (dollars) 363 1,203 4,790

Annual deductible (dollars) 10,000 3,500 500

Out-of-pocket maximum (dollars) 17,500 11,000 3,000

Coinsurance (percent) 50 30 20

Single male, smoker, age 19 5,422 plans available

Premium amount (dollars) 427 1,439 5,266

Annual deductible (dollars) 10,000 2,000 500

Out-of-pocket maximum (dollars) 17,500 9,500 3,000

Coinsurance (percent) 50 30 20

Single female, nonsmoker, age 19 5,422 plans available

Premium amount (dollars) 387 1,433 6,625

Annual deductible (dollars) 10,000 5,000 500

Out-of-pocket maximum (dollars) 17,500 9,000 3,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 19 5,422 plans available

Premium amount (dollars) 456 1,693 7,285

Annual deductible (dollars) 10,000 7,500 500

Out-of-pocket maximum (dollars) 17,500 13,500 3,000

Coinsurance (percent) 50 30 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 92 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 88: In Texas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 5,422 plans available

Premium amount (dollars) 1,464 5,624 24,372

Annual deductible (dollars) 10,000 3,500 250

Out-of-pocket maximum (dollars) 17,500 7,000 3,000

Coinsurance (percent) 50 20 15

Single male, smoker, age 64 5,422 plans available

Premium amount (dollars) 2,584 8,653 30,456

Annual deductible (dollars) 10,000 3,500 250

Out-of-pocket maximum (dollars) 17,500 11,000 3,000

Coinsurance (percent) 50 30 15

Single female, nonsmoker, age 64 5,422 plans available

Premium amount (dollars) 1,616 5,288 20,508

Annual deductible (dollars) 10,000 6,000 250

Out-of-pocket maximum (dollars) 17,500 6,000 3,000

Coinsurance (percent) 50 0 15

Single female, smoker, age 64 5,422 plans available

Premium amount (dollars) 2,760 8,052 25,644

Annual deductible (dollars) 10,000 3,500 250

Out-of-pocket maximum (dollars) 12,500 3,500 3,000

Coinsurance (percent) 30 0 15

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 93 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 89: In Utah, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 524 plans available

Premium amount (dollars) 359 1,140 3,383

Annual deductible (dollars) 10,000 5,000 1,200

Out-of-pocket maximum (dollars) 5,000 7,500 3,600

Coinsurance (percent) 35 20 20

Single male, smoker, age 19 524 plans available

Premium amount (dollars) 359 1,203 3,383

Annual deductible (dollars) 10,000 3,500 1,200

Out-of-pocket maximum (dollars) 5,000 7,000 3,600

Coinsurance (percent) 35 20 20

Single female, nonsmoker, age 19 524 plans available

Premium amount (dollars) 359 1,174 4,398

Annual deductible (dollars) 10,000 3,500 1,200

Out-of-pocket maximum (dollars) 5,000 6,000 3,600

Coinsurance (percent) 35 20 20

Single female, smoker, age 19 524 plans available

Premium amount (dollars) 359 1,232 4,398

Annual deductible (dollars) 10,000 3,500 1,200

Out-of-pocket maximum (dollars) 5,000 6,000 3,600

Coinsurance (percent) 35 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 94 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 90: In Utah, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 524 plans available

Premium amount (dollars) 1,529 4,700 16,746

Annual deductible (dollars) 10,000 2,500 1,200

Out-of-pocket maximum (dollars) 5,000 7,500 3,600

Coinsurance (percent) 35 30 20

Single male, smoker, age 64 524 plans available

Premium amount (dollars) 1,529 5,223 16,746

Annual deductible (dollars) 10,000 3,500 1,200

Out-of-pocket maximum (dollars) 5,000 6,000 3,600

Coinsurance (percent) 35 20 20

Single female, nonsmoker, age 64 524 plans available

Premium amount (dollars) 1,529 4,745 12,686

Annual deductible (dollars) 10,000 2,500 1,200

Out-of-pocket maximum (dollars) 5,000 7,500 3,600

Coinsurance (percent) 35 30 20

Single female, smoker, age 64 524 plans available

Premium amount (dollars) 1,529 5,223 16,073

Annual deductible (dollars) 10,000 3,500 2,000

Out-of-pocket maximum (dollars) 5,000 6,000 5,500

Coinsurance (percent) 35 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 95 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 91: In Vermont, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 5 plans available

Premium amount (dollars) 657 2,462 3,462

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Single male, smoker, age 19 5 plans available

Premium amount (dollars) 657 2,462 3,462

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Single female, nonsmoker, age 19 5 plans available

Premium amount (dollars) 657 2,462 3,462

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Single female, smoker, age 19 5 plans available

Premium amount (dollars) 657 2,462 3,462

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 96 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 92: In Vermont, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 5 plans available

Premium amount (dollars) 985 3,693 5,193

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Single male, smoker, age 64 5 plans available

Premium amount (dollars) 985 3,693 5,193

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Single female, nonsmoker, age 64 5 plans available

Premium amount (dollars) 985 3,693 5,193

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Single female, smoker, age 64 5 plans available

Premium amount (dollars) 985 3,693 5,193

Annual deductible (dollars) 100,000 10,000 3,500

Out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 97 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 93: In Virginia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 711 plans available

Premium amount (dollars) 396 1,234 11,580

Annual deductible (dollars) 7,500 750 750

Out-of-pocket maximum (dollars) 11,000 2,500 5,000

Coinsurance (percent) 50 30 20

Single male, smoker, age 19 711 plans available

Premium amount (dollars) 492 1,416 11,580

Annual deductible (dollars) 7,500 5,000 750

Out-of-pocket maximum (dollars) 11,000 7,000 5,000

Coinsurance (percent) 50 20 20

Single female, nonsmoker, age 19 711 plans available

Premium amount (dollars) 456 1,465 11,580

Annual deductible (dollars) 7,500 5,000 750

Out-of-pocket maximum (dollars) 11,000 7,000 5,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 19 711 plans available

Premium amount (dollars) 576 1,760 11,580

Annual deductible (dollars) 7,500 5,000 750

Out-of-pocket maximum (dollars) 11,000 5,000 5,000

Coinsurance (percent) 50 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 98 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 94: In Virginia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 711 plans available

Premium amount (dollars) 1,608 6,240 48,372

Annual deductible (dollars) 7,500 2,500 100

Out-of-pocket maximum (dollars) 11,000 2,500 2,500

Coinsurance (percent) 50 0 10

Single male, smoker, age 64 711 plans available

Premium amount (dollars) 2,004 8,052 48,372

Annual deductible (dollars) 7,500 2,500 100

Out-of-pocket maximum (dollars) 11,000 5,000 2,500

Coinsurance (percent) 50 0 10

Single female, nonsmoker, age 64 711 plans available

Premium amount (dollars) 1,248 4,979 48,372

Annual deductible (dollars) 7,500 2,500 100

Out-of-pocket maximum (dollars) 11,000 2,500 2,500

Coinsurance (percent) 50 0 10

Single female, smoker, age 64 711 plans available

Premium amount (dollars) 1,560 6,381 48,372

Annual deductible (dollars) 7,500 5,200 100

Out-of-pocket maximum (dollars) 11,000 5,200 2,500

Coinsurance (percent) 50 0 10

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 99 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 95: In Washington, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 69 plans available

Premium amount (dollars) 936 1,488 3,900

Annual deductible (dollars) 10,000 3,500 1,800

Out-of-pocket maximum (dollars) 7,500 8,500 8,300

Coinsurance (percent) 30 25 35

Single male, smoker, age 19 69 plans available

Premium amount (dollars) 1,080 1,776 4,524

Annual deductible (dollars) 10,000 2,500 1,800

Out-of-pocket maximum (dollars) 7,500 8,000 8,300

Coinsurance (percent) 30 40 35

Single female, nonsmoker, age 19 69 plans available

Premium amount (dollars) 936 1,488 3,900

Annual deductible (dollars) 10,000 3,500 1,800

Out-of-pocket maximum (dollars) 7,500 8,500 8,300

Coinsurance (percent) 30 25 35

Single female, smoker, age 19 69 plans available

Premium amount (dollars) 1,080 1,776 4,524

Annual deductible (dollars) 10,000 2,500 1,800

Out-of-pocket maximum (dollars) 7,500 8,000 8,300

Coinsurance (percent) 30 40 35

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 100 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 96: In Washington, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 69 plans available

Premium amount (dollars) 3,444 5,484 13,416

Annual deductible (dollars) 10,000 2,500 1,800

Out-of-pocket maximum (dollars) 7,500 7,500 8,300

Coinsurance (percent) 30 30 35

Single male, smoker, age 64 69 plans available

Premium amount (dollars) 3,960 6,420 15,588

Annual deductible (dollars) 10,000 3,500 1,800

Out-of-pocket maximum (dollars) 7,500 5,000 8,300

Coinsurance (percent) 30 20 35

Single female, nonsmoker, age 64 69 plans available

Premium amount (dollars) 3,444 5,484 13,416

Annual deductible (dollars) 10,000 2,500 1,800

Out-of-pocket maximum (dollars) 7,500 7,500 8,300

Coinsurance (percent) 30 30 35

Single female, smoker, age 64 69 plans available

Premium amount (dollars) 3,960 6,420 15,588

Annual deductible (dollars) 10,000 3,500 1,800

Out-of-pocket maximum (dollars) 7,500 5,000 8,300

Coinsurance (percent) 30 20 35

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 101 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 97: In West Virginia, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 1,766 plans available

Premium amount (dollars) 511 1,369 5,796

Annual deductible (dollars) 10,000 3,000 2,500

Out-of-pocket maximum (dollars) 17,500 3,000 5,000

Coinsurance (percent) 50 0 20

Single male, smoker, age 19 1,766 plans available

Premium amount (dollars) 601 1,575 5,960

Annual deductible (dollars) 10,000 5,000 2,500

Out-of-pocket maximum (dollars) 17,500 5,000 5,000

Coinsurance (percent) 50 0 20

Single female, nonsmoker, age 19 1,766 plans available

Premium amount (dollars) 541 1,430 5,963

Annual deductible (dollars) 10,000 2,850 2,500

Out-of-pocket maximum (dollars) 17,500 4,850 5,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 19 1,766 plans available

Premium amount (dollars) 636 1,646 6,144

Annual deductible (dollars) 10,000 3,500 2,500

Out-of-pocket maximum (dollars) 17,500 5,500 5,000

Coinsurance (percent) 50 50 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 102 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 98: In West Virginia, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 1,766 plans available

Premium amount (dollars) 2,086 6,474 16,958

Annual deductible (dollars) 10,000 1,000 1,000

Out-of-pocket maximum (dollars) 17,500 10,000 3,000

Coinsurance (percent) 50 0 20

Single male, smoker, age 64 1,766 plans available

Premium amount (dollars) 3,682 8,800 19,502

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 17,500 4,500 3,000

Coinsurance (percent) 50 20 20

Single female, nonsmoker, age 64 1,766 plans available

Premium amount (dollars) 2,299 6,135 16,265

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 17,500 5,000 3,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 64 1,766 plans available

Premium amount (dollars) 4,057 8,478 19,994

Annual deductible (dollars) 10,000 2,000 2,850

Out-of-pocket maximum (dollars) 17,500 9,500 2,850

Coinsurance (percent) 50 50 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 103 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 99: In Wisconsin, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 18,151 plans available

Premium amount (dollars) 415 1,193 3,763

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 10,000 3,500 3,000

Coinsurance (percent) 0 0 20

Single male, smoker, age 19 18,151 plans available

Premium amount (dollars) 490 1,602 5,310

Annual deductible (dollars) 3,500 2,500 500

Out-of-pocket maximum (dollars) 4,500 3,500 3,000

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 19 18,151 plans available

Premium amount (dollars) 436 1,470 4,956

Annual deductible (dollars) 10,000 2,000 2,500

Out-of-pocket maximum (dollars) 10,000 4,000 2,500

Coinsurance (percent) 0 20 0 

Single female, smoker, age 19 18,151 plans available

Premium amount (dollars) 557 1,949 6,996

Annual deductible (dollars) 3,500 2,500 2,500

Out-of-pocket maximum (dollars) 4,500 3,500 2,500

Coinsurance (percent) 20 0 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 104 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 100: In Wisconsin, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 18,259 plans available

Premium amount (dollars) 2,059 5,972 17,827

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 20,000 3,500 3,000

Coinsurance (percent) 50 0 20

Single male, smoker, age 64 18,259 plans available

Premium amount (dollars) 2,676 10,704 20,502

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 20,000 5,500 3,000

Coinsurance (percent) 50 0 20

Single female, nonsmoker, age 64 18,259 plans available

Premium amount (dollars) 1,639 4,895 17,098

Annual deductible (dollars) 10,000 2,500 1,000

Out-of-pocket maximum (dollars) 20,000 2,500 3,000

Coinsurance (percent) 50 0 20

Single female, smoker, age 64 18,259 plans available

Premium amount (dollars) 2,131 8,765 20,125

Annual deductible (dollars) 10,000 2,500 500

Out-of-pocket maximum (dollars) 20,000 5,500 3,000

Coinsurance (percent) 50 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 105 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 101: In Wyoming, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 19, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 19 528 plans available

Premium amount (dollars) 915 1,809 3,487

Annual deductible (dollars) 20,000 2,600 1,000

Out-of-pocket maximum (dollars) 20,000 2,600 3,000

Coinsurance (percent) 0 0 20

Single male, smoker, age 19 528 plans available

Premium amount (dollars) 1,114 2,080 4,010

Annual deductible (dollars) 7,500 2,600 1,000

Out-of-pocket maximum (dollars) 10,500 2,600 3,000

Coinsurance (percent) 30 0 20

Single female, nonsmoker, age 19 528 plans available

Premium amount (dollars) 967 1,955 3,714

Annual deductible (dollars) 5,000 1,000 1,000

Out-of-pocket maximum (dollars) 3,000 10,000 3,000

Coinsurance (percent) 20 0 20

Single female, smoker, age 19 528 plans available

Premium amount (dollars) 1,160 2,248 4,272

Annual deductible (dollars) 5,000 1,000 1,000

Out-of-pocket maximum (dollars) 3,000 10,000 3,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure I

Page 106 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 102: In Wyoming, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market for Individuals, Age 64, Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum 

premium

Plan with median 

premium

Plan with maximum 

premium

Single male, nonsmoker, age 64 528 plans available

Premium amount (dollars) 4,006 9,812 19,030

Annual deductible (dollars) 20,000 500 1,000

Out-of-pocket maximum (dollars) 20,000 2,000 2,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 64 528 plans available

Premium amount (dollars) 4,998 11,553 28,545

Annual deductible (dollars) 20,000 2,600 1,000

Out-of-pocket maximum (dollars) 20,000 2,600 2,000

Coinsurance (percent) 0 0 20

Single female, nonsmoker, age 64 528 plans available

Premium amount (dollars) 3,642 9,338 17,801

Annual deductible (dollars) 20,000 1,500 1,000

Out-of-pocket maximum (dollars) 20,000 4,500 3,000

Coinsurance (percent) 0 20 20

Single female, smoker, age 64 528 plans available

Premium amount (dollars) 4,540 10,768 20,471

Annual deductible (dollars) 20,000 2,000 1,000

Out-of-pocket maximum (dollars) 20,000 2,000 3,000

Coinsurance (percent) 0 20 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the 

base premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher 

because they would be determined after more complete underwriting for health conditions and other individual factors.

The number of plans available state-wide may not reflect the total number of plans available to all individuals in the state, as 

insurers may offer some plans only in specific regions of a state. A single insurer may offer several plans within a state, and these 

plans may vary in the base premium or in the plan details, such as network and cost-sharing options.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 107 GAO-14-263R Range of Health Insurance Premiums in 2013

Base Premiums Prior to Underwriting for Urban and Rural Zip Codes 

for Selected States and Consumer Categories

Table 103: In Illinois, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market in One Urban and One Rural Zip Code for Individuals, Age 19, Displayed on the HealthCare.gov Plan 

finder in January 2013

Urban Zip 60610

Chicago, IL

Rural Zip 60945

Iroquois, IL

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 19 194 plans available 434 plans available

Premium Amount (dollars) 628 1,441 4,091 564 1,296 3,030

Annual deductible (dollars) 10,000 2,500 0 7,500 2,000 0 

Out-of-Pocket maximum (dollars) 16,000 1,000 1,000 22,500 6,000 1,000

Coinsurance (percent) 30 20 0 0 0 0 

Single male, smoker, age 19 194 plans available 434 plans available

Premium Amount (dollars) 770 1,801 5,114 564 1,430 3,788

Annual deductible (dollars) 10,000 2,500 0 7,500 1,250 0 

Out-of-Pocket maximum (dollars) 16,000 1,000 1,000 22,500 4,250 1,000

Coinsurance (percent) 30 20 0 0 20 0 

Single female, nonsmoker, age 19 194 plans available 434 plans available

Premium Amount (dollars) 836 2,227 13,944 663 1,920 14,184

Annual deductible (dollars) 10,000 500 0 5,000 3,000 0 

Out-of-Pocket maximum (dollars) 16,000 3,000 1,000 3,000 N/A 3,000

Coinsurance (percent) 30 20 0 20 0 0 

Single female, smoker, age 19 194 plans available 434 plans available

Premium Amount (dollars) 994 2,783 17,430 720 2,031 14,184

Annual deductible (dollars) 10,000 500 0 7,500 250 0 

Out-of-Pocket maximum (dollars) 16,000 3,000 1,000 22,500 3,000 3,000

Coinsurance (percent) 30 20 0 0 20 0 

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 108 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 104: In Illinois, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market in One Urban and One Rural Zip Code for Individuals, Age 64, Displayed on the HealthCare.gov Plan 

finder in January 2013

Urban Zip 60610

Chicago, IL

Rural Zip 60945

Iroquois, IL

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 64 194 plans available 434 plans available

Premium Amount (dollars) 3,210 7,471 21,212 2,832 6,516 15,711

Annual deductible (dollars) 10,000 2,500 0 7,500 1,250 0 

Out-of-Pocket maximum (dollars) 16,000 1,000 1,000 22,500 4,250 1,000

Coinsurance (percent) 30 20 0 0 0 0 

Single male, smoker, age 64 194 plans available 434 plans available

Premium Amount (dollars) 4,739 9,652 26,515 2,832 7,247 19,639

Annual deductible (dollars) 10,000 1,000 0 7,500 1,750 0 

Out-of-Pocket maximum (dollars) 16,000 3,000 1,000 22,500 3,000 1,000

Coinsurance (percent) 30 20 0 0 20 0 

Single female, nonsmoker, age 64 194 plans available 434 plans available

Premium Amount (dollars) 2,884 6,910 23,733 2,160 5,697 17,579

Annual deductible (dollars) 10,000 2,500 0 7,500 1,250 0 

Out-of-Pocket maximum (dollars) 16,000 3,000 1,000 22,500 4,250 1,000

Coinsurance (percent) 30 20 0 0 0 0 

Single female, smoker, age 64 194 plans available 434 plans available

Premium Amount (dollars) 4,015 8,941 29,667 2,160 6,289 21,974

Annual deductible (dollars) 5,000 3,000 0 7,500 500 0 

Out-of-Pocket maximum (dollars) 3,000 6,000 1,000 22,500 2,000 1,000

Coinsurance (percent) 20 30 0 0 0 0 

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 109 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 105: In Nevada, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market in One Urban and One Rural Zip Code for Individuals, Age 19, Displayed on the HealthCare.gov Plan 

finder in January 2013

Urban Zip 89002

Henderson, NV

Rural Zip 89444

Wellington, NV

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 19 122 plans available 90 plans available

Premium Amount (dollars) 318 1,055 5,410 456 1,168 5,895

Annual deductible (dollars) 2,000 500 1,500 10,000 5,000 1,500

Out-of-Pocket maximum (dollars) 4,000 5,000 4,500 3,000 7,000 4,500

Coinsurance (percent) 50 0 30 20 20 30

Single male, smoker, age 19 113 plans available 82 plans available

Premium Amount (dollars) 382 1,266 7,307 549 1,346 7,962

Annual deductible (dollars) 2,000 500 1,500 10,000 5,000 1,500

Out-of-Pocket maximum (dollars) 4,000 5,000 4,500 3,000 0 4,500

Coinsurance (percent) 50 0 30 20 0 30

Single female, nonsmoker, age 19 122 plans available 90 plans available

Premium Amount (dollars) 408 1,234 8,181 471 1,306 8,922

Annual deductible (dollars) 2,000 3,000 1,500 10,000 4,000 1,500

Out-of-Pocket maximum (dollars) 4,000 3,000 4,500 3,000 4,000 4,500

Coinsurance (percent) 50 0 30 20 0 30

Single female, smoker, age 19 113 plans available 82 plans available

Premium Amount (dollars) 490 1,459 11,049 568 1,479 12,050

Annual deductible (dollars) 2,000 N/A 1,500 10,000 2,500 1,500

Out-of-Pocket maximum (dollars) 4,000 0 4,500 3,000 0 4,500

Coinsurance (percent) 50 0 30 20 0 30

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 110 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 106: In Nevada, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market in One Urban and One Rural Zip Code for Individuals, Age 64, Displayed on the HealthCare.gov Plan 

finder in January 2013

Urban Zip 89002

Henderson, NV

Rural Zip 89444

Wellington, NV

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 64 122 plans available 90 plans available

Premium Amount (dollars) 2,484 6,373 20,592 2,816 6,415 21,946

Annual deductible (dollars) 3,000 2,500 1,500 10,000 5,000 1,500

Out-of-Pocket maximum (dollars) 7,000 5,000 4,500 3,000 0 4,500

Coinsurance (percent) 30 30 30 20 0 30

Single male, smoker, age 64 113 plans available 82 plans available

Premium Amount (dollars) 3,392 8,230 27,801 4,239 8,701 29,629

Annual deductible (dollars) 2,000 4,000 1,500 10,000 2,500 1,500

Out-of-Pocket maximum (dollars) 4,000 4,000 4,500 3,000 4,500 4,500

Coinsurance (percent) 50 0 30 20 20 30

Single female, nonsmoker, age 64 122 plans available 90 plans available

Premium Amount (dollars) 2,096 4,797 18,666 2,096 4,720 19,971

Annual deductible (dollars) 10,000 2,500 1,500 10,000 3,500 1,500

Out-of-Pocket maximum (dollars) 3,000 3,000 4,500 3,000 3,000 4,500

Coinsurance (percent) 20 20 30 20 20 30

Single female, smoker, age 64 113 plans available 82 plans available

Premium Amount (dollars) 2,696 6,541 25,197 3,155 6,417 26,959

Annual deductible (dollars) 2,000 4,000 1,500 10,000 5,000 1,500

Out-of-Pocket maximum (dollars) 4,000 4,000 4,500 3,000 7,000 4,500

Coinsurance (percent) 50 0 30 20 20 30

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 111 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 107: In Pennsylvania, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market in One Urban and One Rural Zip Code for Individuals, Age 19, Displayed on the 

HealthCare.gov Plan finder in January 2013

Urban Zip 15028

Coulters, PA

Rural Zip 17212

Big Cove Ta, PA

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 19 86 plans available 96 plans available

Premium Amount (dollars) 557 1,306 9,105 535 1,409 9,081

Annual deductible (dollars) 5,000 2,000 1,500 5,000 5,000 1,000

Out-of-Pocket maximum (dollars) 10,000 3,000 5,500 10,000 6,000 3,000

Coinsurance (percent) 15 10 20 20 20 20

Single male, smoker, age 19 86 plans available 96 plans available

Premium Amount (dollars) 641 1,481 9,105 535 1,608 9,081

Annual deductible (dollars) 5,000 2,500 1,500 5,000 1,500 1,000

Out-of-Pocket maximum (dollars) 10,000 4,500 5,500 10,000 5,000 3,000

Coinsurance (percent) 15 20 20 20 30 20

Single female, nonsmoker, age 19 86 plans available 96 plans available

Premium Amount (dollars) 688 1,441 9,105 769 1,662 9,081

Annual deductible (dollars) 5,000 1,200 1,500 5,000 1,500 1,000

Out-of-Pocket maximum (dollars) 10,000 2,200 5,500 10,000 2,250 3,000

Coinsurance (percent) 15 10 20 20 15 20

Single female, smoker, age 19 86 plans available 96 plans available

Premium Amount (dollars) 691 1,652 9,105 769 1,821 9,081

Annual deductible (dollars) 5,000 2,600 1,500 5,000 0 1,000

Out-of-Pocket maximum (dollars) 1,050 2,600 5,500 10,000 0 3,000

Coinsurance (percent) 0 0 20 20 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 112 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 108: In Pennsylvania, the Range of Annual Base Premiums Prior to Underwriting in the Individual 

(Nongroup) Market in One Urban and One Rural Zip Code for Individuals, Age 64, Displayed on the 

HealthCare.gov Plan finder in January 2013

Urban Zip 15028

Coulters, PA

Rural Zip 17212

Big Cove Ta, PA

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 64 86 plans available 96 plans available

Premium Amount (dollars) 2,140 6,783 18,859 1,821 6,707 29,045

Annual deductible (dollars) 0 2,500 1,000 0 5,000 500

Out-of-Pocket maximum (dollars) N/A 4,500 2,000 0 6,000 1,500

Coinsurance (percent) 0 20 20 0 20 15

Single male, smoker, age 64 86 plans available 96 plans available

Premium Amount (dollars) 2,140 7,467 21,688 1,821 7,210 29,045

Annual deductible (dollars) 0 1,000 1,000 0 2,500 500

Out-of-Pocket maximum (dollars) N/A 3,500 2,000 0 6,000 1,500

Coinsurance (percent) 0 20 20 0 20 15

Single female, nonsmoker, age 64 86 plans available 96 plans available

Premium Amount (dollars) 2,140 5,930 18,155 1,821 6,005 27,075

Annual deductible (dollars) 0 500 1,000 0 2,000 500

Out-of-Pocket maximum (dollars) N/A 1,750 2,000 0 3,000 1,500

Coinsurance (percent) 0 10 20 0 10 15

Single female, smoker, age 64 86 plans available 96 plans available

Premium Amount (dollars) 2,140 6,408 20,879 1,821 6,591 27,075

Annual deductible (dollars) 0 1,500 1,000 0 10,000 500

Out-of-Pocket maximum (dollars) N/A 5,000 2,000 0 10,000 1,500

Coinsurance (percent) 0 30 20 0 0 15

Legend: N/A=Not applicable (value was not reported by the insurer)

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 113 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 109: In Texas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market in One Urban and One Rural Zip Code for Individuals, Age 19, Displayed on the HealthCare.gov Plan 

finder in January 2013

Urban Zip 75248

Dallas, TX

Rural Zip 79506

Blackwell, TX

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 19 228 plans available 229 plans available

Premium Amount (dollars) 566 1,285 3,957 624 1,255 3,403

Annual deductible (dollars) 10,000 2,000 500 10,000 7,500 500

Out-of-Pocket maximum (dollars) 17,500 7,000 3,000 3,000 7,500 3,000

Coinsurance (percent) 50 50 20 25 0 20

Single male, smoker, age 19 228 plans available 229 plans available

Premium Amount (dollars) 666 1,518 4,350 728 1,500 3,756

Annual deductible (dollars) 10,000 5,000 500 10,000 3,000 250

Out-of-Pocket maximum (dollars) 17,500 5,000 3,000 5,000 3,000 3,000

Coinsurance (percent) 50 0 20 0 0 15

Single female, nonsmoker, age 19 228 plans available 229 plans available

Premium Amount (dollars) 605 1,532 5,465 697 1,512 4,704

Annual deductible (dollars) 10,000 5,000 500 10,000 1,500 500

Out-of-Pocket maximum (dollars) 17,500 11,000 3,000 17,500 5,000 3,000

Coinsurance (percent) 50 30 20 50 30 20

Single female, smoker, age 19 228 plans available 229 plans available

Premium Amount (dollars) 711 1,817 6,008 820 1,806 5,172

Annual deductible (dollars) 10,000 5,000 500 10,000 5,000 500

Out-of-Pocket maximum (dollars) 17,500 6,000 3,000 17,500 5,000 3,000

Coinsurance (percent) 50 30 20 50 0 20

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.
Enclosure II

Page 114 GAO-14-263R Range of Health Insurance Premiums in 2013

Table 110: In Texas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup) 

Market in One Urban and One Rural Zip Code for Individuals, Age 64, Displayed on the HealthCare.gov Plan 

finder in January 2013

Urban Zip 75248

Dallas, TX

Rural Zip 79506

Blackwell, TX

Consumer type

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Plan with 

minimum 

premium

Plan with 

median 

premium

Plan with 

maximum 

premium

Single male, nonsmoker, age 64 228 plans available 229 plans available

Premium Amount (dollars) 2,284 6,206 21,972 2,632 6,115 19,368

Annual deductible (dollars) 10,000 3,500 250 10,000 1,500 250

Out-of-Pocket maximum (dollars) 17,500 6,000 3,000 17,500 6,500 3,000

Coinsurance (percent) 50 20 15 50 30 15

Single male, smoker, age 64 228 plans available 229 plans available

Premium Amount (dollars) 4,030 9,120 27,468 4,225 9,124 24,216

Annual deductible (dollars) 10,000 5,000 250 7,500 3,500 250

Out-of-Pocket maximum (dollars) 17,500 5,000 3,000 10,000 9,500 3,000

Coinsurance (percent) 50 20 15 30 30 15

Single female, nonsmoker, age 64 228 plans available 229 plans available

Premium Amount (dollars) 2,521 5,648 18,492 2,612 5,648 16,296

Annual deductible (dollars) 10,000 5,000 250 7,500 5,000 250

Out-of-Pocket maximum (dollars) 17,500 6,000 3,000 10,000 6,000 3,000

Coinsurance (percent) 50 30 15 30 30 15

Single female, smoker, age 64 228 plans available 229 plans available

Premium Amount (dollars) 3,624 8,458 23,124 4,161 8,192 20,376

Annual deductible (dollars) 10,000 3,500 250 7,500 6,000 250

Out-of-Pocket maximum (dollars) 12,500 7,000 3,000 10,000 6,000 3,000

Coinsurance (percent) 30 50 15 30 0 15

Source: GAO analysis of Center for Consumer Information and Insurance Oversight (CCIIO) data.

Notes: Because insurers can impose different premiums on individuals on the basis of a variety of factors, the data represent the base 

premium amount, rather than the actual premium amount an individual would be charged. Actual premiums could be higher because they 

would be determined after more complete underwriting for health conditions and other individual factors.

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.

Data reflect available information for all plans for which data were displayed on HealthCare.gov as of January 2013 and may include 

plans with little or no enrollment.

(291182) 
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