Page 1 GAO-13-712R Range of Health Insurance Premiums in 2013

441 G St. N.W.

Washington, DC 20548

July 23, 2013

The Honorable Orrin G. Hatch

Ranking Member

Committee on Finance

United States Senate

Subject: Private Health Insurance: The Range of Base Premiums in the Individual Market by 

State in January 2013

Dear Senator Hatch:

Millions of Americans obtain health coverage by purchasing private health insurance,1 including 

over 11 million individuals who purchased individual market plans in 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. 

Currently, in most states, under applicable law, individual health insurance market premium 

rates may vary on the basis of age, gender, health status, and other factors. In addition, states 

vary in their specific requirements for what insurers can consider in underwriting, which is the 

process of assessing the health status of the insurance applicant and setting the premium 

according to the health risk of that individual.3 With certain exceptions, when individuals 

purchasing coverage in the individual market undergo underwriting, they can have their 

coverage denied, offered at a higher-than-average premium, or offered with a rider that 

excludes coverage of a preexisting condition.4 The Center for Consumer Information and 

Insurance Oversight (CCIIO) within the Department of Health and Human Services (HHS) 

Centers for Medicare & Medicaid Services (CMS) currently maintains an online portal—the 

HealthCare.gov Plan Finder—that displays insurers’ base premiums prior to underwriting to 

assist consumers in comparing health insurance coverage options in the individual market.5

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

could affect private health insurance requirements and the resulting cost of individual health 

insurance premiums. For example, insurers will no longer be able to use gender and health 

 

1

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

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

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

2

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

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

3

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

Insurance Rates (Washington, D.C.: January 20, 2012). In any given state, premiums may vary according to the 

rating factors allowed by the state. For example, a state may prohibit premiums in the individual market from varying 

based on health factors, but may allow premiums to vary based on age, gender, or other risk factors.

4

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

insurance coverage.

5

This online portal was established pursuant to a requirement in the Patient Protection and Affordable Care Act 

(PPACA), Pub. L. No. 111–148, §§ 1103(a), 10102(b), 124 Stat. 119, 146, 892 (2010). The Plan Finder can be found 

at http://finder.healthcare.gov/.
Page 2 GAO-13-712R Range of Health Insurance Premiums in 2013

status to set premium rates and will be restricted in the amount they can vary premiums based 

on age and tobacco use, among other provisions.6 PPACA also included an individual mandate 

that will require most individuals to have health insurance.7 While some of the PPACA 

provisions have been implemented, others will not take effect until January 2014. As a result, 

beginning in 2014, the way insurers may calculate base premiums prior to underwriting may 

change.8

To examine the range of base premiums 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 examine premium amounts that existed prior to the full 

implementation of the PPACA provisions. This report examines the range of base premiums for 

health insurance in the individual market that were displayed on the HealthCare.gov Plan Finder 

in the month of January 2013.

9 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.10

 

6

See, Pub. L. No. 111-148, § 1201, 124 Stat. 154. In March 2012, GAO reported that there were 5 states with 

protections similar to PPACA. We classified states as having protections similar to PPACA if the state prohibited the 

denial of coverage to individuals on the basis of preexisting conditions, or if the state had rating restrictions that 

affected insurers’ ability to adjust an individual’s health insurance premiums on the basis of an individual’s health 

status.

Because insurers may impose different rates on 

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, 

which could be higher than the base rates because the actual premium amounts would have 

been determined after more complete underwriting for health conditions and other factors. 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 types 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. While we selected zip codes within 

each state randomly, states were selected on the basis of geographic location and included one 

7

Pub. L. No. 111-148, §§ 1501, 10106, 124 Stat. 242, 907, as amended by Pub. L. No. 111-152, §§ 1002, 1004, 

124 Stat. 1029, 1032.

8

In addition, beginning January 1, 2014, premium tax credits and cost-sharing subsidies—subsidies that will help 

individuals pay for out-of-pocket expenses such as deductibles and copays—will become available under PPACA.

9

Insurance companies may offer multiple health insurance products in each state, and multiple health plans may be 

available for each product. For example, the same product may have plans with different cost sharing features. In 

addition, insurance companies can vary 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.

10HealthCare.gov data include enrollment information at the product level. However, multiple plans may be 

associated with a single product; therefore, plan-level enrollment data were not available.
Page 3 GAO-13-712R Range of Health Insurance Premiums in 2013

state from each of the four census regions.11

We conducted our work from March 2013 to July 2013 in accordance with all sections of 

GAO’s Quality Assurance Framework that are relevant to our objectives. The framework 

requires that we plan and perform the engagement to obtain sufficient and appropriate evidence 

to meet our stated objectives and to discuss any limitations in our work. We believe that the 

information and data obtained, and the analysis conducted, provide a reasonable basis for any 

findings and conclusions.

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 in the individual market displayed on the HealthCare.gov Plan 

Finder as of January 2013 in each of the 50 states and the District of Columbia are reported in 

enclosure I. Enclosure II shows the range of base premiums for the same categories of 

individuals for urban and rural zip codes in four states.

Agency Comments

We provided the Department of Health and Human Services (HHS) with a draft of this report for 

review; it had no comments.

– – – – – 

We are sending copies of this report to the Secretary of Health and Human Services and other 

interested parties. In addition, the report will be available at no charge on GAO’s website at 

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 

 

11Urban 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.
Enclosure I

Page 4 GAO-13-712R 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 Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Source: GAO analysis of the 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.

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 512 plans available

Premium amount (dollars) 849 1,435 3,228

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

Out-of-pocket maximum (dollars) 16,000 12,000 6,000

Coinsurance (percent) 30 30 20

Single male, smoker, age 30 512 plans available

Premium amount (dollars) 948 1,808 4,085

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

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

Coinsurance (percent) 20 30 20

Single female, nonsmoker, age 30 512 plans available

Premium amount (dollars) 948 1,961 4,341

Annual deductible (dollars) 3,250 6,000 2,000

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

Coinsurance (percent) 20 0 20

Single female, smoker, age 30 512 plans available

Premium amount (dollars) 948 2,415 5,407

Annual deductible (dollars) 3,250 4,000 2,000

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

Coinsurance (percent) 20 20 20

Family of four, parents age 40 512 plans available

Premium amount (dollars) 3,120 6,691 14,388

Family annual deductible (dollars) 6,450 22,500 6,000

Family out-of-pocket maximum (dollars) 10,000 31,500 18,000

Coinsurance (percent) 20 20 20

Couple, age 55 512 plans available

Premium amount (dollars) 4,452 7,551 17,378

Family annual deductible (dollars) 6,450 12,000 6,000

Family out-of-pocket maximum (dollars) 10,000 18,000 18,000

Coinsurance (percent) 20 20 20
Enclosure I

Page 5 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium 

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 178 plans available

Premium amount (dollars) 1,027 1,835 3,972

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

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

Coinsurance (percent) 0 20 20

Single male, smoker, age 30 178 plans available

Premium amount (dollars) 1,181 2,110 4,584

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

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

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 30 178 plans available

Premium amount (dollars) 1,242 2,229 6,792

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

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

Coinsurance (percent) 0 20 20

Single female, smoker, age 30 178 plans available

Premium amount (dollars) 1,429 2,564 7,824

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

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

Coinsurance (percent) 0 20 20

Family of four, parents age 40 175 plans available

Premium amount (dollars) 4,723 8,681 32,304

Family annual deductible (dollars) N/A 15,000 2,000

Family out-of-pocket maximum (dollars) N/A 21,000 4,000

Coinsurance (percent) 0 20 20

Couple, age 55 175 plans available

Premium amount (dollars) 6,176 10,681 31,812

Family annual deductible (dollars) N/A 15,000 2,000

Family out-of-pocket maximum (dollars) N/A 21,000 4,000

Coinsurance (percent) 0 20 20

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

Source: GAO analysis of the 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-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 736 plans available

Premium amount (dollars) 456 1,046 6,815

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

Out-of-pocket maximum (dollars) 5,000 9,500 5,900

Coinsurance (percent) 40 30 20

Single male, smoker, age 30 736 plans available

Premium amount (dollars) 501 1,267 9,490

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

Out-of-pocket maximum (dollars) 5,000 2,500 5,900

Coinsurance (percent) 40 20 20

Single female, nonsmoker, age 30 736 plans available

Premium amount (dollars) 624 1,424 9,708

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

Out-of-pocket maximum (dollars) 5,000 6,500 3,500

Coinsurance (percent) 40 20 30

Single female, smoker, age 30 736 plans available

Premium amount (dollars) 686 1,716 13,840

Annual deductible (dollars) 10,000 4,000 3,900

Out-of-pocket maximum (dollars) 5,000 No Maximum 5,900

Coinsurance (percent) 40 0 20

Family of four, parents age 40 480 plans available

Premium amount (dollars) 2,691 4,408 10,115

Family annual deductible (dollars) 30,000 6,000 6,000

Family out-of-pocket maximum (dollars) 48,000 18,000 18,000

Coinsurance (percent) 30 20 20

Couple, age 55 736 plans available

Premium amount (dollars) 2,496 5,578 41,559

Family annual deductible (dollars) 20,000 22,500 11,700

Family out-of-pocket maximum (dollars) N/A 31,500 No Maximum

Coinsurance (percent) 40 20 20

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 7 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 386 plans available

Premium amount (dollars) 437 899 2,201

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

Single male, smoker, age 30 386 plans available

Premium amount (dollars) 437 1,132 2,531

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

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

Coinsurance (percent) 0 30 20

Single female, nonsmoker, age 30 386 plans available

Premium amount (dollars) 681 1,240 2,971

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

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

Coinsurance (percent) 0 20 20

Single female, smoker, age 30 386 plans available

Premium amount (dollars) 681 1,505 3,417

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

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

Coinsurance (percent) 0 20 20

Family of four, parents age 40 369 plans available

Premium amount (dollars) 2,278 4,256 7,449

Family annual deductible (dollars) 50,000 6,000 6,000

Family out-of-pocket maximum (dollars) 50,000 18,000 18,000

Coinsurance (percent) 0 20 20

Couple, age 55 386 plans available

Premium amount (dollars) 578 4,630 8,997

Family annual deductible (dollars) 15,000 15,000 6,000

Family out-of-pocket maximum (dollars) 33,000 33,000 18,000

Coinsurance (percent) 30 30 20

Source: GAO analysis of the 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 

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.

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.
Enclosure I

Page 8 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 617 plans available

Premium amount (dollars) 672 2,232 13,836

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

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

Coinsurance (percent) 50 25 N/A

Single male, smoker, age 30 617 plans available

Premium amount (dollars) 672 2,472 13,836

Annual deductible (dollars) 6,500 3,400 2,000

Out-of-pocket maximum (dollars) 9,500 3,400 3,000

Coinsurance (percent) 50 0 N/A

Single female, nonsmoker, age 30 617 plans available

Premium amount (dollars) 672 2,232 13,836

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

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

Coinsurance (percent) 50 25 N/A

Single female, smoker, age 30 617 plans available

Premium amount (dollars) 672 2,472 13,836

Annual deductible (dollars) 6,500 3,400 2,000

Out-of-pocket maximum (dollars) 9,500 3,400 3,000

Coinsurance (percent) 50 0 N/A

Family of four, parents age 40 314 plans available

Premium amount (dollars) 2,832 8,841 43,632

Family annual deductible (dollars) 13,000 15,000 4,000

Family out-of-pocket maximum (dollars) 19,000 21,000 6,000

Coinsurance (percent) 50 20 N/A

Couple, age 55 599 plans available

Premium amount (dollars) 2,880 10,020 36,780

Family annual deductible (dollars) 13,000 5,000 4,000

Family out-of-pocket maximum (dollars) 19,000 15,000 6,000

Coinsurance (percent) 50 25 N/A

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 9 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 2,571 plans available

Premium amount (dollars) 673 2,424 11,439

Annual deductible (dollars) 10,000 5,950 500

Out-of-pocket maximum (dollars) 17,500 5,950 3,000

Coinsurance (percent) 50 0 20

Single male, smoker, age 30 2,571 plans available

Premium amount (dollars) 918 2,935 13,270

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, nonsmoker, age 30 2,571 plans available

Premium amount (dollars) 673 2,424 11,439

Annual deductible (dollars) 10,000 5,950 500

Out-of-pocket maximum (dollars) 17,500 5,950 3,000

Coinsurance (percent) 50 0 20

Single female, smoker, age 30 2,571 plans available

Premium amount (dollars) 918 2,935 13,270

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

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

Coinsurance (percent) 50 20 20

Family of four, parents age 40 1,266 plans available

Premium amount (dollars) 2,394 7,573 19,684

Family annual deductible (dollars) 20,000 N/A 3,000

Family out-of-pocket maximum (dollars) 35,000 N/A 9,000

Coinsurance (percent) 50 20 20

Couple, age 55 1,930 plans available

Premium amount (dollars) 2,981 9,528 36,826

Family annual deductible (dollars) 20,000 7,000 1,500

Family out-of-pocket maximum (dollars) 35,000 14,000 6,500

Coinsurance (percent) 50 30 20

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

Source: GAO analysis of the 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 

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.

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.
Enclosure I

Page 10 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 7: In Connecticut, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 470 plans available

Premium amount (dollars) 936 1,910 4,511

Annual deductible (dollars) 10,000 4,000 500

Out-of-pocket maximum (dollars) 12,500 4,000 3,500

Coinsurance (percent) 20 0 20

Single male, smoker, age 30 470 plans available

Premium amount (dollars) 936 2,265 5,639

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

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

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 30 469 plans available

Premium amount (dollars) 1,188 2,381 5,075

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

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

Coinsurance (percent) 20 0 20

Single female, smoker, age 30 470 plans available

Premium amount (dollars) 1,188 2,763 6,907

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

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

Coinsurance (percent) 20 20 20

Family of four, parents age 40 412 plans available

Premium amount (dollars) 4,980 9,404 22,719

Family annual deductible (dollars) 24,000 15,000 1,000

Family out-of-pocket maximum (dollars) 24,000 21,000 7,000

Coinsurance (percent) 0 20 20

Couple, age 55 470 plans available

Premium amount (dollars) 4,068 10,454 24,037

Family annual deductible (dollars) 20,000 7,500 1,000

Family out-of-pocket maximum (dollars) 25,000 13,500 7,000

Coinsurance (percent) 20 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 11 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 123 plans available

Premium amount (dollars) 623 1,379 2,648

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

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

Coinsurance (percent) 20 0 20

Single male, smoker, age 30 123 plans available

Premium amount (dollars) 747 1,661 3,318

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

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

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 30 123 plans available

Premium amount (dollars) 826 1,735 3,527

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

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

Coinsurance (percent) 20 30 20

Single female, smoker, age 30 123 plans available

Premium amount (dollars) 991 2,097 4,393

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

Out-of-pocket maximum (dollars) 3,000 5,000 6,000

Coinsurance (percent) 20 30 20

Family of four, parents age 40 78 plans available

Premium amount (dollars) 4,022 6,275 11,689

Family annual deductible (dollars) 30,000 22,500 6,000

Family out-of-pocket maximum (dollars) 48,000 31,500 18,000

Coinsurance (percent) 30 20 20

Couple, age 55 116 plans available

Premium amount (dollars) 3,391 7,246 14,797

Family annual deductible (dollars) 20,000 2,000 2,000

Family out-of-pocket maximum (dollars) 3,000 3,000 3,000

Coinsurance (percent) 20 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 12 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 9: In District of Columbia, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 309 plans available

Premium amount (dollars) 643 1,749 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 male, smoker, age 30 309 plans available

Premium amount (dollars) 1,006 2,112 12,056

Annual deductible (dollars) 10,000 3,500 100

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

Coinsurance (percent) 50 50 10

Single female, nonsmoker, age 30 309 plans available

Premium amount (dollars) 643 2,112 12,056

Annual deductible (dollars) 10,000 2,600 100

Out-of-pocket maximum (dollars) 17,500 5,000 2,500

Coinsurance (percent) 50 20 10

Single female, smoker, age 30 309 plans available

Premium amount (dollars) 1,006 2,518 12,056

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

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

Coinsurance (percent) 50 30 10

Family of four, parents age 40 309 plans available

Premium amount (dollars) 2,338 7,656 43,952

Family annual deductible (dollars) 20,000 N/A 200

Family out-of-pocket maximum (dollars) 35,000 5,000 5,000

Coinsurance (percent) 50 0 10

Couple, age 55 309 plans available

Premium amount (dollars) 2,642 9,593 57,412

Family annual deductible (dollars) 20,000 30,000 200

Family out-of-pocket maximum (dollars) 35,000 30,000 5,000

Coinsurance (percent) 50 0 10

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 13 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 10: In Florida, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 7,669 plans available

Premium amount (dollars) 624 1,704 6,921

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

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

Coinsurance (percent) 20 20 20

Single male, smoker, age 30 7,669 plans available

Premium amount (dollars) 624 2,088 7,959

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

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

Coinsurance (percent) 20 30 20

Single female, nonsmoker, age 30 7,669 plans available

Premium amount (dollars) 792 2,547 8,367

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

Out-of-pocket maximum (dollars) 7,500 5,150 3,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 30 7,669 plans available

Premium amount (dollars) 828 3,024 9,623

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

Out-of-pocket maximum (dollars) 7,500 6,000 3,000

Coinsurance (percent) 20 25 20

Family of four, parents age 40 1,140 plans available

Premium amount (dollars) 3,984 9,826 32,744

Family annual deductible (dollars) 22,500 7,500 3,000

Family out-of-pocket maximum (dollars) 31,500 7,500 9,000

Coinsurance (percent) 30 0 20

Couple, age 55 6,877 plans available

Premium amount (dollars) 2,868 8,364 40,287

Family annual deductible (dollars) 20,000 7,500 3,000

Family out-of-pocket maximum (dollars) 25,000 10,000 9,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 14 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 11: In Georgia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 4,209 plans available

Premium amount (dollars) 363 1,293 8,526

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

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

Coinsurance (percent) 40 20 20

Single male, smoker, age 30 4,196 plans available

Premium amount (dollars) 495 1,573 9,142

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

Out-of-pocket maximum (dollars) 17,500 8,000 3,000

Coinsurance (percent) 40 20 20

Single female, nonsmoker, age 30 4,209 plans available

Premium amount (dollars) 467 1,712 10,164

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

Out-of-pocket maximum (dollars) 17,500 11,000 3,000

Coinsurance (percent) 40 40 20

Single female, smoker, age 30 4,196 plans available

Premium amount (dollars) 638 2,065 11,458

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

Out-of-pocket maximum (dollars) 17,500 5,000 3,000

Coinsurance (percent) 40 20 20

Family of four, parents age 40 1,973 plans available

Premium amount (dollars) 1,869 5,386 26,671

Family annual deductible (dollars) 20,000 4,000 1,500

Family out-of-pocket maximum (dollars) 35,000 19,000 7,000

Coinsurance (percent) 40 40 20

Couple, age 55 4,161 plans available

Premium amount (dollars) 2,252 6,975 32,137

Family annual deductible (dollars) 20,000 10,000 1,500

Family out-of-pocket maximum (dollars) 35,000 15,000 7,000

Coinsurance (percent) 40 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 15 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 12: In Hawaii, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 34 plans available

Premium amount (dollars) 770 5,175 7,339

Annual deductible (dollars) N/A 0 0

Out-of-pocket maximum (dollars) 5,000 2,500 2,500

Coinsurance (percent) N/A 20 20

Single male, smoker, age 30 34 plans available

Premium amount (dollars) 770 5,175 7,339

Annual deductible (dollars) N/A 0 0 

Out-of-pocket maximum (dollars) 5,000 2,500 2,500

Coinsurance (percent) N/A 20 20

Single female, nonsmoker, age 30 34 plans available

Premium amount (dollars) 864 5,296 7,339

Annual deductible (dollars) 2,500 0 0 

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

Coinsurance (percent) 20 20 20

Single female, smoker, age 30 34 plans available

Premium amount (dollars) 864 5,296 7,339

Annual deductible (dollars) 2,500 0 0 

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

Coinsurance (percent) 20 20 20

Family of four, parents age 40 29 plans available

Premium amount (dollars) 2,592 17,485 23,088

Family annual deductible (dollars) 5,000 0 0 

Family out-of-pocket maximum (dollars) 7,000 7,500 7,500

Coinsurance (percent) 20 10 20

Couple, age 55 31 plans available

Premium amount (dollars) 2,862 20,804 29,009

Family annual deductible (dollars) 5,000 0 0 

Family out-of-pocket maximum (dollars) 7,000 7,500 7,500

Coinsurance (percent) 20 20 20

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 16 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 13: In Idaho, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 245 plans available

Premium amount (dollars) 702 1,466 3,922

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

Out-of-pocket maximum (dollars) 2,000 8,500 2,850

Coinsurance (percent) 20 50 0 

Single male, smoker, age 30 245 plans available

Premium amount (dollars) 738 1,768 5,352

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

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

Coinsurance (percent) 30 50 0 

Single female, nonsmoker, age 30 245 plans available

Premium amount (dollars) 936 1,966 4,657

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

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

Coinsurance (percent) 40 50 0

Single female, smoker, age 30 245 plans available

Premium amount (dollars) 996 2,347 6,355

Annual deductible (dollars) 7,500 10,000 2,850

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

Coinsurance (percent) 20 0 0 

Family of four, parents age 40 207 plans available

Premium amount (dollars) 3,192 7,170 16,073

Family annual deductible (dollars) 20,000 6,000 5,700

Family out-of-pocket maximum (dollars) 25,000 10,000 5,700

Coinsurance (percent) 40 10 0

Couple, age 55 245 plans available

Premium amount (dollars) 3,600 8,444 19,656

Family annual deductible (dollars) 20,000 7,000 5,700

Family out-of-pocket maximum (dollars) 25,000 10,000 5,700

Coinsurance (percent) 40 20 0 

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 17 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 14: In Illinois, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,854 plans available

Premium amount (dollars) 573 1,451 5,632

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

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

Coinsurance (percent) 30 0 0 

Single male, smoker, age 30 1,854 plans available

Premium amount (dollars) 661 1,722 7,040

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

Out-of-pocket maximum (dollars) 22,500 7,000 1,000

Coinsurance (percent) 0 30 0 

Single female, nonsmoker, age 30 1,854 plans available

Premium amount (dollars) 816 2,170 14,578

Annual deductible (dollars) 10,000 4,000 0 

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

Coinsurance (percent) 30 20 0

Single female, smoker, age 30 1,854 plans available

Premium amount (dollars) 900 2,518 18,223

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

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

Coinsurance (percent) 0 20 0 

Family of four, parents age 40 1,262 plans available

Premium amount (dollars) 2,694 6,224 31,536

Family annual deductible (dollars) 30,000 18,000 0 

Family out-of-pocket maximum (dollars) 48,000 18,000 3,000

Coinsurance (percent) 30 0 0

Couple, age 55 1,374 plans available

Premium amount (dollars) 3,028 7,519 37,790

Family annual deductible (dollars) 30,000 18,000 0 

Family out-of-pocket maximum (dollars) 48,000 18,000 3,000

Coinsurance (percent) 30 0 0 

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 18 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 15: In Indiana, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 2,278 plans available

Premium amount (dollars) 513 1,593 4,422

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

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

Coinsurance (percent) 0 30 20

Single male, smoker, age 30 2,278 plans available

Premium amount (dollars) 667 1,957 5,542

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

Out-of-pocket maximum (dollars) N/A 4,500 3,000

Coinsurance (percent) 0 30 20

Single female, nonsmoker, age 30 2,278 plans available

Premium amount (dollars) 746 2,156 8,662

Annual deductible (dollars) N/A 6,000 500

Out-of-pocket maximum (dollars) N/A 8,000 2,500

Coinsurance (percent) 0 20 20

Single female, smoker, age 30 2,278 plans available

Premium amount (dollars) 970 2,719 9,844

Annual deductible (dollars) N/A 6,000 500

Out-of-pocket maximum (dollars) N/A 8,000 2,500

Coinsurance (percent) 0 20 20

Family of four, parents age 40 760 plans available

Premium amount (dollars) 3,757 7,366 17,112

Family annual deductible (dollars) 22,500 15,000 3,000

Family out-of-pocket maximum (dollars) 31,500 15,000 9,000

Coinsurance (percent) 30 0 20

Couple, age 55 2,130 plans available

Premium amount (dollars) 3,210 8,958 22,110

Family annual deductible (dollars) 12,000 7,500 2,000

Family out-of-pocket maximum (dollars) 12,000 13,500 6,000

Coinsurance (percent) 0 20 20

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 19 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 16: In Iowa, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,404 plans available

Premium amount (dollars) 442 1,341 3,215

Annual deductible (dollars) 5,000 2,600 500

Out-of-pocket maximum (dollars) 10,000 2,600 1,500

Coinsurance (percent) 40 0 10

Single male, smoker, age 30 1,404 plans available

Premium amount (dollars) 597 1,548 3,722

Annual deductible (dollars) 5,000 2,600 1,500

Out-of-pocket maximum (dollars) 10,000 5,000 4,000

Coinsurance (percent) 40 20 10

Single female, nonsmoker, age 30 1,404 plans available

Premium amount (dollars) 678 1,656 6,171

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

Out-of-pocket maximum (dollars) 10,000 3,000 1,500

Coinsurance (percent) 40 20 10

Single female, smoker, age 30 1,404 plans available

Premium amount (dollars) 916 1,953 7,080

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

Out-of-pocket maximum (dollars) 10,000 8,000 1,500

Coinsurance (percent) 40 40 10

Family of four, parents age 40 1,170 plans available

Premium amount (dollars) 3,408 6,595 17,946

Family annual deductible (dollars) 22,500 4,500 1,500

Family out-of-pocket maximum (dollars) 31,500 13,500 4,500

Coinsurance (percent) 30 20 10

Couple, age 55 1,404 plans available

Premium amount (dollars) 1,807 7,707 16,892

Family annual deductible (dollars) 10,000 7,500 3,000

Family out-of-pocket maximum (dollars) 20,000 13,500 9,000

Coinsurance (percent) 40 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 20 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 17: In Kansas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,727 plans available

Premium amount (dollars) 405 1,497 9,804

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

Out-of-pocket maximum (dollars) 17,500 4,000 5,000

Coinsurance (percent) 50 20 20

Single male, smoker, age 30 1,727 plans available

Premium amount (dollars) 452 1,847 9,804

Annual deductible (dollars) 10,000 5,000 2,500

Out-of-pocket maximum (dollars) 11,000 7,000 5,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 30 1,727 plans available

Premium amount (dollars) 459 1,900 11,016

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

Out-of-pocket maximum (dollars) 17,500 4,500 5,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 30 1,727 plans available

Premium amount (dollars) 626 2,270 11,016

Annual deductible (dollars) 10,000 2,600 2,500

Out-of-pocket maximum (dollars) 17,500 5,000 5,000

Coinsurance (percent) 50 20 20

Family of four, parents age 40 1,278 plans available

Premium amount (dollars) 1,875 7,049 17,970

Family annual deductible (dollars) 20,000 5,000 3,000

Family out-of-pocket maximum (dollars) 35,000 5,000 9,000

Coinsurance (percent) 50 20 20

Couple, age 55 1,715 plans available

Premium amount (dollars) 230 7,916 25,356

Family annual deductible (dollars) 20,000 5,800 5,000

Family out-of-pocket maximum (dollars) 30,000 0 10,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 21 GAO-13-712R Range of Health Insurance Premiums in 2013

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

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 2,222 plans available

Premium amount (dollars) 395 1,200 3,348

Annual deductible (dollars) 10,000 500 500

Out-of-pocket maximum (dollars) 17,500 4,000 3,000

Coinsurance (percent) 50 30 20

Single male, smoker, age 30 2,222 plans available

Premium amount (dollars) 539 1,781 4,510

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

Out-of-pocket maximum (dollars) 17,500 4,500 3,000

Coinsurance (percent) 50 50 20

Single female, nonsmoker, age 30 2,222 plans available

Premium amount (dollars) 511 1,680 6,913

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

Out-of-pocket maximum (dollars) 17,500 8,500 2,500

Coinsurance (percent) 50 20 20

Single female, smoker, age 30 2,222 plans available

Premium amount (dollars) 698 2,478 8,304

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

Out-of-pocket maximum (dollars) 17,500 5,000 2,500

Coinsurance (percent) 50 20 20

Family of four, parents age 40 310 plans available

Premium amount (dollars) 1,857 3,282 7,158

Family annual deductible (dollars) 20,000 7,000 5,700

Family out-of-pocket maximum (dollars) 35,000 22,000 5,700

Coinsurance (percent) 50 50 0

Couple, age 55 2,114 plans available

Premium amount (dollars) 2,399 6,284 15,883

Family annual deductible (dollars) 20,000 1,000 1,500

Family out-of-pocket maximum (dollars) 35,000 8,000 6,500

Coinsurance (percent) 50 30 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 22 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 19: In Louisiana, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,931 plans available

Premium amount (dollars) 441 1,459 4,224

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 30 1,931 plans available

Premium amount (dollars) 506 1,864 4,858

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

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

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 30 1,931 plans available

Premium amount (dollars) 622 1,953 9,189

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

Out-of-pocket maximum (dollars) 1,000 5,500 2,000

Coinsurance (percent) 20 50 20

Single female, smoker, age 30 1,931 plans available

Premium amount (dollars) 713 2,473 9,852

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

Out-of-pocket maximum (dollars) 1,000 7,500 2,000

Coinsurance (percent) 20 30 20

Family of four, parents age 40 1,444 plans available

Premium amount (dollars) 1,932 6,833 21,070

Family annual deductible (dollars) 15,000 15,000 1,500

Family out-of-pocket maximum (dollars) 1,000 22,000 2,000

Coinsurance (percent) 20 20 20

Couple, age 55 1,878 plans available

Premium amount (dollars) 238 7,878 19,843

Family annual deductible (dollars) 22,500 15,000 1,500

Family out-of-pocket maximum (dollars) 10,500 22,000 2,000

Coinsurance (percent) 30 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 23 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 11 plans available

Premium amount (dollars) 1,522 9,286 24,132

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 30 11 plans available

Premium amount (dollars) 1,522 9,286 24,132

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 30 11 plans available

Premium amount (dollars) 1,522 9,286 24,132

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 30 11 plans available

Premium amount (dollars) 1,522 9,286 24,132

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 

Family of four, parents age 40 11 plans available

Premium amount (dollars) 5,507 28,361 77,183

Family annual deductible (dollars) 24,000 N/A N/A

Family out-of-pocket maximum (dollars) 26,000 4,000 N/A

Coinsurance (percent) 20 0 0

Couple, age 55 11 plans available

Premium amount (dollars) 6,284 25,657 58,248

Family annual deductible (dollars) 24,000 N/A N/A

Family out-of-pocket maximum (dollars) 26,000 4,000 N/A

Coinsurance (percent) 20 0 0 

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 24 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 21: In Maryland, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 55 plans available

Premium amount (dollars) 744 2,280 6,000

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

Out-of-pocket maximum (dollars) 12,500 4,000 2,500

Coinsurance (percent) 30 20 10

Single male, smoker, age 30 55 plans available

Premium amount (dollars) 744 2,280 6,000

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

Out-of-pocket maximum (dollars) 12,500 4,000 2,500

Coinsurance (percent) 30 20 10

Single female, nonsmoker, age 30 55 plans available

Premium amount (dollars) 780 2,676 6,000

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

Out-of-pocket maximum (dollars) 10,000 5,000 2,500

Coinsurance (percent) 0 0 10

Single female, smoker, age 30 55 plans available

Premium amount (dollars) 780 2,676 6,000

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

Out-of-pocket maximum (dollars) 10,000 5,000 2,500

Coinsurance (percent) 0 0 10

Family of four, parents age 40 48 plans available

Premium amount (dollars) 2,532 6,660 16,164

Family annual deductible (dollars) 20,000 2,800 200

Family out-of-pocket maximum (dollars) 20,000 5,600 5,000

Coinsurance (percent) 0 0 10

Couple, age 55 55 plans available

Premium amount (dollars) 3,396 8,148 22,968

Family annual deductible (dollars) 20,000 6,000 200

Family out-of-pocket maximum (dollars) No Maximum 6,000 5,000

Coinsurance (percent) 20 0 10

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 25 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 22: In Massachusetts, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 96 plans available

Premium amount (dollars) 2,564 3,438 5,069

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 30 96 plans available

Premium amount (dollars) 2,564 3,438 5,069

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 30 96 plans available

Premium amount (dollars) 2,564 3,438 5,069

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 30 96 plans available

Premium amount (dollars) 2,564 3,438 5,069

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 

Family of four, parents age 40 96 plans available

Premium amount (dollars) 11,330 15,193 22,398

Family annual deductible (dollars) 4,000 3,000 N/A

Family out-of-pocket maximum (dollars) 10,000 6,000 No Maximum

Coinsurance (percent) 20 0 0

Couple, age 55 96 plans available

Premium amount (dollars) 9,868 13,233 19,509

Family annual deductible (dollars) 4,000 3,000 N/A

Family out-of-pocket maximum (dollars) 10,000 6,000 No Maximum

Coinsurance (percent) 20 0 0 

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 26 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 23: In Michigan, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 734 plans available

Premium amount (dollars) 607 1,072 6,559

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

Out-of-pocket maximum (dollars) 10,000 6,500 4,000

Coinsurance (percent) 20 20 20

Single male, smoker, age 30 734 plans available

Premium amount (dollars) 607 1,285 6,559

Annual deductible (dollars) 5,000 3,500 1,500

Out-of-pocket maximum (dollars) 10,000 9,500 4,000

Coinsurance (percent) 20 30 20

Single female, nonsmoker, age 30 734 plans available

Premium amount (dollars) 744 1,416 6,559

Annual deductible (dollars) 10,000 2,750 1,500

Out-of-pocket maximum (dollars) 12,000 5,950 4,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 30 734 plans available

Premium amount (dollars) 744 1,652 6,600

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

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

Coinsurance (percent) 20 30 20

Family of four, parents age 40 480 plans available

Premium amount (dollars) 2,870 4,582 8,126

Family annual deductible (dollars) 30,000 15,000 6,000

Family out-of-pocket maximum (dollars) 48,000 27,000 18,000

Coinsurance (percent) 30 20 20

Couple, age 55 722 plans available

Premium amount (dollars) 3,156 5,556 14,940

Family annual deductible (dollars) 20,000 10,000 1,000

Family out-of-pocket maximum (dollars) 25,000 25,000 10,000

Coinsurance (percent) 20 40 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 27 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 24: In Minnesota, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,098 plans available

Premium amount (dollars) 683 1,540 7,485

Annual deductible (dollars) 15,000 5,000 150

Out-of-pocket maximum (dollars) 17,500 5,000 1,650

Coinsurance (percent) 20 0 20

Single male, smoker, age 30 1,098 plans available

Premium amount (dollars) 876 2,046 9,980

Annual deductible (dollars) 12,600 6,000 150

Out-of-pocket maximum (dollars) 13,600 6,000 1,650

Coinsurance (percent) 20 0 20

Single female, nonsmoker, age 30 1,098 plans available

Premium amount (dollars) 683 1,540 7,485

Annual deductible (dollars) 15,000 5,000 150

Out-of-pocket maximum (dollars) 17,500 5,000 1,650

Coinsurance (percent) 20 0 20

Single female, smoker, age 30 1,098 plans available 

Premium amount (dollars) 876 2,046 9,980

Annual deductible (dollars) 12,600 6,000 150

Out-of-pocket maximum (dollars) 13,600 6,000 1,650

Coinsurance (percent) 20 0 20

Family of four, parents age 40 300 plans available

Premium amount (dollars) 3,580 6,063 10,393

Family annual deductible (dollars) 20,000 10,000 5,700

Family out-of-pocket maximum (dollars) 35,000 14,000 5,700

Coinsurance (percent) 50 50 0

Couple, age 55 1,013 plans available

Premium amount (dollars) 2,879 6,559 31,554

Family annual deductible (dollars) 30,000 7,000 450

Family out-of-pocket maximum (dollars) 35,000 14,000 4,950

Coinsurance (percent) 20 30 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 28 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 25: In Mississippi, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 578 plans available

Premium amount (dollars) 612 1,509 5,681

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

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

Coinsurance (percent) 0 30 20

Single male, smoker, age 30 578 plans available

Premium amount (dollars) 705 1,865 6,586

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, nonsmoker, age 30 578 plans available

Premium amount (dollars) 881 2,066 8,275

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

Out-of-pocket maximum (dollars) 10,000 9,500 3,000

Coinsurance (percent) 0 30 20

Single female, smoker, age 30 578 plans available

Premium amount (dollars) 1,017 2,469 9,594

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

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

Coinsurance (percent) 0 20 20

Family of four, parents age 40 288 plans available

Premium amount (dollars) 4,091 6,564 12,658

Family annual deductible (dollars) 30,000 10,500 6,000

Family out-of-pocket maximum (dollars) 48,000 28,500 18,000

Coinsurance (percent) 30 30 20

Couple, age 55 578 plans available

Premium amount (dollars) 578 8,318 26,672

Family annual deductible (dollars) 15,000 15,000 1,500

Family out-of-pocket maximum (dollars) 33,000 24,000 6,500

Coinsurance (percent) 30 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 29 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,547 plans available

Premium amount (dollars) 440 1,442 3,957

Annual deductible (dollars) 10,000 1,000 5,000

Out-of-pocket maximum (dollars) 11,000 6,000 6,000

Coinsurance (percent) 20 30 30

Single male, smoker, age 30 1,547 plans available

Premium amount (dollars) 440 1,796 4,551

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

Out-of-pocket maximum (dollars) 11,000 8,000 6,000

Coinsurance (percent) 20 20 30

Single female, nonsmoker, age 30 1,547 plans available

Premium amount (dollars) 641 2,048 7,608

Annual deductible (dollars) N/A 5,000 500

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

Coinsurance (percent) 0 20 10

Single female, smoker, age 30 1,547 plans available

Premium amount (dollars) 792 2,501 9,228

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

Out-of-pocket maximum (dollars) 11,000 2,500 3,000

Coinsurance (percent) 20 0 10

Family of four, parents age 40 600 plans available

Premium amount (dollars) 1,995 8,286 18,195

Family annual deductible (dollars) 30,000 15,000 15,000

Family out-of-pocket maximum (dollars) 33,000 15,000 18,000

Coinsurance (percent) 20 0 30

Couple, age 55 1,449 plans available

Premium amount (dollars) 247 7,856 23,793

Family annual deductible (dollars) 20,000 22,500 15,000

Family out-of-pocket maximum (dollars) 30,000 31,500 18,000

Coinsurance (percent) 20 20 30

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 30 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 176 plans available

Premium amount (dollars) 783 1,430 4,046

Annual deductible (dollars) 10,000 7,500 2,850

Out-of-pocket maximum (dollars) 17,500 7,500 2,850

Coinsurance (percent) 50 0 0 

Single male, smoker, age 30 176 plans available

Premium amount (dollars) 840 1,932 5,522

Annual deductible (dollars) 10,000 3,500 2,850

Out-of-pocket maximum (dollars) 15,000 11,000 2,850

Coinsurance (percent) 40 50 0 

Single female, nonsmoker, age 30 176 plans available

Premium amount (dollars) 783 1,430 4,046

Annual deductible (dollars) 10,000 7,500 2,850

Out-of-pocket maximum (dollars) 17,500 7,500 2,850

Coinsurance (percent) 50 0 0

Single female, smoker, age 30 176 plans available

Premium amount (dollars) 840 1,932 5,522

Annual deductible (dollars) 10,000 3,500 2,850

Out-of-pocket maximum (dollars) 15,000 11,000 2,850

Coinsurance (percent) 40 50 0 

Family of four, parents age 40 166 plans available

Premium amount (dollars) 2,968 5,183 13,677

Family annual deductible (dollars) 20,000 7,000 5,700

Family out-of-pocket maximum (dollars) 35,000 22,000 5,700

Coinsurance (percent) 50 50 0

Couple, age 55 176 plans available

Premium amount (dollars) 3,465 6,256 16,035

Family annual deductible (dollars) 20,000 15,000 5,700

Family out-of-pocket maximum (dollars) 35,000 15,000 5,700

Coinsurance (percent) 50 0 0 

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 31 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 28: In Nebraska, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,071 plans available

Premium amount (dollars) 349 1,688 3,888

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

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

Coinsurance (percent) 20 20 20

Single male, smoker, age 30 1,071 plans available

Premium amount (dollars) 437 2,005 4,470

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 30 1,071 plans available

Premium amount (dollars) 409 2,135 4,700

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 30 1,071 plans available

Premium amount (dollars) 511 2,571 6,317

Annual deductible (dollars) 5,000 2,600 1,000

Out-of-pocket maximum (dollars) 10,000 2,600 3,000

Coinsurance (percent) 20 0 20

Family of four, parents age 40 809 plans available

Premium amount (dollars) 4,019 8,529 18,393

Family annual deductible (dollars) 20,000 N/A 3,000

Family out-of-pocket maximum (dollars) 30,000 N/A 9,000

Coinsurance (percent) 30 20 20

Couple, age 55 1,048 plans available

Premium amount (dollars) 4,555 10,089 22,630

Family annual deductible (dollars) 20,000 30,000 3,000

Family out-of-pocket maximum (dollars) 26,000 9,000 9,000

Coinsurance (percent) 40 20 20

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 32 GAO-13-712R Range of Health Insurance Premiums in 2013

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

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 209 plans available

Premium amount (dollars) 427 1,356 7,219

Annual deductible (dollars) 2,000 7,500 1,500

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

Coinsurance (percent) 50 20 30

Single male, smoker, age 30 192 plans available

Premium amount (dollars) 513 1,562 9,750

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

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

Coinsurance (percent) 50 20 30

Single female, nonsmoker, age 30 209 plans available

Premium amount (dollars) 627 1,920 12,456

Annual deductible (dollars) 2,000 7,500 1,500

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

Coinsurance (percent) 50 20 30

Single female, smoker, age 30 192 plans available

Premium amount (dollars) 752 2,239 16,818

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

Out-of-pocket maximum (dollars) 4,000 0 4,500

Coinsurance (percent) 50 0 30

Family of four, parents age 40 17 plans available

Premium amount (dollars) 3,276 9,552 17,112

Family annual deductible (dollars) 9,000 0 1,500

Family out-of-pocket maximum (dollars) 21,000 4,000 6,000

Coinsurance (percent) 30 N/A 20

Couple, age 55 200 plans available

Premium amount (dollars) 3,198 8,104 36,891

Family annual deductible (dollars) 20,000 12,000 3,000

Family out-of-pocket maximum (dollars) 3,000 16,000 9,000

Coinsurance (percent) 20 20 30

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 33 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 30: In New Hampshire, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 135 plans available

Premium amount (dollars) 897 2,117 15,092

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

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

Coinsurance (percent) 50 50 20

Single male, smoker, age 30 136 plans available

Premium amount (dollars) 1,320 3,114 22,638

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

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

Coinsurance (percent) 50 50 20

Single female, nonsmoker, age 30 135 plans available

Premium amount (dollars) 897 2,117 15,092

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

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

Coinsurance (percent) 50 50 20

Single female, smoker, age 30 136 plans available

Premium amount (dollars) 1,320 3,114 22,638

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

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

Coinsurance (percent) 50 50 20

Family of four, parents age 40 136 plans available

Premium amount (dollars) 3,882 8,444 26,567

Family annual deductible (dollars) 20,000 10,000 1,000

Family out-of-pocket maximum (dollars) 35,000 10,000 8,000

Coinsurance (percent) 50 0 20

Couple, age 55 136 plans available

Premium amount (dollars) 4,776 10,105 29,202

Family annual deductible (dollars) 20,000 4,000 1,000

Family out-of-pocket maximum (dollars) 35,000 14,000 8,000

Coinsurance (percent) 50 50 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 34 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 31: In New Jersey, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 65 plans available

Premium amount (dollars) 2,232 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 30 65 plans available

Premium amount (dollars) 2,232 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 30 65 plans available

Premium amount (dollars) 2,688 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 30 65 plans available

Premium amount (dollars) 2,688 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

Family of four, parents age 40 59 plans available

Premium amount (dollars) 13,608 53,784 117,300

Family annual deductible (dollars) 0 5,000 2,000

Family out-of-pocket maximum (dollars) 0 5,000 2,000

Coinsurance (percent) 0 30 20

Couple, age 55 65 plans available

Premium amount (dollars) 8,628 35,112 86,568

Family annual deductible (dollars) N/A 5,000 2,000

Family out-of-pocket maximum (dollars) N/A 5,000 2,000

Coinsurance (percent) 0 40 20

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 35 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 32: In New Mexico, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 828 plans available

Premium amount (dollars) 473 1,372 2,864

Annual deductible (dollars) 7,500 3,500 1,500

Out-of-pocket maximum (dollars) 7,500 3,500 1,500

Coinsurance (percent) 0 0 0 

Single male, smoker, age 30 828 plans available

Premium amount (dollars) 524 1,557 3,293

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, nonsmoker, age 30 828 plans available

Premium amount (dollars) 495 1,625 3,259

Annual deductible (dollars) 7,500 2,500 1,000

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

Coinsurance (percent) 0 20 20

Single female, smoker, age 30 828 plans available

Premium amount (dollars) 549 1,869 3,747

Annual deductible (dollars) 7,500 2,500 1,000

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

Coinsurance (percent) 0 20 20

Family of four, parents age 40 740 plans available

Premium amount (dollars) 2,787 5,690 11,229

Family annual deductible (dollars) 22,500 15,000 1,000

Family out-of-pocket maximum (dollars) 31,500 15,000 6,000

Coinsurance (percent) 30 0 15

Couple, age 55 778 plans available

Premium amount (dollars) 2,141 6,804 14,310

Family annual deductible (dollars) 15,000 30,000 N/A

Family out-of-pocket maximum (dollars) 15,000 30,000 N/A

Coinsurance (percent) 0 0 0 

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 36 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 33: In New York, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 120 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 30 120 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 30 120 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 30 120 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 

Family of four, parents age 40 119 plans available

Premium amount (dollars) 4,527 14,375 75,396

Family annual deductible (dollars) N/A No Maximum N/A

Family out-of-pocket maximum (dollars) No Maximum No Maximum N/A

Coinsurance (percent) 0 0 0

Couple, age 55 112 plans available

Premium amount (dollars) 4,454 9,936 50,524

Family annual deductible (dollars) 2,400 2,500 0 

Family out-of-pocket maximum (dollars) 12,100 12,100 N/A

Coinsurance (percent) N/A N/A 0 

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 37 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 34: In North Carolina, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 2,062 plans available

Premium amount (dollars) 505 1,513 6,728

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

Out-of-pocket maximum (dollars) 17,500 4,500 5,000

Coinsurance (percent) 50 20 20

Single male, smoker, age 30 2,062 plans available

Premium amount (dollars) 690 1,884 9,195

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

Out-of-pocket maximum (dollars) 17,500 5,000 5,000

Coinsurance (percent) 50 0 20

Single female, nonsmoker, age 30 2,062 plans available

Premium amount (dollars) 649 1,932 8,948

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

Out-of-pocket maximum (dollars) 17,500 5,500 5,000

Coinsurance (percent) 0 0 20

Single female, smoker, age 30 2,062 plans available

Premium amount (dollars) 886 2,424 13,285

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

Out-of-pocket maximum (dollars) 17,500 7,000 5,000

Coinsurance (percent) 50 50 20

Family of four, parents age 40 1,560 plans available

Premium amount (dollars) 2,442 6,828 19,052

Family annual deductible (dollars) 20,000 4,000 3,000

Family out-of-pocket maximum (dollars) 35,000 11,000 9,000

Coinsurance (percent) 50 50 20

Couple, age 55 2,062 plans available

Premium amount (dollars) 3,039 8,421 41,128

Family annual deductible (dollars) 20,000 10,000 9,000

Family out-of-pocket maximum (dollars) 35,000 10,000 No Maximum

Coinsurance (percent) 50 0 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 38 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 35: In North Dakota, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 250 plans available

Premium amount (dollars) 674 1,341 4,215

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 male, smoker, age 30 250 plans available

Premium amount (dollars) 674 1,690 4,215

Annual deductible (dollars) 7,500 5,000 250

Out-of-pocket maximum (dollars) 10,000 7,000 2,000

Coinsurance (percent) 30 50 20

Single female, nonsmoker, age 30 250 plans available

Premium amount (dollars) 674 1,341 4,215

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, smoker, age 30 250 plans available

Premium amount (dollars) 674 1,690 4,215

Annual deductible (dollars) 7,500 5,000 250

Out-of-pocket maximum (dollars) 10,000 7,000 2,000

Coinsurance (percent) 30 50 20

Family of four, parents age 40 192 plans available

Premium amount (dollars) 2,775 5,276 13,009

Family annual deductible (dollars) 20,000 15,000 500

Family out-of-pocket maximum (dollars) 35,000 15,000 4,000

Coinsurance (percent) 50 0 20

Couple, age 55 215 plans available

Premium amount (dollars) 3,486 6,641 15,489

Family annual deductible (dollars) 20,000 5,700 500

Family out-of-pocket maximum (dollars) 35,000 10,700 4,000

Coinsurance (percent) 50 50 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 39 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 36: In Ohio, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 2,440 plans available

Premium amount (dollars) 492 1,485 7,404

Annual deductible (dollars) 7,500 2,600 750

Out-of-pocket maximum (dollars) 7,500 2,600 3,750

Coinsurance (percent) 0 0 20

Single male, smoker, age 30 2,440 plans available

Premium amount (dollars) 492 1,803 7,404

Annual deductible (dollars) 7,500 2,600 750

Out-of-pocket maximum (dollars) 7,500 5,000 3,750

Coinsurance (percent) 0 20 20

Single female, nonsmoker, age 30 2,440 plans available

Premium amount (dollars) 720 1,989 9,919

Annual deductible (dollars) 7,500 1,500 750

Out-of-pocket maximum (dollars) 7,500 4,000 3,750

Coinsurance (percent) 0 50 20

Single female, smoker, age 30 2,440 plans available

Premium amount (dollars) 720 2,457 9,919

Annual deductible (dollars) 7,500 1,500 750

Out-of-pocket maximum (dollars) 7,500 5,000 3,750

Coinsurance (percent) 0 30 20

Family of four, parents age 40 1,153 plans available

Premium amount (dollars) 3,286 7,152 27,815

Family annual deductible (dollars) 22,500 4,500 N/A

Family out-of-pocket maximum (dollars) 31,500 13,500 6,000

Coinsurance (percent) 30 20 N/A

Couple, age 55 2,368 plans available

Premium amount (dollars) 3,036 8,434 39,294

Family annual deductible (dollars) 11,000 4,500 No Maximum

Family out-of-pocket maximum (dollars) 11,000 13,500 No Maximum

Coinsurance (percent) 0 30 20

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

Source: GAO analysis of the 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 

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.

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.
Enclosure I

Page 40 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 37: In Oklahoma, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,101 plans available

Premium amount (dollars) 624 1,707 4,733

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

Out-of-pocket maximum (dollars) No Maximum 3,000 3,000

Coinsurance (percent) 30 0 20

Single male, smoker, age 30 1,087 plans available

Premium amount (dollars) 744 2,029 5,967

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

Out-of-pocket maximum (dollars) No Maximum 4,000 3,000

Coinsurance (percent) 30 0 20

Single female, nonsmoker, age 30 1,101 plans available

Premium amount (dollars) 876 2,197 10,032

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 30 1,087 plans available

Premium amount (dollars) 1,044 2,682 11,904

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

Out-of-pocket maximum (dollars) No Maximum 7,000 1,000

Coinsurance (percent) 30 20 20

Family of four, parents age 40 806 plans available

Premium amount (dollars) 2,940 8,211 21,720

Family annual deductible (dollars) 30,000 4,500 600

Family out-of-pocket maximum (dollars) No Maximum 13,500 No Maximum

Coinsurance (percent) 30 20 20

Couple, age 55 1,101 plans available

Premium amount (dollars) 585 9,985 24,225

Family annual deductible (dollars) 15,000 15,000 3,000

Family out-of-pocket maximum (dollars) 45,000 21,000 3,000

Coinsurance (percent) 20 20 0 

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 41 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 38: In Oregon, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 725 plans available

Premium amount (dollars) 624 1,668 4,644

Annual deductible (dollars) 10,000 5,000 1,000

Out-of-pocket maximum (dollars) 15,000 10,000 4,000

Coinsurance (percent) 40 35 20

Single male, smoker, age 30 131 plans available

Premium amount (dollars) 624 1,992 4,644

Annual deductible (dollars) 10,000 N/A 1,000

Out-of-pocket maximum (dollars) 15,000 N/A 4,000

Coinsurance (percent) 40 0 20

Single female, nonsmoker, age 30 725 plans available

Premium amount (dollars) 624 1,668 4,644

Annual deductible (dollars) 10,000 5,000 1,000

Out-of-pocket maximum (dollars) 15,000 10,000 4,000

Coinsurance (percent) 40 35 20

Single female, smoker, age 30 131 plans available

Premium amount (dollars) 624 1,992 4,644

Annual deductible (dollars) 10,000 N/A 1,000

Out-of-pocket maximum (dollars) 15,000 N/A 4,000

Coinsurance (percent) 40 0 20

Family of four, parents age 40 657 plans available

Premium amount (dollars) 2,448 5,687 15,000

Family annual deductible (dollars) 30,000 10,000 3,000

Family out-of-pocket maximum (dollars) N/A 12,500 N/A

Coinsurance (percent) 40 50 20

Couple, age 55 721 plans available

Premium amount (dollars) 3,372 7,489 20,604

Family annual deductible (dollars) 30,000 10,000 3,000

Family out-of-pocket maximum (dollars) N/A 12,500 N/A

Coinsurance (percent) 40 50 20

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 42 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 39: In Pennsylvania, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 2,128 plans available

Premium amount (dollars) 619 1,691 9,105

Annual deductible (dollars) 5,000 10,000 1,500

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

Coinsurance (percent) 15 0 20

Single male, smoker, age 30 2,114 plans available

Premium amount (dollars) 636 1,918 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 female, nonsmoker, age 30 2,128 plans available

Premium amount (dollars) 930 2,412 11,288

Annual deductible (dollars) 5,000 N/A 500

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

Coinsurance (percent) 0 0 15

Single female, smoker, age 30 2,114 plans available

Premium amount (dollars) 1,042 2,700 11,288

Annual deductible (dollars) 5,000 250 500

Out-of-pocket maximum (dollars) 1,050 1,500 1,500

Coinsurance (percent) 0 20 15

Family of four, parents age 40 1,965 plans available

Premium amount (dollars) 3,349 7,621 32,271

Family annual deductible (dollars) 10,000 15,000 1,500

Family out-of-pocket maximum (dollars) 20,000 18,000 4,500

Coinsurance (percent) 20 20 15

Couple, age 55 2,090 plans available

Premium amount (dollars) 3,522 10,273 44,625

Family annual deductible (dollars) 0 15,000 1,500

Family out-of-pocket maximum (dollars) 0 15,000 4,500

Coinsurance (percent) 0 0 15

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 43 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 40: In Rhode Island, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 6 plans available

Premium amount (dollars) 1,450 2,334 2,960

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 30 6 plans available

Premium amount (dollars) 3,203 5,156 6,539

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 30 6 plans available

Premium amount (dollars) 2,167 3,489 4,425

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 30 6 plans available

Premium amount (dollars) 3,203 5,156 6,539

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

Family of four, parents age 40 5 plans available

Premium amount (dollars) 5,611 7,958 10,092

Family annual deductible (dollars) 10,000 5,000 2,000

Family out-of-pocket maximum (dollars) 12,100 15,000 6,000

Coinsurance (percent) 0 20 20

Couple, age 55 5 plans available

Premium amount (dollars) 7,373 10,457 13,261

Family annual deductible (dollars) 10,000 5,000 2,000

Family out-of-pocket maximum (dollars) 12,100 15,000 6,000

Coinsurance (percent) 0 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 44 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 41: In South Carolina, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,103 plans available

Premium amount (dollars) 700 1,893 4,945

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

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

Coinsurance (percent) 30 30 20

Single male, smoker, age 30 1,103 plans available

Premium amount (dollars) 756 2,139 6,231

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

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

Coinsurance (percent) 30 30 20

Single female, nonsmoker, age 30 1,103 plans available

Premium amount (dollars) 1,072 2,720 6,743

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

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

Coinsurance (percent) 30 20 20

Single female, smoker, age 30 1,103 plans available

Premium amount (dollars) 1,158 3,122 9,117

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

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

Coinsurance (percent) 30 20 20

Family of four, parents age 40 390 plans available

Premium amount (dollars) 6,106 11,576 22,509

Family annual deductible (dollars) 22,500 15,000 3,000

Family out-of-pocket maximum (dollars) 31,500 15,000 9,000

Coinsurance (percent) 30 0 20

Couple, age 55 1,061 plans available

Premium amount (dollars) 3,804 11,448 27,694

Family annual deductible (dollars) 20,000 5,000 3,000

Family out-of-pocket maximum (dollars) 25,000 5,000 9,000

Coinsurance (percent) 20 0 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 45 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 42: In South Dakota, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 626 plans available

Premium amount (dollars) 514 2,165 4,921

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

Out-of-pocket maximum (dollars) 10,000 5,000 1,500

Coinsurance (percent) 40 0 10

Single male, smoker, age 30 626 plans available

Premium amount (dollars) 617 2,609 5,413

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

Out-of-pocket maximum (dollars) 10,000 8,500 1,500

Coinsurance (percent) 40 20 10

Single female, nonsmoker, age 30 626 plans available

Premium amount (dollars) 787 2,733 8,132

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

Out-of-pocket maximum (dollars) 10,000 4,500 1,500

Coinsurance (percent) 40 30 10

Single female, smoker, age 30 626 plans available

Premium amount (dollars) 945 3,280 8,946

Annual deductible (dollars) 5,000 7,500 500

Out-of-pocket maximum (dollars) 10,000 11,000 1,500

Coinsurance (percent) 40 20 10

Family of four, parents age 40 577 plans available

Premium amount (dollars) 4,306 10,243 21,564

Family annual deductible (dollars) 15,000 15,000 3,000

Family out-of-pocket maximum (dollars) 21,000 15,000 9,000

Coinsurance (percent) 50 0 20

Couple, age 55 622 plans available

Premium amount (dollars) 2,333 12,376 26,532

Family annual deductible (dollars) 10,000 4,500 3,000

Family out-of-pocket maximum (dollars) 20,000 10,500 9,000

Coinsurance (percent) 40 20 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 46 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 43: In Tennessee, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,161 plans available

Premium amount (dollars) 522 1,689 4,880

Annual deductible (dollars) 7,500 1,500 3,000

Out-of-pocket maximum (dollars) 10,500 4,500 5,000

Coinsurance (percent) 20 30 20

Single male, smoker, age 30 1,161 plans available

Premium amount (dollars) 631 2,004 6,676

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

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

Coinsurance (percent) 0 0 20

Single female, nonsmoker, age 30 1,161 plans available

Premium amount (dollars) 763 2,183 6,548

Annual deductible (dollars) 7,500 5,000 3,000

Out-of-pocket maximum (dollars) 10,500 7,000 5,000

Coinsurance (percent) 20 20 20

Single female, smoker, age 30 1,161 plans available

Premium amount (dollars) 930 2,616 9,656

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

Out-of-pocket maximum (dollars) 10,000 6,500 5,000

Coinsurance (percent) 0 0 20

Family of four, parents age 40 746 plans available

Premium amount (dollars) 3,155 9,338 21,340

Family annual deductible (dollars) 22,500 4,500 3,000

Family out-of-pocket maximum (dollars) 28,500 13,500 9,000

Coinsurance (percent) 20 30 20

Couple, age 55 1,161 plans available

Premium amount (dollars) 578 9,416 29,646

Family annual deductible (dollars) 15,000 30,000 9,000

Family out-of-pocket maximum (dollars) 33,000 30,000 No Maximum

Coinsurance (percent) 30 0 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 47 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 44: In Texas, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 5,422 plans available

Premium amount (dollars) 363 1,358 4,875

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

Out-of-pocket maximum (dollars) 17,500 14,500 3,000

Coinsurance (percent) 50 30 20

Single male, smoker, age 30 5,422 plans available

Premium amount (dollars) 495 1,713 5,880

Annual deductible (dollars) 10,000 4,000 250

Out-of-pocket maximum (dollars) 17,500 6,000 3,000

Coinsurance (percent) 50 20 15

Single female, nonsmoker, age 30 5,422 plans available

Premium amount (dollars) 470 1,830 7,234

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

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

Coinsurance (percent) 50 0 20

Single female, smoker, age 30 5,422 plans available

Premium amount (dollars) 642 2,291 8,387

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

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

Coinsurance (percent) 50 30 20

Family of four, parents age 40 3,720 plans available

Premium amount (dollars) 1,845 6,054 22,800

Family annual deductible (dollars) 20,000 15,000 750

Family out-of-pocket maximum (dollars) 35,000 18,000 6,000

Coinsurance (percent) 50 30 15

Couple, age 55 5,422 plans available

Premium amount (dollars) 2,227 7,338 26,616

Family annual deductible (dollars) 20,000 7,000 750

Family out-of-pocket maximum (dollars) 35,000 22,000 6,000

Coinsurance (percent) 50 30 15

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 48 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 45: In Utah, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 524 plans available

Premium amount (dollars) 581 1,558 3,890

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 30 524 plans available

Premium amount (dollars) 581 1,662 3,890

Annual deductible (dollars) 10,000 3,000 1,200

Out-of-pocket maximum (dollars) 5,000 3,000 3,600

Coinsurance (percent) 35 0 20 

Single female, nonsmoker, age 30 524 plans available

Premium amount (dollars) 696 1,693 4,398

Annual deductible (dollars) 10,000 3,500 1,200

Out-of-pocket maximum (dollars) 5,000 11,000 3,600

Coinsurance (percent) 35 30 20

Single female, smoker, age 30 524 plans available

Premium amount (dollars) 696 1,798 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

Family of four, parents age 40 434 plans available

Premium amount (dollars) 3,193 5,712 11,512

Family annual deductible (dollars) 22,500 5,000 1,500

Family out-of-pocket maximum (dollars) 32,500 5,000 6,500

Coinsurance (percent) 30 0 20

Couple, age 55 524 plans available

Premium amount (dollars) 2,348 6,853 20,524

Family annual deductible (dollars) 30,000 20,000 2,400

Family out-of-pocket maximum (dollars) 15,000 20,000 7,200

Coinsurance (percent) 35 0 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 49 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 46: In Vermont, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 5 plans available

Premium amount (dollars) 665 2,493 3,505

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 30 5 plans available

Premium amount (dollars) 665 2,493 3,505

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 30 5 plans available

Premium amount (dollars) 665 2,493 3,505

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 30 5 plans available

Premium amount (dollars) 665 2,493 3,505

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

Family of four, parents age 40 0 plans available

Premium amount (dollars) N/A N/A N/A

Family annual deductible (dollars) N/A N/A N/A

Family out-of-pocket maximum (dollars) N/A N/A N/A

Coinsurance (percent) N/A N/A N/A

Couple, age 55 5 plans available

Premium amount (dollars) 1,807 6,778 9,531

Family annual deductible (dollars) 200,000 20,000 7,000

Family out-of-pocket maximum (dollars) No Maximum No Maximum No Maximum

Coinsurance (percent) 30 30 30

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 50 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 47: In Virginia, the Range of Annual Base Premiums Prior to Underwriting in the Individual (Nongroup)

Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 711 plans available

Premium amount (dollars) 456 1,350 13,488

Annual deductible (dollars) 7,500 2,500 100

Out-of-pocket maximum (dollars) 11,000 5,000 2,500

Coinsurance (percent) 50 20 10

Single male, smoker, age 30 711 plans available

Premium amount (dollars) 564 1,680 13,488

Annual deductible (dollars) 7,500 N/A 100

Out-of-pocket maximum (dollars) 11,000 N/A 2,500

Coinsurance (percent) 50 20 10

Single female, nonsmoker, age 30 711 plans available

Premium amount (dollars) 588 1,850 13,488

Annual deductible (dollars) 7,500 2,500 100

Out-of-pocket maximum (dollars) 11,000 5,000 2,500

Coinsurance (percent) 50 20 10

Single female, smoker, age 30 711 plans available

Premium amount (dollars) 744 2,335 13,488

Annual deductible (dollars) 7,500 6,000 100

Out-of-pocket maximum (dollars) 11,000 8,000 2,500

Coinsurance (percent) 50 20 10

Family of four, parents age 40 49 plans available

Premium amount (dollars) 2,688 11,244 44,064

Family annual deductible (dollars) 20,000 1,000 200

Family out-of-pocket maximum (dollars) 20,000 5,000 5,000

Coinsurance (percent) 0 20 10

Couple, age 55 711 plans available

Premium amount (dollars) 2,028 7,616 64,620

Family annual deductible (dollars) 15,000 3,000 200

Family out-of-pocket maximum (dollars) 22,000 6,000 5,000

Coinsurance (percent) 50 30 10

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 51 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 48: In Washington, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median 

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 69 plans available

Premium amount (dollars) 1,248 2,016 4,836

Annual deductible (dollars) 10,000 1,000 1,800

Out-of-pocket maximum (dollars) 7,500 5,000 8,300

Coinsurance (percent) 30 20 35

Single male, smoker, age 30 69 plans available

Premium amount (dollars) 1,440 2,340 5,568

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 30 69 plans available

Premium amount (dollars) 1,248 2,016 4,836

Annual deductible (dollars) 10,000 1,000 1,800

Out-of-pocket maximum (dollars) 7,500 5,000 8,300

Coinsurance (percent) 30 20 35

Single female, smoker, age 30 69 plans available

Premium amount (dollars) 1,440 2,340 5,568

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

Family of four, parents age 40 20 plans available

Premium amount (dollars) 5,424 10,296 20,112

Family annual deductible (dollars) 10,000 N/A 1,800

Family out-of-pocket maximum (dollars) 10,000 N/A 8,300

Coinsurance (percent) 0 25 35

Couple, age 55 67 plans available

Premium amount (dollars) 5,880 9,528 22,992

Family annual deductible (dollars) 30,000 7,000 1,800

Family out-of-pocket maximum (dollars) 22,500 10,000 8,300

Coinsurance (percent) 30 20 35

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

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 52 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 49: In West Virginia, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 1,766 plans available

Premium amount (dollars) 511 1,476 5,958

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

Single male, smoker, age 30 1,766 plans available

Premium amount (dollars) 697 1,800 6,228

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

Out-of-pocket maximum (dollars) 17,500 3,000 5,000

Coinsurance (percent) 50 20 20

Single female, nonsmoker, age 30 1,766 plans available

Premium amount (dollars) 654 1,825 6,624

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

Out-of-pocket maximum (dollars) 17,500 3,000 5,000

Coinsurance (percent) 50 20 20

Single female, smoker, age 30 1,766 plans available

Premium amount (dollars) 893 2,228 6,993

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

Out-of-pocket maximum (dollars) 17,500 3,000 5,000

Coinsurance (percent) 50 20 20

Family of four, parents age 40 1,579 plans available

Premium amount (dollars) 2,391 6,409 16,987

Family annual deductible (dollars) 20,000 15,000 3,000

Family out-of-pocket maximum (dollars) 35,000 21,000 9,000

Coinsurance (percent) 50 20 20

Couple, age 55 1,766 plans available

Premium amount (dollars) 3,099 8,429 20,901

Family annual deductible (dollars) 20,000 4,000 3,000

Family out-of-pocket maximum (dollars) 35,000 11,000 9,000

Coinsurance (percent) 50 50 20

Source: GAO analysis of the 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

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.

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.
Enclosure I

Page 53 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 50: In Wisconsin, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 18,151 plans available

Premium amount (dollars) 468 1,295 3,924

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

Out-of-pocket maximum (dollars) 4,500 5,500 3,000

Coinsurance (percent) 20 0 20

Single male, smoker, age 30 18,151 plans available

Premium amount (dollars) 539 1,839 5,537

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

Out-of-pocket maximum (dollars) 4,500 5,000 3,000

Coinsurance (percent) 20 20 20

Single female, nonsmoker, age 30 18,151 plans available

Premium amount (dollars) 616 1,723 6,612

Annual deductible (dollars) 3,500 2,500 0 

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

Coinsurance (percent) 20 0 N/A

Single female, smoker, age 30 18,151 plans available

Premium amount (dollars) 709 2,418 8,655

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 

Family of four, parents age 40 1,512 plans available

Premium amount (dollars) 2,375 6,806 17,858

Family annual deductible (dollars) 30,000 4,000 3,000

Family out-of-pocket maximum (dollars) 50,000 8,000 9,000

Coinsurance (percent) 50 20 20

Couple, age 55 18,079 plans available

Premium amount (dollars) 160 7,028 21,972

Family annual deductible (dollars) 30,000 4,500 3,000

Family out-of-pocket maximum (dollars) 30,000 24,500 9,000

Coinsurance (percent) 0 50 20

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

Source: GAO analysis of the 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 

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.

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.
Enclosure I

Page 54 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 51: In Wyoming, the Range of Annual Base Premiums Prior to Underwriting in the Individual

(Nongroup) Market for Selected Consumers Displayed on the HealthCare.gov Plan Finder in January 2013

Consumer type

Plan with minimum

premium

Plan with median

premium

Plan with maximum

premium

Single male, nonsmoker, age 30 528 plans available

Premium amount (dollars) 1,064 2,046 3,930

Annual deductible (dollars) 20,000 2,600 1,000

Out-of-pocket maximum (dollars) 20,000 5,000 3,000

Coinsurance (percent) 0 20 20

Single male, smoker, age 30 528 plans available

Premium amount (dollars) 1,232 2,346 4,519

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

Out-of-pocket maximum (dollars) 10,500 2,000 3,000

Coinsurance (percent) 30 20 20

Single female, nonsmoker, age 30 528 plans available

Premium amount (dollars) 1,298 2,500 4,819

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

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

Coinsurance (percent) 30 0 20

Single female, smoker, age 30 528 plans available

Premium amount (dollars) 1,493 2,875 5,559

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

Out-of-pocket maximum (dollars) 10,500 10,000 1,500

Coinsurance (percent) 30 0 20

Family of four, parents age 40 464 plans available

Premium amount (dollars) 5,028 9,424 18,592

Family annual deductible (dollars) 22,500 5,000 3,000

Family out-of-pocket maximum (dollars) 31,500 9,000 9,000

Coinsurance (percent) 30 20 20

Couple, age 55 524 plans available

Premium amount (dollars) 5,559 12,255 22,874

Family annual deductible (dollars) 40,000 N/A 3,000

Family out-of-pocket maximum (dollars) 40,000 N/A 9,000

Coinsurance (percent) 0 0 20

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

Source: GAO analysis of the 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

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.

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.
Enclosure II

Page 55 GAO-13-712R 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 52: 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 Selected Consumers 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 30 194 plans available 434 plans available

Premium amount (dollars) 742 1,901 5,632 677 1,612 4,172

Annual deductible (dollars) 10,000 5,000 0 10,000 4,000 0 

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

Coinsurance (percent) 30 30 0 30 20 0 

Single male, smoker, age 30 194 plans available 434 plans available

Premium amount (dollars) 930 2,393 7,040 696 1,784 5,215

Annual deductible (dollars) 10,000 1,250 0 7,500 0 0 

Out-of-pocket maximum (dollars) 16,000 4,250 1,000 22,500 3,000 1,000

Coinsurance (percent) 30 20 0 0 0 0 

Single female, nonsmoker, age 30 194 plans available 434 plans available

Premium amount (dollars) 1,058 3,146 14,578 948 2,560 10,798

Annual deductible (dollars) 10,000 500 0 7,500 3,000 0 

Out-of-pocket maximum (dollars) 16,000 3,000 1,000 22,500 6,000 1,000

Coinsurance (percent) 30 20 0 0 30 0 

Single female, smoker, age 30 194 plans available 434 plans available

Premium amount (dollars) 1,292 3,932 18,223 948 2,736 13,498

Annual deductible (dollars) 10,000 500 0 7,500 1,750 0 

Out-of-pocket maximum (dollars) 16,000 3,000 1,000 22,500 4,750 1,000

Coinsurance (percent) 30 20 0 0 0 0 

Family of four, parents age 40 178 plans available 178 plans available

Premium amount (dollars) 3,489 8,905 31,536 3,187 6,929 23,358

Family annual deductible (dollars) 30,000 3,500 0 30,000 5,200 0 

Family out-of-pocket maximum (dollars) 48,000 6,000 3,000 48,000 10,000 3,000

Coinsurance (percent) 30 20 0 30 0 0 

Couple, age 55 194 plans available 194 plans available

Premium amount (dollars) 3,921 11,129 37,790 3,582 8,418 27,991

Family annual deductible (dollars) 30,000 9,000 0 30,000 3,500 0 

Family out-of-pocket maximum (dollars) 48,000 18,000 3,000 48,000 9,500 3,000

Coinsurance (percent) 30 30 0 30 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.
Enclosure II

Page 56 GAO-13-712R Range of Health Insurance Premiums in 2013

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 57 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 53: 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 Selected Consumers 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 30 122 plans available 90 plans available

Premium amount (dollars) 427 1,252 5,486 520 1,303 5,986

Annual deductible (dollars) 2,000 3,000 1,500 10,000 3,500 1,500

Out-of-pocket maximum (dollars) 4,000 6,000 4,500 3,000 0 4,500

Coinsurance (percent) 50 20 30 20 0 30

Single male, smoker, age 30 113 plans available 82 plans available

Premium amount (dollars) 513 1,449 7,410 626 1,559 8,085

Annual deductible (dollars) 2,000 7,500 1,500 10,000 2,500 1,500

Out-of-pocket maximum (dollars) 4,000 0 4,500 3,000 600 4,500

Coinsurance (percent) 50 0 30 20 30 30

Single female, nonsmoker, age 30 122 plans available 90 plans available

Premium amount (dollars) 627 1,723 9,497 688 1,709 10,333

Annual deductible (dollars) 2,000 3,500 1,500 10,000 3,000 1,500

Out-of-pocket maximum (dollars) 4,000 3,500 4,500 3,000 0 4,500

Coinsurance (percent) 50 0 30 20 0 30

Single female, smoker, age 30 113 plans available 82 plans available

Premium amount (dollars) 752 2,009 12,823 828 2,040 13,952

Annual deductible (dollars) 2,000 N/A 1,500 10,000 10,000 1,500

Out-of-pocket maximum (dollars) 4,000 0 4,500 3,000 12,500 4,500

Coinsurance (percent) 50 0 30 20 20 30

Family of four, parents age 40 9 plans available 8 plans available

Premium amount (dollars) 3,276 8,688 15,552 3,936 11,064 17,112

Family annual deductible (dollars) 9,000 0 1,500 9,000 0 1,500

Family out-of-pocket maximum (dollars) 21,000 4,000 6,000 21,000 10,000 6,000

Coinsurance (percent) 30 N/A 20 30 N/A 20

Couple, age 55 113 plans available 81 plans available

Premium amount (dollars) 3,198 7,531 28,139 3,198 7,360 30,165

Family annual deductible (dollars) 20,000 5,000 3,000 20,000 7,000 3,000

Family out-of-pocket maximum (dollars) 3,000 3,000 9,000 3,000 3,000 9,000

Coinsurance (percent) 20 20 30 20 20 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: 

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.

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.

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 58 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 54: 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 Selected Consumers Displayed on the 

HealthCare.gov Plan Finder in January 2013

Urban Zip 15028 

Coulters, PA 

Rural Zip 17212 

Big Cove Tannery, 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 30 86 plans available 96 plans available

Premium amount (dollars) 619 1,511 9,105 636 1,555 9,081

Annual deductible (dollars) 5,000 10,000 1,500 5,000 5,000 1,000

Out-of-pocket maximum (dollars) 10,000 10,000 5,500 10,000 6,000 3,000

Coinsurance (percent) 15 0 20 20 20 20

Single male, smoker, age 30 86 plans available 96 plans available

Premium amount (dollars) 712 1,651 9,105 636 1,752 9,081

Annual deductible (dollars) 5,000 250 1,500 5,000 N/A 1,000

Out-of-pocket maximum (dollars) 10,000 2,000 5,500 10,000 N/A 3,000

Coinsurance (percent) 15 10 20 20 0 20

Single female, nonsmoker, age 30 86 plans available 96 plans available

Premium amount (dollars) 1,042 2,140 9,105 1,083 2,405 11,288

Annual deductible (dollars) 5,000 0 1,500 5,000 5,000 500

Out-of-pocket maximum (dollars) 10,000 N/A 5,500 10,000 5,000 1,500

Coinsurance (percent) 15 0 20 20 0 15

Single female, smoker, age 30 86 plans available 96 plans available

Premium amount (dollars) 1,199 2,342 9,105 1,083 2,580 11,288

Annual deductible (dollars) 5,000 1,500 1,500 5,000 10,000 500

Out-of-pocket maximum (dollars) 10,000 4,500 5,500 10,000 10,000 1,500

Coinsurance (percent) 15 20 20 20 0 15

Family of four, parents age 40 53 plans available 71 plans available

Premium amount (dollars) 3,929 7,406 27,129 3,349 7,126 32,271

Family annual deductible (dollars) 7,000 30,000 3,000 10,000 3,000 1,500

Family out-of-pocket maximum (dollars) 10,000 30,000 11,000 20,000 4,500 4,500

Coinsurance (percent) 20 0 20 20 15 15

Couple, age 55 78 plans available 96 plans available

Premium amount (dollars) 3,638 9,186 23,266 3,645 8,635 44,625

Family annual deductible (dollars) 10,000 N/A 3,000 0 2,400 1,500

Family out-of-pocket maximum (dollars) 20,000 N/A 6,000 0 4,400 4,500

Coinsurance (percent) 15 20 20 0 10 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:

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.

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.

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 59 GAO-13-712R Range of Health Insurance Premiums in 2013

Table 55: 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 Selected Consumers 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 30 228 plans available 229 plans available

Premium amount (dollars) 566 1,454 4,236 653 1,452 3,744

Annual deductible (dollars) 10,000 6,000 250 10,000 1,750 250

Out-of-pocket maximum (dollars) 17,500 6,000 3,000 17,500 3,000 3,000

Coinsurance (percent) 50 0 15 50 10 15

Single male, smoker, age 30 228 plans available 229 plans available

Premium amount (dollars) 773 1,820 5,304 773 1,824 4,668

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

Out-of-pocket maximum (dollars) 17,500 13,000 3,000 5,000 3,000 3,000

Coinsurance (percent) 50 20 15 0 25 15

Single female, nonsmoker, age 30 228 plans available 229 plans available

Premium amount (dollars) 733 1,971 5,957 845 1,953 5,136

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

Out-of-pocket maximum (dollars) 17,500 13,000 3,000 17,500 6,000 3,000

Coinsurance (percent) 50 20 20 50 30 20

Single female, smoker, age 30 228 plans available 229 plans available

Premium amount (dollars) 1,001 2,435 7,212 1,139 2,439 6,348

Annual deductible (dollars) 10,000 10,000 250 10,000 2,850 250

Out-of-pocket maximum (dollars) 17,500 13,000 3,000 5,000 5,350 3,000

Coinsurance (percent) 50 20 15 0 50 15

Family of four, parents age 40 159 plans available 159 plans available

Premium amount (dollars) 2,878 6,408 20,556 3,317 6,590 18,120

Family annual deductible (dollars) 20,000 15,000 750 20,000 10,500 750

Family out-of-pocket maximum (dollars) 35,000 33,000 6,000 35,000 28,500 6,000

Coinsurance (percent) 50 30 15 50 30 15

Couple, age 55 228 plans available 229 plans available

Premium amount (dollars) 3,473 7,723 24,000 4,002 7,760 21,156

Family annual deductible (dollars) 20,000 7,000 750 22,500 15,000 750

Family out-of-pocket maximum (dollars) 35,000 14,000 6,000 25,000 20,000 6,000

Coinsurance (percent) 50 20 15 30 20 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.
Enclosure II

Page 60 GAO-13-712R Range of Health Insurance Premiums in 2013

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.

(291124)
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