base premiums on five factors age, geographic location and if you smoked How insurance companies set health premiums Insurance firms may charge up to 50% higher premiums age rating only a few factors Under the ACA, this is locked down at 3x max five factors. Insurance firms may charge up to 50% higher premiums How Insurance Companies Set Health Premiums age, geographic location and if you smoked five factors https://www.healthcare.gov/how-plans-set-your-premiums/ HealthCare.gov