Methodology & Data Sources

Data Source

All data comes directly from the Centers for Medicare & Medicaid Services (CMS) Health Insurance Marketplace Public Use Files (PUF). CMS releases this data annually before each Open Marketplace period. It includes every qualified health plan (QHP) offered on the federal HealthCare.gov marketplace, plan details, premiums, deductibles, and issuer information for each participating county.

Coverage

PlainHealthPlan covers 2,055 counties across 30 states that use the federal HealthCare.gov marketplace, with data from 183 insurance issuers and plan years 2022 through 2026. This multi-year dataset enables premium trend analysis showing how costs have changed over five marketplace cycles. States that operate their own insurance marketplaces, including California (Covered California), New York, Massachusetts, Colorado, Connecticut, and others, are not included in the CMS federal marketplace PUF data, as those states publish their own plan data through separate systems.

Processing Pipeline

1. Download CMS QHP Landscape and Rate/Benefits PUF files for each plan year (2022–2026)
2. Parse plan-level records: premium rates by age, metal level (Bronze/Silver/Gold/Platinum), deductible, out-of-pocket maximum, and copay structure
3. Extract the age-27 benchmark premium, the CMS standard reference age, for each plan in each county
4. Compute county-level aggregates: average premium by metal level, number of plans, number of issuers, benchmark Silver plan premium
5. Compute multi-year premium trends by comparing the age-27 benchmark across 2022–2026
6. Build issuer profiles with coverage area, plan count, metal levels offered, and average premiums

Premium Reference Age

Premiums shown are base rates for a 27-year-old non-tobacco user - the CMS industry benchmark age. ACA premiums are age-rated: a 60-year-old pays up to 3x the age-27 rate. Actual premiums depend on your age, tobacco status, and any Advanced Premium Tax Credit (APTC) subsidy you qualify for.

Data Vintage and Update Frequency

CMS publishes Marketplace PUF data annually before each Open Marketplace period, typically in October. Each release contains the complete plan offerings for the upcoming plan year. PlainHealthPlan maintains data for plan years 2022 through 2026, enabling multi-year premium trend analysis. The database is updated when CMS publishes new PUF files for each plan year cycle.

Accuracy Commitment

PlainHealthPlan reproduces CMS PUF data exactly as published. Premium rates, deductibles, out-of-pocket maximums, and plan details are presented without modification. County-level aggregates (average premiums, plan counts, issuer counts) are calculated directly from the underlying plan-level records. When CMS issues corrections or updated PUF files, PlainHealthPlan incorporates the revised data in its next database refresh.

Limitations

• States that operate their own insurance marketplaces (California, New York, Massachusetts, Colorado, Connecticut, and others) are not included in the CMS federal marketplace PUF data. Residents of those states should consult their state marketplace for plan and premium information.
• Premiums shown are base rates for a 27-year-old non-tobacco user. Actual costs depend on the enrollee's age (premiums increase up to 3x for older adults under ACA age-rating rules), tobacco use status, and eligibility for Advanced Premium Tax Credits (APTC) which can substantially reduce monthly costs.
• Plan availability and premiums change each year during Open Marketplace period. Historical data reflects the conditions at the time of filing and may not represent current plan offerings.
• This data is for informational purposes only. Consult HealthCare.gov or a licensed insurance agent for current plan options and subsidy eligibility. PlainHealthPlan is not affiliated with CMS or any government agency.

Contact

Questions about our methodology? Contact us.