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Exchange plans beat out premiums of off-exchange plans by 40%


The least expensive plans offered by UnitedHealthcare, Aetna, Cigna and Assurant were over 40% more expensive on average than the least expensive plans on the exchanges

Off-exchange plans are almost half as expensive as exchange plans, according to a new study by HealthPocket. 

Across bronze, silver and gold metal plans, the least expensive premiums offered by UnitedHealthcare, Aetna, Cigna and Assurant were more than 40% more expensive on average than the least expensive premiums on the exchanges. 

The study found that in 39 states: 

  • Exchanges had the lowest cost bronze plan option in 36 states;

  • Exchanges had the lowest cost silver plan option in 35 states; and

  • Exchanges had the lowest cost gold plan option in 35 states. 

"The increased price competitiveness of the exchange plans may increase enrollment in these plans," says Kev Coleman, head of data and research at HealthPocket.

For premium comparisons, HealthPocket assumed that the enrollee was a 40 year-old nonsmoker. Platinum plans were not included because many areas did not have platinum plan options. 


Coleman says that a few factors contribute to these findings.

  • Off-exchange plans may believe they are in a less competitive market;

  • Plans with broader hospital networks are associated with higher premiums; and

  • Premiums could be influenced by the expected differences among risk pools and their attendant rates of medical usage.

"The possible entry of large off-exchange carriers into exchanges in 2015 may not have any significant effect for consumers with respect to greater premium competition," he says. "However, off-exchange carriers may look to adjust their healthcare provider networks to become more cost competetive with the exchange plans."

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