Exchange-only health plans more expensive than plans sold both on and off exchange

MOUNTAIN VIEW, Calif., May 21, 2015 -- When comparing the average premiums of exchange-only health plans to health plans sold simultaneously on-exchange and off-exchange, HealthPocket found that the exchange-only health plans were not as competitive on price. This trend of higher premiums was observed across the bronze, silver, and gold health plan categories of Affordable Care Act health insurance.

Using the government's Health Insurance Marketplace public use files, HealthPocket found that only a small percentage of metal plans were distributed exclusively through government exchanges, as opposed to distributed both on and off-exchange. For every one exchange-only metal plan within the government dataset, there were approximately 29 metal plans that were simultaneously offered on and off-exchange. The insurance companies offering the exchange-only health plans within the government records were various Blue Cross Blue Shield entities as well a CO-OP health insurance company.

HealthPocket found the biggest difference in average premiums was for bronze plan health insurance. The exchange-only bronze plan premiums were approximately 15% more expensive on average than the premiums for bronze plans sold both on and off-exchange. Exchange-only silver plans were nearly 7% more expensive than their on/off exchange competitors and gold plans were approximately 5% more expensive. Data was not available for exchange-only platinum health plans.

"The higher average premiums we observed for health plans sold exclusively on-exchange may be the result of multiple factors," said Kev Coleman, Head of Research & Data at HealthPocket, "Among these factors is the fact that health plans sold on-exchange are not paid for at list price by most enrollees but, instead, often have sizable premium subsidies applied. Off-exchange consumers are more likely unsubsidized and may be more price sensitive than on-exchange consumers who enjoy premium subsidization."

The full results of the study as well as its methodology can be reviewed in "Exchange-Only Health Plans Average Higher Premiums Than Competitors that Sell Plans Both On & Off-Exchange" at HealthPocket.com.

HealthPocket.com is a free website that compares and ranks all health insurance plans, helping individuals, families, and small businesses to make their best health plan decisions. HealthPocket publishes health insurance market analyses and other consumer advocacy research. HealthPocket's research is nonpartisan and uses only objective data from government, non-profit, and private sources that carry no conditions that might restrict the site from serving as an unbiased resource. HealthPocket, Inc. is independently managed and based in Mountain View, California. Learn more at www.HealthPocket.com.