Health Insurance Issuer Participation and New Entrants in the Health Insurance Marketplace in 2015. Methodology

09/23/2014

For the purposes of this analysis, we define an issuer as an entity offering one or more individual market QHPs11 through a Marketplace (Marketplace plans) and count as a separate issuer each unique issuer identification number in the Health Insurance Oversight System (HIOS) of the Centers for Medicare & Medicaid Services’ Center for Consumer Information and Insurance Oversight. An entity’s HIOS code is specific to each state. Based on this definition, for purposes of this analysis, no issuer is counted as being active in more than one state. The number of 2014 and 2015 issuers was tabulated by CCIIO from information in HIOS and supplemented with information from the FFM plan landscape file, publicly available issuer filings, state press releases, and media reports.12

We consider an issuer to be a “new entrant” in 2015 if it did not participate in a given state’s Marketplace in 2014 based on its HIOS ID number, and we define “exiting” issuers as those which were active in a given state in 2014 but have not filed for participation in 2015.

The 2015 data reported here were available as of September 4, 2014, and are preliminary and incomplete. Not all states and issuers have submitted information to HIOS. The QHP certification process had not yet been completed at the time of this analysis.

The total number of issuers in a state, as shown in Tables 1 and 2 does not necessarily reflect the amount of choice available to each individual consumer. Some issuers’ service areas do not include the entire state; therefore, the number of issuers offering plans in a given rating area is typically less than the total number of issuers that are active in a state.

This brief considers only individual market QHP issuers, and it does not reflect data for SHOP or stand-alone dental plan issuers.


11 This brief considers only individual market Qualified Health Plan (QHP) issuers, and not State Health Options Plan (SHOP) or stand-alone dental plan (SADP) issuers.

12 To verify the number of 2014 issuers, we used the January 2014 version of the FFM plan landscape file publicly available at: https://www.healthcare.gov/health-plan-information.

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