The premium comparisons assumed a 40 year-old nonsmoker purchasing a health plan with an effective date of July 1, 2014. The four major off-exchange insurance companies used were United Healthcare, Aetna, Cigna, and Assurant.
Plans sold off-exchange must offer the same essential health benefits as plans sold on the exchanges, but the primary difference between buying plans on- or off-exchange is that only on-exchange plans are eligible for government subsidies.
On average the least expensive bronze plans offered by the four off-exchange insurers were 45% more expensive than the least expensive bronze plans offered on the exchanges.
On average the least expensive silver plans offered by the four off-exchange insurers were 39% more expensive than the least expensive silver plans offered on the exchanges.
The cheapest United Healthcare gold plan was 41% more expensive on average than the cheapest exchange gold plan, while the cheapest Assurant gold plan was 39% more expensive.
What explains these huge differences? Note that these premiums are observed before tax credits are applied to the exchange premiums. Tax credits would make the differences even greater, because off-exchange plans are not eligible for those subsidies. The biggest factor driving these premium differences must be the provider networks available in the off-exchange plans versus the exchange plans. This blog has long argued that ObamaCare’s exchange plans offer extremely limited access to physicians and hospitals. HealthPocket’s research corroborates our understanding that only high-income people, who are not eligible for tax credits, are likely to get comprehensive health insurance under ObamaCare.