Quarterly Marketplace Effectuated Enrollment Snapshots by State
Guidance for consumers with effectuated Health Insurance Marketplace coverage. The data includes tables with state-level effectuated enrollment, the number of consumers with Applied Premium Tax Credit (APTC) subsidies, and the number of consumers with Cost-Sharing Reduction (CSR) subsidies; state-level effectuated enrollment cut by metal level; and state-level numbers with the average APTC subsidy amount for those consumers receiving APTC.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 01, 2020
The Office of Enterprise Data and Analytics (OEDA), within the Centers for Medicare & Medicaid Services (CMS), has prepared public data sets with the total number of consumers in all 50 states and Washington, DC with Marketplace coverage. The data includes consumers with effectuated Health Insurance Marketplace coverage – individuals who paid their premiums and had an active policy on the date of the snapshot.[1] The tables include state-level effectuated enrollment, the number of consumers with Applied Premium Tax Credit (APTC) subsidies, and the number of consumers with Cost-Sharing Reduction (CSR) subsidies; state-level effectuated enrollment cut by metal level; and state-level numbers with the average APTC subsidy amount for those consumers receiving APTC.
The data are available in two formats: (1) a downloadable Excel file and (2) an online interactive dataset that allows users to sort and filter data directly without downloading.
[1] Individuals effectuate their enrollment by paying their first month’s premium. This snapshot measures individuals who effectuated their enrollment and have an active policy on the date of the snapshot; it does not measure the rate at which consumers pay their first month’s premium. Active policies include those who have paid for the current month and individuals who may be in a grace period for non-payment. Grace periods can vary by state and issuer. For those individuals receiving APTC, issuers are required to give enrollees a three month grace period. 45 CFR §§ 155.430 and 156.270.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.