Individual Market Rating Reforms
This data is presented as an interactive tool that allows users to: filter by timeframe/year, select specific data columns (distributions), filter by state or geography, and view the data as a table, map, or trend chart.
as of December 10, 2021
Location Age Rating Ratio State-Established Age Curve? Tobacco Rating Ratio Uniform Family Tiers?
United States 3:1 Federal Default Age Curve 1.5:1 Per Member Rating Alabama Yes Alaska Arizona Arkansas 1.2:1 California 1:1 Colorado 1.15:1 Connecticut 1.5:1 Delaware District of Columbia Yes 1:1 Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky 1.4:1 Louisiana Maine Maryland Massachusetts 2.1 Yes 1:1 Michigan Minnesota Yes Mississippi Yes Missouri Montana Nebraska Nevada New Hampshire New Jersey 1:1 New Mexico New York 1:1 1:1 Yes North Carolina North Dakota Ohio Oklahoma Oregon Yes Pennsylvania Rhode Island 1:1 South Carolina South Dakota Tennessee Texas Utah Yes Vermont 1:1 1:1 Yes Virginia Washington West Virginia Wisconsin Wyoming
Notes
The Market Rules and Rate Review Final Rule (45 CFR Part 147) provides that each state will have age rating ratios of 3:1 using a federally established age curve, tobacco rating ratios of no more than 1.5:1 and per member rating unless a state requests ratios less than the standard or is a community rating state with uniform family tiers. The federal defaults are listed under the United States. If a cell is blank in the data table for a state, then the federal default applies.
The Protecting Affordable Coverage for Employees Act (Pub. L. 114-60) amended the definition of small employer in section 1304(b) of the Affordable Care Act and section 2791(e) of the Public Health Service Act to mean generally an employer with 1-50 employees, with the option for states to expand the definition of small employer to 1-100 employees.
For Federal default age curve and state-specific age curve variations, see
For state-specific family tier ratios for NY and VT, see
Sources
Market Rating Reforms, State Specific Rating Variations , CCIIO; updated December 10, 2021.