Health Insurance Marketplace Public Use Files (Marketplace PUFs)

The Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) is committed to increasing transparency in the Health Insurance Marketplace. While health plan information including benefits, copayments, premiums, and geographic coverage is publically available on Healthcare.gov, CMS has also released downloadable public use files (PUFs) so that researchers and other stakeholders can more easily access Marketplace data.

The Health Insurance Marketplace Public Use Files (Marketplace PUFs) are available for plan years 2014 through 2017 to support timely benefit and rate analysis. It is important to note that the 2017 Marketplace PUFs will be updated regularly to reflect the plan data that consumers will see when shopping for a Marketplace Qualified Health Plan (QHP).  Data for the 2017 Marketplace PUFs were imported to CMS systems on May 10, 2017.

The Marketplace PUFs include plan and issuer level information for certified Qualified Health Plans (QHPs) and stand-alone dental plans (SADPs) offered to individuals and small businesses through the Health Insurance Marketplace. The Marketplace PUFs include data from states participating in the Federally Facilitated Marketplaces (FFM), which include State Partnership Marketplaces (SPMs), and states whose State-based Marketplaces rely on the federal information technology platform for QHP eligibility and enrollment functionality. The Marketplace PUFs do not contain any data on plans offered in states that established and operate their own Marketplace (State-based Marketplace) and do not rely on the federal platform for QHP eligibility and enrollment functionality.

The Marketplace PUFs consist of ten separate files as described below:

• Benefits and Cost Sharing PUF (BenCS-PUF) – Plan-level data on essential health benefits, coverage limits, and cost sharing.
• Rate PUF (Rate-PUF) – Plan-level data on individual rates based on an eligible subscriber’s age, tobacco use, and geographic location.
• Plan Attributes PUF (Plan-PUF) – Plan-level data on maximum out of pocket payments, deductibles, cost sharing, HSA eligibility, formulary ID, and other plan attributes.
• Business Rules PUF (BR-PUF) – Plan-level data on the application of rates, such as allowed relationships (e.g., spouse, dependents) and tobacco use.
• Service Area PUF (SA-PUF) – Issuer-level data on the geographic coverage or service area (i.e., where the plan is offered) including state, county, and zip code.
• Network (Ntwrk-PUF) – Issuer-level data identifying provider network URLs.
• Plan ID Crosswalk PUF (CW-PUF) – Plan-level data mapping plans offered in 2014 to plans offered in 2015.
• Machine-readable URL PUF (MR-PUF)—Issuer-level URL locations for machine-readable plan network provider and formulary information
• Transparency in Coverage PUF (TC-PUF) – Issuer-level claims, appeals, and active URL data. This PUF contains data from PY2015 for issuers participating in the Marketplace in PY2017.
• Quality PUF (Qual-PUF) – Quality ratings data for plans in PY2017 pilot states (VA and WI).

For more information about the Marketplace PUFs, please review the General Information Factsheet, Data Disclaimer-User Agreement and Data Dictionaries.

•  General Information Factsheet
•  Marketplace PUF FAQs 
•  Data Disclaimer - User Agreement
•  Data Disclaimer for Machine-readable URL PUF
•  Data Disclaimer for Transparency in Coverage PUF 

To access and download each PUF, click on the associated link in the Downloads section below.

Downloads

2017 Marketplace PUF Datasets