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 PUF) are available for plan years 2014 through 2016 to support timely benefit and rate analysis. It is important to note that the 2016 Marketplace PUF 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 2016 Marketplace PUF were imported to CMS systems on July 29, 2016. The 2015 Marketplace PUF data were imported to CMS systems on July 24, 2015, and the 2014 Marketplace PUF data were imported on July 30, 2014.
The Marketplace PUF includes 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 PUF includes 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 PUF does 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, nor does it contain enrollment or claims data.
The Marketplace PUF consists of eight 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
For more information about the Marketplace PUF, please review the General Information Factsheet, Data Disclaimer-User Agreement and Data Dictionaries.
To access and download each PUF, click on the associated link in the Downloads section below.
Downloads
2016 Marketplace PUF Datasets
Before you download
The Benefits and Cost Sharing PUF and the Rate PUF datasets included in the zip files are extremely large and may be burdensome to download and/or cause computer performance issues. Downloading the files with the assistance of the Akamai Download Manager application should make downloading the data easier by offering the option to pause and restart downloading to minimize resource allocation impact. Be advised that the file size, once downloaded, may still be prohibitive if you are not using a robust data viewing application. Microsoft Excel has limitations on the number of records it can display, which these two files exceed.
Benefits and Cost Sharing PUF (Updated July 29, 2016)
Rate PUF (Updated July 29, 2016)
Plan Attributes PUF (Updated July 29, 2016)
Business Rules PUF (Updated July 29, 2016)
Service Area PUF (Updated July 29, 2016)
Network PUF (Updated July 29, 2016)
Plan ID Crosswalk PUF (Updated January 7, 2016)
Machine-readable URL PUF (Updated March 28, 2016)
2015 Marketplace PUF Datasets
Data current as of July 24, 2015
Before you download
The Benefits and Cost Sharing PUF and the Rate PUF datasets included in the zip files are extremely large and may be burdensome to download and/or cause computer performance issues. Downloading the files with the assistance of the Akamai Download Manager application should make downloading the data easier by offering the option to pause and restart downloading to minimize resource allocation impact. Be advised that the file size, once downloaded, may still be prohibitive if you are not using a robust data viewing application. Microsoft Excel has limitations on the number of records it can display, which these two files exceed.
Benefits and Cost Sharing PUF
2014 Marketplace PUF Datasets
Data current as of July 30, 2014
Before you download
The Benefits and Cost Sharing PUF and the Rate PUF datasets included in the zip files are extremely large and may be burdensome to download and/or cause computer performance issues. Downloading the files with the assistance of the Akamai Download Manager application should make downloading the data easier by offering the option to pause and restart downloading to minimize resource allocation impact. Be advised that the file size, once downloaded, may still be prohibitive if you are not using a robust data viewing application. Microsoft Excel has limitations on the number of records it can display, which these two files exceed.
Benefits and Cost Sharing PUF
Support and Further Information
Users with questions about the Marketplace PUF, the Marketplace data validation process, or QHP/SADP certification, should contact QHPinfo_data@cms.hhs.gov. Responses to PUF-related questions will be released regularly in a Frequently Asked Questions (FAQ) document posted to http://www.cms.gov/CCIIO/Resources/Data-Resources/marketplace-puf.html. CMS will only respond to questions related to the Marketplace PUF, and will not respond to questions about developer tools or other public use files. The Marketplace PUF will be updated regularly to incorporate incorporate approved data corrections from issuers including Small Business Health Options (SHOP) quarterly rate updates.