Your Source for Health Reform

Topic: Premiums



The amount that a person, family or company pays for their health insurance plan, usually monthly, is the premium. Workers covered through their employer normally have the premium deducted from their paycheck. Medicare patients typically have their medical insurance premium deducted from their Social Security benefit.


1 2 3

8 Million and Counting: Premiums and Cost Sharing

This May 2014 policy brief from the Robert Wood Johnson Foundation takes a deeper look at premiums, cost sharing and benefit design in the new Health Insurance Marketplaces based on a comprehensive dataset of information for all ACA silver plans.

List of Qualified Health Plans on the Illinois Small Business (SHOP) Marketplace

This spreadsheet lists all Qualified Health Plans on Illinois’ Small Business Health Options Program. QHPs are listed by county, with sample premiums for individuals and families. The SHOP is Health Insurance Marketplace for employers with less than 50 FTEs. (For all qualified individual and family plans, see this page.)

List of Qualified Health Plans on the Illinois Marketplace

This data set from HealthCare.gov lists the Qualified Health Plans for individuals and families on the Illinois Health Insurance Marketplace by county, with sample premiums. (For qualified SHOP plans, see this page.)

Illinois Health Insurance Geographic Rating Areas

Your health insurance premiums for Marketplace plans depend on what part of the state you live in. This table from CMS shows which geographic rating area your county falls into. This information is the same for the individual and small group markets.

Small Business Provisions of the ACA

This July 2013 fact sheet from the federal Small Business Administration details the provisions of the Affordable Care Act that will help small businesses by lowering premium cost growth and increasing access to quality, affordable health insurance. It also linkts additional resources from the IRS, the Department of Labor, and HealthCare.gov.

SHOP Application Form for Small Business Employees

CMS released sample SHOP applications that employees of small businesses will use to apply for coverage if they are eligible to get SHOP health coverage from their employer. (There are two print versions of the SHOP application: this one for the small business employee, and another one for the small business owner.)

Premiums and Employee Contributions for Employer-Sponsored Health Insurance

The average private sector premiums in 2011 were $5,222 for single coverage, $10,329 for employee-plus-one, and $15,022 for family coverage. Employees contribued an average of $1,090 for single coverage, $2,736 for plus-one, and $3,962 for family plans. The numbers for public sector plans are also given. This January 2013 statistical brief summarizes the results of the Agency for Health Care Research and Quality’s Medical Expenditure Panel Survey.

Comparing Experiences of Adults 55-64 with Those on Medicare

This May 2012 issue brief from the Kaiser Family Foundation discusses provisions of the Affordable Care Act that will expand access to health coverage for those who are approaching retirement but too young for Medicare. It compares the experiences of both uninsured and privately insured adults age 55-64 with those of Medicare beneficiaries. (more…)

DOI Application for Federal Funds To Enhance Rate Review

In September 2010, the Illinois Department of Insurance applied for and was awarded a $1 million federal grant to enhance its rate review capacity. As outlined in this grant application, the Department will use this funding for: necessary upgrades to technical infrastructure; additional staff to assist with new filings and reviews; and enhanced information for consumers and policymakers.

Premium Increases and Rate Review Authority in Illinois

This presentation by the Illinois Department of Insurance in February 2011 described the state of health insurance premium review in Illinois in light of the ACA. Before enactment of the ACA, most plans were not required to even inform the Department of rate changes or rate amounts for group policies. In September 2010, the Department received a $1 million federal grant to enhance its rate review capacity,

1 2 3