Individual and Family Plan Market Overview

A Special Enrollment Period (SEP) this year allowed for widespread shopping and switching mid-year. As of September 2021, an estimated 12.2 million people were enrolled in federal and state marketplaces. A staggering 89% had a new or updated plan selection during the SEP. Of these, 2.8 million (26%) were new enrollees and 74% were existing members that changed plans (or had one auto-determined for them).

Along with the SEP, legislative action substantially raised the amount of subsidies available to members. Those over 400% of the Federal Poverty Level (FPL) were newly eligible for subsidies, and those at 150% of the FPL or below should have had access to a $0 premium Silver plan. Some members who were unemployed also received extra subsidies for their premiums.

Even before the new subsidies, most HealthCare.gov states had lower average benchmark plan premiums than in 2020.

How this Study Helps Clients

In a year of unprecedented market churn, insurance companies seeking to assure the satisfaction and retention of their IFP customers need to understand the market forces spurring so many consumers to seek new health plans.

To uncover these dynamics, this report provides an analysis of 1,874 consumers' survey responses.  These responses reveal the details of:

• health plan benefits that create and destroy member loyalty
• the importance of Brand Equity to mobilized consumers
• the experience of members with respect to the cost-sharing requirements of their plans
• the experience of members when trying to understand and use their benefits
• the experience of members when seeking care
• the experience of members when contacting customer service

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