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Survey of Non-Group Health Insurance Enrollees

About The Groups Described In This Report

This survey reports on the views and experiences of all people purchasing health insurance coverage in the non-group market. However, because of the complexities of the market and the changes brought about by the ACA, much of this report breaks out responses by different subgroups based on how they obtained their coverage and their previous insurance status. The ACA made major changes to the non-group insurance market, including new rules that standardize coverage, guarantee access to those with pre-existing conditions, and provide subsidies based on income for those buying coverage through new Health Insurance Exchanges (also known as Marketplaces; these terms are used interchangeably throughout this report).

Those rules took effect for coverage beginning on or after January 1, 2014. People were able to purchase this “ACA-compliant” coverage either through an Exchange or directly from an insurance company during an open enrollment period that began October 1, 2013 and ended March 31, 2014 (with some opportunities for special enrollment periods after that). This survey includes individuals who purchased these new ACA-compliant plans, as well as people who are currently enrolled in “non-compliant” plans, including those who were grandfathered under the ACA because they were purchased before the law went into effect, those who renewed policies last year or bought coverage that began before January 1, and those who have been able to keep their old policies for a period of time under a federal transition policy at the discretion of states.

A more detailed breakdown of the main groups described in this report is provided below.

Total non-group market: All individuals ages 18-64 whose primary source of health insurance coverage is a plan they purchased themselves, either directly from an insurance company or through a state or federal Health Insurance Marketplace, regardless of plan start date (see Survey Methodology for more details on inclusion criteria).

ACA-compliant plans (68% of total non-group market1): Allplans that took effect on or after January 1, 2014, including those purchased through a state or federal Marketplace and those purchased directly from an insurance company.

Exchange plans (48% of total non-group market): Plans that were purchased from a state or federal Health Insurance Exchange, including Exchange plans purchased through a health insurance agent or broker.

Compliant, non-Exchange plans (16% of total non-group market): Plans that took effect on or after January 1, 2014 that were purchased directly from an insurance company, including non-Exchange plans purchased through a health insurance agent or broker.

ACA-compliant plans by prior insurance status2:

Previously uninsured, now in ACA-compliant plan (34% of total non-group market): Those with ACA-compliant plans who say they were uninsured immediately prior to purchasing their current plan.

Plan switchers (those who switched from a non-compliant to a compliant plan, 13% of total non-group market): Those with ACA-compliant plans who say they were covered by a different non-group plan (presumably, a non-compliant plan) immediately prior to purchasing their current plan, including those who chose to switch and those who had their prior plans cancelled.

Previously employer-sponsored insurance/COBRA (12% of total non-group market): Those with ACA-compliant plans who say they were covered by an employer-sponsored plan or COBRA immediately prior to purchasing their current plan.

Non-compliant plans (31% of total non-group market): Plans purchased outside the Health Insurance Exchange that took effect before January 1, 2014.

Executive Summary Section 1: Basic Demographics Of The Non-Group Market