Health Insurance Exchange Public Use Files (Exchange 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 Exchange. While health plan information including benefits, copayments, premiums, and geographic coverage is publicly available on Healthcare.gov, CMS also publishes downloadable public use files (PUFs) so that researchers and other stakeholders can more easily access Exchange data.

The Health Insurance Exchange Public Use Files (Exchange PUFs) are available for plan years 2014 to 2022 to support timely benefit and rate analysis. It is important to note that the 2022 Exchange PUFs will be updated regularly to reflect the plan data that consumers will see when shopping for an Exchange Qualified Health Plan (QHP). Data for the 2022 Exchange PUFs were imported to CMS systems by May 4, 2022.

The Exchange PUFs include plan and issuer level information on certified Qualified Health Plans (QHPs) and stand-alone dental plans (SADPs) offered to individuals and small businesses through the Health Insurance Exchange. The Exchange PUFs include data from states participating in the Federally Facilitated Exchanges (FFE) including states performing plan management functions, and states whose State-based Exchanges rely on the federal information technology platform for QHP eligibility and enrollment (SBE-FP). The PUFs also include data on Multi-State Plans (MSPs) and certified off-exchange SADPs. The Exchange PUFs generally exclude information from SBEs that do not rely on the federal platform for QHP eligibility and enrollment.

The Exchange PUFs consist of twelve separate files as described below:

  • Benefits and Cost Sharing PUF (BenCS-PUF) – Plan variant-level data on essential health benefits, coverage limits, and cost sharing.
  • Rate PUF (Rate-PUF) – Plan-level data on rates based on an eligible subscriber’s age, tobacco use, and geographic location; and family-tier rates.
  • Plan Attributes PUF (Plan-PUF) – Plan-level data on maximum out of pocket payments, deductibles, HSA eligibility, formulary ID, and other plan attributes.
  • Business Rules PUF (BR-PUF) – Plan-level data on rating business rules, such as maximum age for a dependent, and allowed dependent relationships.
  • Service Area PUF (SA-PUF) – Issuer-level data on geographic service areas 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 the previous plan year to plans offered in the current plan year.
  • Machine-readable URL PUF (MR-PUF)—Issuer-level URL locations for machine-readable network provider and formulary information.
  • Transparency in Coverage PUF (TC-PUF) – Issuer and plan-level claims, appeals, and active URL data. The PY2022 PUF contains data from PY2020 for issuers participating in the Exchange in PY2020.
  • Quality PUF (Qual-PUF) – Quality ratings data for plans offered through the Federally-Facilitated Exchange. The PY2017 PUF is found below. The PY2018 through PY2022 PUFs are found here.
  • Nationwide Quality Rating System PUF (NatQRS-PUF) – Quality ratings data for plans offered through Exchanges nationwide, including State Based Exchanges (SBE). The PY2020 through PY2022 PUFs are found here.
  • Enrollee Survey PUF (ES-PUF) – Results from the QHP Enrollee Survey for plans offered through Exchanges nationwide, including State Based Exchanges (SBE). The PY2022 PUF is found here

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

Health Insurance Exchange PUF Data Dictionaries
Benefits and Cost Sharing Data Dictionary (PDF)
Rate Data Dictionary (PDF)
Plan Attributes Data Dictionary (PDF)
Business Rules Data Dictionary (PDF)
Service Area Data Dictionary (PDF)
Network Data Dictionary (PDF)
Plan ID Crosswalk Data Dictionary (PDF)
Machine-readable Data Dictionary (PDF)
Transparency in Coverage Data Dictionary (PDF)
Quality Data Dictionary
Nationwide Quality Rating System Data Dictionary
Enrollee Survey Data Dictionary

 

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

Downloads

2022 Exchange PUF Datasets

2021 Exchange PUF Datasets

2020 Exchange PUF Datasets

2019 Exchange PUF Datasets

2018 Exchange PUF Datasets

2017 Exchange PUF Datasets

2016 Exchange PUF Datasets

2015 Exchange PUF Datasets

2014 Exchange PUF Datasets

Further Information

The plan year 2022 Exchange PUFs will be updated regularly to incorporate approved data corrections from issuers including Small Business Health Options Program (SHOP) quarterly rate updates. Note that data in the plan year 2022 Exchange PUFs may vary from the data shown on HealthCare.gov due to difference in dates between display of approved data changes and release of Exchange PUFs updates.