Skip to Main Content
 

The Center for Consumer Information & Insurance Oversight

 

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 publically 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 2019 to support timely benefit and rate analysis. It is important to note that the 2019 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 2019 Exchange PUFs were imported to CMS systems by November 5, 2018.

The Exchange PUFs include 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 Exchange. The Exchange PUFs include data from states participating in the Federally Facilitated Exchanges (FFE), State Partnership Exchanges (SPEs) and states whose State-based Exchanges rely on the federal information technology platform for QHP eligibility and enrollment functionality (SBE-FP). The PUFs also include data on Multi-State Plans (MSPs) and certified off-exchange SADPs. The Exchange PUFs exclude information from SBEs that do not rely on the federal platform for QHP eligibility and enrollment functionality.

The Exchange PUFs consist of ten 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 individual 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 allowed relationships (e.g., spouse, dependents) and tobacco use.
  • 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 plan network provider and formulary information.
  • Transparency in Coverage PUF (TC-PUF) – Issuer-level claims, appeals, and active URL data. The PY2019 PUF contains data from PY2017 for issuers participating in the Exchange in PY2017.
  • Quality PUF (Qual-PUF) – Quality ratings data for plans in pilot states. The PY17 Quality PUF is found below. Quality PUFs for more recent plan years are 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
Rate Data Dictionary
Plan Attributes Data Dictionary
Business Rules Data Dictionary
Service Area Data Dictionary
Network Data Dictionary
Plan ID Crosswalk Data Dictionary
Machine-readable Data Dictionary
Transparency in Coverage Data Dictionary
Quality Data Dictionary

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

Downloads

2019 Exchange PUF Datasets

Benefits and Cost Sharing PUF (Updated November 5, 2018)

Rate PUF (Updated November 5, 2018)

Plan Attributes PUF (Updated November 5, 2018)

Business Rules PUF (Updated November 5, 2018)

Service Area PUF (Updated November 5, 2018)

Network PUF (Updated November 5, 2018)

Plan ID Crosswalk PUF (Updated October 31, 2018)

Machine-readable URL PUF (Updated October 29, 2018)

Transparency in Coverage PUF (Updated October 15, 2018)

2018 Exchange PUF Datasets

Benefits and Cost Sharing PUF (Updated July 27, 2018)

Rate PUF (Updated July 27, 2018)

Plan Attributes PUF (Updated July 27, 2018)

Business Rules PUF (Updated July 27, 2018)

Service Area PUF (Updated July 27, 2018)

Network PUF (Updated July 27, 2018)

Plan ID Crosswalk PUF (Updated November 3, 2017)

Machine-readable URL PUF (Updated May 3, 2018)

Transparency in Coverage PUF (Updated October 19, 2017)

Quality PUF (Updated October 31, 2017)

2017 Exchange PUF Datasets
 

Benefits and Cost Sharing PUF (Updated August 9, 2017)

Rate PUF (Updated August 9, 2017)

Plan Attributes PUF (Updated August 9, 2017)

Business Rules PUF (Updated August 9, 2017)

Service Area PUF (Updated August 9, 2017)

Network PUF (Updated August 9, 2017)

Plan ID Crosswalk PUF (Updated November 3, 2017)

Machine-readable URL PUF (Updated May 19, 2017)

Transparency in Coverage PUF (Updated January 9, 2017)

Quality PUF (Updated November 8, 2016)

2016 Exchange PUF Datasets
 

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 Exchange PUF Datasets

Benefits and Cost Sharing PUF (Updated July 24, 2015)

Rate PUF (Updated July 24, 2015)

Plan Attributes PUF (Updated July 24, 2015)

Business Rules PUF (Updated July 24, 2015)

Service Area PUF (Updated July 24, 2015)

Network PUF (Updated July 24, 2015)

Plan ID Crosswalk PUF (Updated January 7, 2015)

2014 Exchange PUF Datasets
 

Benefits and Cost Sharing PUF (Updated July 30, 2014)

Rate PUF (Updated July 30, 2014)

Plan Attributes PUF (Updated July 30, 2014)

Business Rules PUF (Updated July 30, 2014)

Service Area PUF (Updated July 30, 2014)

Network PUF (Updated July 30, 2014)

Support and Further Information

Users with questions about the Exchange PUFs, the Exchange 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 Exchange PUFs, and will not respond to questions about developer tools or other public use files. The Exchange PUFs will be updated regularly to incorporate approved data corrections from issuers including Small Business Health Options (SHOP) quarterly rate updates.

 
.