Estimated premiums in 2014 were calculated using actual health insurance rates generated by the GoHealth Quote Engine. Using quotes from GoHealth, the calculator determines an average premium for most ZIP codes in the United States for 2013. The calculator then uses that average to estimate 2014-level rates. For a small set of states, GoHealth uses the Congressional Budget Office’s estimates, rather than actual health insurance quotes to calculate 2014 premium estimates. Those states include: HI, ME and RI.
Rates used in the calculator for a single individual were based on a 40 year old female who is healthy and a non-smoker. Rates used in the calculator for families were made using a healthy 40 year old woman as the primary applicant with a 40 year old spouse, and children under the ages of 18.
The actual premium payment is a reflection of how much an eligible individual/family can expect to pay after their tax subsidy has been applied. The highest amount that a household will be expected to pay for health insurance coverage is 9.5 percent of their annual income.
The calculated out-of-pocket costs is the maximum dollar amount an individual/family would have to pay for health care services, not including premiums, in 2014. An individual/family may or may not reach this maximum level, depending on how much they utilize health care services in a year.