When it comes to buying individual health insurance, you have two options: on-exchange plans, which you purchase through government marketplaces, and off-exchange plans that you buy directly from insurers.
As 2026 approaches with higher-than-expected rate increases, you might be wondering how these changes will impact health insurance plans on the public and private exchanges.
In this article, we’ll compare rate trends between on- and off-exchange plans to see which offers better savings potential.In this blog post, you’ll learn:
The projected rate increases for on-exchange health insurance plans.
The projected rate increases for off-exchange health insurance plans.
The benefits of buying off-exchange health insurance plans.
An overview of on-exchange plans
You can purchase an on-exchange plan through the federal Health Insurance Marketplace, or a state-based exchange. The Affordable Care Act (ACA) created these marketplaces to give individuals and families a central place to compare and enroll in coverage.
One of the biggest advantages of shopping on-exchange is that eligible enrollees can access premium tax credits and cost-sharing reductions, which can significantly lower the cost of monthly premiums and out-of-pocket expenses.
An overview of off-exchange plans
You can purchase an off-exchange plan through a licensed broker, agent, orhealth insurance company. These private plans are still ACA-compliant if they’re major medical coverage. However, because they’re sold outside of the government marketplace, off-exchange plans aren’t eligible for federal premium subsidies.
This option can be a good fit for individuals who don’t qualify for financial assistance and want access to a broader selection of carriers or plan designs than what may be available on-exchange.
Rate increases for 2026
Annual rate increases are normal forindividualandgroup plans. They happen during Open Enrollment for most years (though sometimes, individual rates can actuallydecrease). But they’re particularly steep for 2026.
This is due tofactors1like:
A growing demand for GLP-1 drugs, such as Ozempic and Wegovy. This increases healthcare costs for insurers, leading to higher premiums.
The expiration of the enhanced advanced premium tax credits (APTCs).
Tariffs on imported medical supplies and prescription drugs. Insurers attributing their rate hikes to tariffs are increasing premiums by an extra 3% compared to what they would be without these new tariffs.
On-exchange vs. Off-exchange
Remodel Health experts analyzed the unweightedrate increasesfor both on- and off-exchange health insurance plans in 11 states. Based on our findings, premium increases tend to be greater on average for on-exchange health plans compared to off-exchange options across the metal tiers.
On-exchange
Off-exchange
Bronze plans
Silver plans
Gold plans
Bronze plans
Silver plans
Gold plans
Connecticut
12.86%
23.84%
8.59%
7.59%
15.32%
14.30%
Illinois
11.29%
29.99%
1.36%
14.09%
12.53%
N/A
Indiana
22.60%
14.53%
19.09%
12.14%
10.34%
14.01%
Maine
17.34%
16.40%
20.74%
11.22%
11.07%
11.40%
Maryland
14.25%
13.31%
14.21%
19.22%
14.62%
12.58%
Michigan
14.02%
16.09%
15.77%
N/A
15.67%
12.17%
Minnesota
20.36%
18.20%
16.50%
23.33%
16.54%
13.07%
Oregon
11.51%
4.42%
8.01%
1.36%
1.84%
10.13%
Washington
12.29%
36.90%
1.25%
9.94%
7.02%
7.78%
Rhode Island
26.27%
25.23%
26.14%
27.59%
26.44%
27.17%
Colorado
26.82%
28.21%
23.13%
31.34%
31.37%
36.76%
Is an off-exchange health insurance plan the better option?
On-exchange insurance carriers are adjusting their rates to address the impact of adverse selection, influenced by shifts in Medicaid eligibility and the potential end to APTCs. So if you want to save money, an off-exchange plan might offer you a more affordable monthly premium.
Additional benefits of an off-exchange health plan include:
Cost-control.Off-exchange health plans offer more customizable options, covering various metal levels, deductibles, and premiums, which can align with your budget. They might be cheaper by providing different networks, coverage limits, or excluding certain benefits that you may not need.
More insurance plan options.Private exchanges provide access to a wider array of plans, including vision, dental, and short-term health insurance.
Personalized support.You can use insurance brokers on-exchange, but off-exchange brokers often provide personalized service and expertise. They have in-depth knowledge of private insurance, helping you find affordable and comprehensive coverage for you and your employees.
While off-exchange plans may be seeing smaller rate increases than on-exchange plans for 2026, that doesn’t necessarily mean an off-exchange plan is the cheapest option. You’ll want to compare plans and premiums between on- and off-exchange plans in your area.
Go off-exchange with Remodel Health
As mentioned, group health insurance also faces annual rate hikes. According to a PwC survey2, medical costs in the U.S. are expected to rise 8.5% for group plans in 2026, the same rate as in 2025. But, it isn’t uncommon for groups with high benefits utilization to see rate hikes of 20% or greater.
By offering your employees anindividual coverage health reimbursement arrangement(ICHRA), you can leverage the cost-effectiveness of individual health insurance. An ICHRA serves as an alternative to a traditional group health insurance plan.
Here’s how it works:
You set a monthly allowance of tax-free money for your employees to use on health insurance premiums.
Your employees pick the health insurance plans that work best for them, instead of getting stuck with a one-size-fits-all group plan.
If your employees choose plans that cost more than the allowance you offer, they pay the difference.
Plus, when you offer anICHRA through Remodel Health, your employees can shop for off-exchange health plans straight from their accounts. This improves the experience of shopping for individual coverage since they won’t have to navigate the marketplace alone.
Conclusion
Understanding how rate increases affect off-exchange versus on-exchange plans is crucial for choosing the right healthcare plan. While both options have unique benefits and challenges, many policyholders question which path provides more financial stability. Heading into 2026, off-exchange health insurance plans are seeing smaller rate increases, which can make monthly premiums more affordable for you and your employees.
Carriers are investing in ICHRA-specific and specialized health plans
Carriers are building ICHRA-specific plans to meet rising demand. Explore how these tailored health plans improve access, pricing, and employee choice.
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