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:
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.
On-exchange health plans must meet ACA requirements, including covering essential health benefits and offering protections for pre-existing conditions.
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.
You can purchase an off-exchange plan through a licensed broker, agent, or health 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.
Annual rate increases are normal for individual and group plans. They happen during Open Enrollment for most years (though sometimes, individual rates can actually decrease). But they’re particularly steep for 2026.
This is due to factors1 like:
Remodel Health experts analyzed the unweighted rate increases for 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% |
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:
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.
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 an individual 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:
Plus, when you offer an ICHRA 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.
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.