Health Insurance Rating Methodology

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Table of Contents

The Forbes Advisor Philosophy How Forbes Advisor Rates Health Insurance Companies Our Methodology Process Why You Can Trust Our Health Insurance Team Forbes Advisor Health Insurance Editorial Team

The Forbes Advisor Philosophy

Our role at Forbes Advisor is to provide you with simple, easy-to-understand information to help you make smart financial decisions on choosing a health insurance company for you and your family. Our editorial process is not influenced by health insurance companies, stakeholders or anyone else. We rate health insurance companies based on factors that may affect you, such as the types of plans offered and complaints against insurers.

How Forbes Advisor Rates Health Insurance Companies

We use the following factors in our health insurance ratings.


	Complaints made to state insurance departments: We used complaint data from the National Association of Insurance Commissioners. The NAIC collects complaints to state insurance departments. Source: National Association of Insurance Commissioners
	Why it’s important to consumers: A company’s complaint level can indicate customer satisfaction for an insurer.


	Plan ratings from the National Committee for Quality Assurance: The NCQA is an independent, nonprofit organization that accredits health plans and produces ratings. We collected ratings for each company’s rated plans and devised an average for each company. Source: National Committee for Quality Assurance
	Why it’s important to consumers: NCQA collects information on specific metrics, including patient experience, prevention, treatment, overall rating of the health plan and rating of care. This information can provide a glimpse at a health plan’s quality.


	Deductible: The deductible is how much you have to pay for healthcare in a year before the health plan begins picking up a portion of the costs. Companies with health plans that had low deductibles got more points. Source: HealthCare.gov
	Why it’s important to consumers: A health plan’s deductible is a major factor in how much you’ll pay in out-of-pocket costs during the year.


	Breadth of health plans: Health insurance companies may offer up to four types of plan benefit designs (PPO, HMO, EPO and POS). We gave companies that offered more types of plans more points. Source: HealthCare.gov
	Why it’s important to consumers: Health plan benefit design plays a key role in how health insurance costs and the flexibility and barriers you may experience receiving care. Companies that offer more types of health plans provide more options, which gives a better chance you’ll find a health plan benefit design that’s right for you.


	Metal tier offerings: The ACA marketplace at HealthCare.gov has four metal tier levels. We gave points to companies that offered more tier plan options. Source: HealthCare.gov
	Why it’s important to consumers: Health plan costs, including premiums, deductibles and out-of-pocket expenses, affect a plan’s metal tier. The Affordable Care Act marketplace bases metal tiers on those costs. An insurer that offers multiple metal tiers means you have more flexibility to decide on whether you’d rather pay lower premiums or lower out-of-pocket costs.


	Affordable Care Marketplace rates: We used the average Affordable Care Act marketplace rates. Source: Forbes Advisor staff research
	Why it’s important to consumers: Health insurance cost is one of the key factors when deciding on a health plan.


	Short-term health insurance rates: We compared quotes for a 30-year-old woman who is a nonsmoker for three cities: Orlando, Florida, Phoenix and El Paso, Texas. We took the three lowest quotes for each plan in each city and came up with an average. Source: Forbes Advisor staff research
	Why it’s important to consumers: Paying less for coverage doesn’t necessarily mean more money in your wallet for other things.


	Coverage maximum: Unlike standard health insurance, a short-term health insurance plan has maximum coverage, either lifetime or annual, which is the most the company will pay for an individual’s care. Source: Forbes Advisor staff research
	Why it’s important to consumers: A plan’s coverage maximum plays an important factor when deciding on a short-term health plan.


	Coinsurance: Coinsurance is the percentage you pay for healthcare services after you reach your plan’s deductible. The insurer picks up the rest of the bill until you reach the coverage limit. Source: Forbes Advisor staff research
	Why it’s important to consumers: Lower coinsurance levels mean less money out of pocket, so we gave those plans more points.


	Prescription drug coverage: Many short-term health insurance plans don’t offer prescription drug benefits or only give a discount card for members. We analyzed which short-term plans offer prescription drugs, which ones do not and which have exclusions that only cover prescription drugs for specific reasons, such as only during hospitalizations. Source: Forbes Advisor staff research
	Why it’s important to consumers: A short-term health plan without prescription coverage means you may have to pay for all prescription costs.

Our Methodology Process

Best Health Insurance Companies

To determine the best health insurance companies, we analyzed 84 data points about coverage and quality for seven large health insurance companies to determine the best health insurance companies.

Complaints made to state insurance departments: 30% of score
Plan ratings from the National Committee for Quality Assurance: 30% of score
Average silver plan deductible: 20% of score
Breadth of health plans: 10% of score
Metal tier offerings: 10% of score

Best Affordable Health Insurance Companies

We analyzed 84 data points about coverage and quality for seven large health insurance companies to determine the best affordable health insurance companies for small business owners.

Complaints made to state insurance departments: 30% of score
Plan ratings from the National Committee for Quality Assurance: 30% of score
Average silver plan deductible: 20% of score
Breadth of health plans: 10% of score
Metal tier offerings: 10% of score

Best Health Insurance Companies for Young Adults

To find the best health insurance companies for young adults, we identified the best health insurance companies and looked at the average monthly Affordable Care Act marketplace plan costs for 21-year-olds and 27-year-olds.

Average Affordable Care Marketplace rates: 50% of score
Complaints made to state insurance departments: 25% of score
Plan ratings from the National Committee for Quality Assurance: 25% of score

Best Health Insurance for Small Business Owners

We analyzed 84 data points about coverage and quality for seven large health insurance companies to determine the best health insurance providers for small business owners.

Complaints made to state insurance departments: 30% of score
Plan ratings from the National Committee for Quality Assurance: 30% of score
Average silver plan deductible: 20% of score
Breadth of health plans: 10% of score
Metal tier offerings: 10% of score

Best Short-Term Health Insurance Companies

To identify the best short-term health insurance companies, we evaluated companies based on average monthly cost, coverage and out-of-pocket costs.

Short-term health insurance rates: 25% of score
Coverage maximum: 25% of score
Deductible: 20% of score
Coinsurance: 15% of score
Prescription drug coverage: 15% of score

Why You Can Trust Our Health Insurance Team

Our editorial team has over 102 years of combined insurance experience and our goal is to provide you with unbiased ratings and information. We use a data-driven methodology to score health insurance companies. Each company is evaluated on consistent metrics to ensure all companies are measured equally.

Read more details on our editorial guidelines.

Forbes Advisor Health Insurance Editorial Team

Expert Round-Up: How to Choose the Best Health Insurance for You
Les Masterson Forbes Advisor Editor		Les Masterson is a deputy editor and insurance analyst at Forbes Advisor. He has been a journalist, reporter, editor and content creator for more than 25 years. He has covered insurance for a decade, including auto, home, life and health. Before covering insurance, Les was a news editor and reporter for Patch and Community Newspaper Company and also covered healthcare, mortgages, credit cards and personal loans for multiple websites.
What inspires Les: Health insurance plays such an important role in people’s lives. Having health insurance provides access to healthcare that can extend your life. Health insurance can also help you avoid financial ruin. Those factors make covering health insurance so important.
Penny Gusner Forbes Advisor Senior Writer		Penny Gusner is a senior insurance writer and analyst at Forbes Advisor. For more than 20 years, she has been helping consumers learn how insurance laws, data, trends, and coverages affect them. Penny enjoys translating the complexities of insurance into easy-to-understand advice and tips to help consumers make the best choices for their needs. Her work has been featured in numerous major media outlets.
What inspires Penny: I was inspired by aging parents’ health to understand health insurance and the different ways in which to get coverage. I learned the many terms used in health insurance to help teach my folks how to navigate their policies and properly read their bills.
Amy Danise Forbes Advisor Editor		Amy Danise is the managing editor for insurance at Forbes Advisor, which encompasses auto, home, renters, life, pet, travel, health and small business insurance. She is an experienced editor, writer and team leader with an extensive background in the insurance sector. With a career spanning more than three decades, she has focused her work on consumer-oriented publications.
What inspires Amy: Even if you don’t have much choice in what health plan you have because you get it through work, understanding and using your coverage correctly can mean saving thousands of dollars a year. This motivates me to help people understand what they have.
Michelle Megna Forbes Advisor Editor		Michelle Megna is a lead editor for insurance at Forbes Advisor. She has been a journalist for over 35 years, writing about insurance for consumers for the last decade. Prior to covering insurance, Michelle was: a lifestyle reporter, a magazine editor covering consumer technology; a foreign correspondent; and a local newspaper reporter.
What inspires Michelle: Coinsurance, copay, FSA, HSA, ACA, HDHP, HMO, PPO—the amount of jargon involved in health insurance can be overwhelming. That can lead to people being misinformed and making the wrong decisions about the type of coverage that’s best for them. I love being able to explain how different types of health plans work, what they cover and how costs are shared so people can choose the coverage that’s best for them.
Jason Metz Forbes Advisor Editor		As a former claims handler and fraud investigator, Jason Metz has worked on a multitude of complex and multifaceted claims. The insurance industry can be seemingly opaque, and Jason enjoys breaking down confusing terms and products to help others make well-informed decisions.
What inspires Jason: It’s easy to make rushed or uniformed health insurance decisions during open enrollment, then forget about it until the following year. I want to help people get a better understanding of what they’re choosing and hopefully save themselves some money and frustration in the long run.
Ashlee Valentine Forbes Advisor Editor		Ashlee Valentine is an insurance editor, journalist and business professional with an MBA and more than 17 years of experience in business and personal finance. She is passionate about empowering others to protect life’s most important assets. When Ashlee isn’t spreading insurance knowledge or solving television murder mysteries, she enjoys spending time with her family (including the furry and feathery ones) on their farm in Kentucky.
What inspires Ashlee: We all need it, but it isn’t always easy to know what we need, what plan to select and how to translate all the fine print. I enjoy our health insurance topics because they simplify health insurance topics that are often complex and overwhelming.

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