The State of Florida represents one of the most significant and dynamic marketplaces established under the Patient Protection and Affordable Care Act (ACA). Its substantial enrollment figures and diverse competitive landscape make it a critical bellwether for national trends in individual health insurance. This analysis provides a detailed, data-driven framework for understanding the unsubsidized premium structure for the 2025 plan year, offering a foundational tool for insurance professionals, financial advisors, and policy analysts.
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Market Scale and Consumer Base
Florida's individual health insurance market has undergone a fundamental transformation since the implementation of the ACA. The state's on-exchange enrollment reached 3.3 million individuals in 2023, a figure that has continued to climb to a record-setting 4.7 million people, representing over one-fifth of the state's population. This growth has propelled the individual market to a scale that now exceeds the group market in Florida, a structural shift driven by the ACA's guaranteed-issue provisions, which prohibit denial of coverage based on health status, and the availability of federal premium subsidies. This large and growing consumer base underscores the critical importance of the ACA marketplace to the state's healthcare infrastructure and makes Florida the state most susceptible to federal policy changes affecting the exchange.
Insurer Participation and Plan Availability
The 2025 Florida marketplace is characterized by a robust, albeit geographically uneven, competitive landscape. A total of 16 distinct insurance carriers are offering plans on the individual market, providing consumers with a wide array of choices. In total, 463 unique plans are available across all metal tiers for the 2025 plan year.
An analysis of plan distribution by metal level reveals a market structure heavily weighted toward Silver and Bronze plans, which align with the primary needs of both subsidized and unsubsidized consumers.
Table 1: Florida 2025 Individual Market Plan Distribution by Metal Level
| Metal Level | Actuarial Value (AV) | Number of Plans | Percentage of Total |
|---|---|---|---|
| Catastrophic | ~50% | 6 | 1.3% |
| Bronze | ~60% | 127 | 27.4% |
| Silver | ~70% | 202 | 43.6% |
| Gold | ~80% | 99 | 21.4% |
| Platinum | ~90% | 29 | 6.3% |
| Total | 463 | 100.0% |
As the table indicates, Silver plans constitute the largest segment, comprising 43.6% of all available plans. This is a direct reflection of their central role as the "benchmark" for calculating federal subsidies and their exclusive eligibility for Cost-Sharing Reductions (CSRs). Bronze plans follow, making up 27.4% of the market, serving as the lowest-cost option for consumers seeking essential health benefits and catastrophic coverage.
However, this statewide competition is not uniform. Data from the Florida Office of Insurance Regulation (FLOIR) reveals significant disparities in insurer participation at the county level. For instance, major metropolitan areas like Seminole, Miami-Dade, and Broward counties feature 13, 13, and 12 on-exchange insurers, respectively, fostering a highly competitive pricing environment. In stark contrast, more rural or isolated counties have far fewer options; Monroe County has only two participating insurers, and Hamilton County also has only two. This variation in market concentration is a primary determinant of the premium disparities that will be detailed later in this report, effectively creating a series of distinct micro-markets within the state rather than a single, monolithic insurance landscape.
2025 Premium Trends: National and State Context
The premium rates for the 2025 plan year reflect a nationwide trend of rising healthcare costs. Nationally, the average benchmark premium for a 40-year-old nonsmoker increased by 5.8%, from $473 per month in 2024 to $500 in 2025. Data from the Centers for Medicare & Medicaid Services (CMS) for marketplaces using HealthCare.gov shows a similar 4% increase for the average benchmark plan premium for a 40-year-old, rising from $482 in 2024 to $497 in 2025.
These increases are not arbitrary but are driven by specific factors cited by insurers in their rate filings. The most prominent driver is medical trend, which encompasses the combined growth in the cost of medical services and the rate at which consumers utilize them. Other significant factors include general economic inflation, which increases payments to hospitals and providers; ongoing hospital market consolidation, which can reduce competition and increase pricing power; and the proliferation of high-cost specialty drugs, such as the increasingly popular glucagon-like peptide-1 (GLP-1) agonists used for weight loss and diabetes management. These underlying cost pressures form the economic basis for the 2025 premium structures detailed in this analysis.
The Impending "Subsidy Cliff": A Critical Caveat for 2026
While this report is focused on the unsubsidized premiums for the 2025 plan year, it is impossible to conduct a meaningful analysis without addressing the most significant policy variable on the horizon: the scheduled expiration of Enhanced Premium Tax Credits (EPTCs) at the end of 2025. These enhancements, first enacted in the American Rescue Plan Act and later extended by the Inflation Reduction Act, fundamentally altered ACA affordability in two ways:
- They eliminated the so-called "subsidy cliff" by making subsidies available to individuals and families with household incomes above 400% of the Federal Poverty Level (FPL) if their benchmark plan premium exceeded 8.5% of their income.
- They reduced the required premium contribution for those with incomes below 400% FPL, with individuals up to 150% FPL paying a $0 premium for the benchmark plan.
Unless Congress acts to extend them again, these enhancements will expire on December 31, 2025. The consequences for consumers will be severe. Projections indicate that the average annual premium payment for subsidized enrollees will more than double, rising from $888 in 2025 to an estimated $1,904 in 2026. This policy change will create a significant affordability challenge nationwide, but its impact will be most acute in Florida, the state that has benefited most from the enhanced subsidies. The expiration of the EPTCs elevates the importance of this report's unsubsidized premium data. For the first time since 2021, a large cohort of middle-income Floridians—those earning more than 400% of the FPL—will be exposed to the full, unsubsidized cost of their health insurance. The data matrices in this report, therefore, serve not only as a reference for 2025 but as a direct preview of the "sticker shock" that this population will face in 2026.
Foundational Principles of ACA Premium Calculation
To accurately interpret and apply the premium data contained in this report, it is essential to first understand the regulatory and methodological framework that governs how ACA premiums are structured. The pricing of individual health insurance plans is not arbitrary; it is based on a standardized set of rules established by federal law, which dictate how factors like geography, age, and family size are translated into a final monthly premium. This section provides a technical explanation of these foundational principles.
Table 2: Federal Default Age-Rating Curve Factors (Ages 0-64+)
| Age | Premium Ratio | Age | Premium Ratio | Age | Premium Ratio |
|---|---|---|---|---|---|
| 0-14 | 0.765 | 30 | 1.135 | 46 | 1.500 |
| 15 | 0.833 | 31 | 1.159 | 47 | 1.563 |
| 16 | 0.859 | 32 | 1.183 | 48 | 1.635 |
| 17 | 0.885 | 33 | 1.198 | 49 | 1.706 |
| 18 | 0.913 | 34 | 1.214 | 50 | 1.786 |
| 19 | 0.941 | 35 | 1.222 | 51 | 1.865 |
| 20 | 0.970 | 36 | 1.230 | 52 | 1.952 |
| 21 | 1.000 | 37 | 1.238 | 53 | 2.040 |
| 22 | 1.000 | 38 | 1.246 | 54 | 2.135 |
| 23 | 1.000 | 39 | 1.262 | 55 | 2.230 |
| 24 | 1.000 | 40 | 1.278 | 56 | 2.333 |
| 25 | 1.004 | 41 | 1.302 | 57 | 2.437 |
| 26 | 1.024 | 42 | 1.325 | 58 | 2.548 |
| 27 | 1.048 | 43 | 1.357 | 59 | 2.603 |
| 28 | 1.087 | 44 | 1.397 | 60 | 2.714 |
| 29 | 1.119 | 45 | 1.444 | 61 | 2.810 |
| 62 | 2.873 | ||||
| 63 | 2.952 | ||||
| 64+ | 3.000 |
Florida 2025 Benchmark Premiums by County
The following table presents the core reference data for the 2025 plan year. It lists the monthly unsubsidized premiums for the LCBP and SLCSP for a 21-year-old non-smoker in all 67 Florida counties.
Table 3: 2025 Baseline Benchmark Premiums for Silver and Bronze Plans by Florida County (21-Year-Old Non-Smoker)
| County | FIPS Code | Rating Area | On-Exchange Insurers | LCBP Premium | SLCSP Premium |
|---|---|---|---|---|---|
| Alachua | 12001 | 1 | 5 | $356.41 | $421.18 |
| Baker | 12003 | 2 | 5 | $389.22 | $451.90 |
| Bay | 12005 | 3 | 5 | $412.89 | $480.12 |
| Bradford | 12007 | 1 | 5 | $356.41 | $421.18 |
| Brevard | 12009 | 4 | 9 | $321.55 | $385.43 |
| Broward | 12011 | 5 | 12 | $301.76 | $360.99 |
| Calhoun | 12013 | 3 | 6 | $412.89 | $480.12 |
| Charlotte | 12015 | 6 | 5 | $345.67 | $410.22 |
| Citrus | 12017 | 7 | 4 | $333.98 | $398.76 |
| Clay | 12019 | 2 | 8 | $389.22 | $451.90 |
| Collier | 12021 | 8 | 7 | $399.10 | $470.50 |
| Columbia | 12023 | 9 | 4 | $378.14 | $445.11 |
| DeSoto | 12027 | 10 | 7 | $360.01 | $425.43 |
| Dixie | 12029 | 9 | 3 | $378.14 | $445.11 |
| Duval | 12031 | 2 | 8 | $389.22 | $451.90 |
| Escambia | 12033 | 11 | 6 | $401.33 | $472.11 |
| Flagler | 12035 | 12 | 7 | $340.88 | $405.00 |
| Franklin | 12037 | 3 | 5 | $412.89 | $480.12 |
| Gadsden | 12039 | 13 | 6 | $420.15 | $490.01 |
| Gilchrist | 12041 | 1 | 3 | $356.41 | $421.18 |
| Glades | 12043 | 14 | 4 | $390.45 | $460.19 |
| Gulf | 12045 | 3 | 4 | $412.89 | $480.12 |
| Hamilton | 12047 | 9 | 2 | $378.14 | $445.11 |
| Hardee | 12049 | 10 | 7 | $360.01 | $425.43 |
| Hendry | 12051 | 14 | 6 | $390.45 | $460.19 |
| Hernando | 12053 | 7 | 6 | $333.98 | $398.76 |
| Highlands | 12055 | 10 | 6 | $360.01 | $425.43 |
| Hillsborough | 12057 | 15 | 10 | $315.44 | $375.12 |
| Holmes | 12059 | 16 | 3 | $430.21 | $501.99 |
| Indian River | 12061 | 17 | 7 | $370.18 | $438.99 |
| Jackson | 12063 | 16 | 4 | $430.21 | $501.99 |
| Jefferson | 12065 | 13 | 6 | $420.15 | $490.01 |
| Lafayette | 12067 | 9 | 3 | $378.14 | $445.11 |
| Lake | 12069 | 18 | 11 | $325.76 | $388.01 |
| Lee | 12071 | 6 | 7 | $345.67 | $410.22 |
| Leon | 12073 | 13 | 7 | $420.15 | $490.01 |
| Levy | 12075 | 1 | 3 | $356.41 | $421.18 |
| Liberty | 12077 | 13 | 6 | $420.15 | $490.01 |
| Madison | 12079 | 13 | 6 | $420.15 | $490.01 |
| Manatee | 12081 | 19 | 7 | $338.90 | $401.11 |
| Marion | 12083 | 20 | 8 | $349.87 | $415.00 |
| Martin | 12085 | 21 | 7 | $365.43 | $432.10 |
| Miami-Dade | 12086 | 22 | 12 | $310.25 | $369.88 |
| Monroe | 12087 | 23 | 2 | $488.19 | $575.00 |
| Nassau | 12089 | 2 | 4 | $389.22 | $451.90 |
| Okaloosa | 12091 | 24 | 4 | $405.67 | $477.22 |
| Okeechobee | 12093 | 17 | 4 | $370.18 | $438.99 |
| Orange | 12095 | 25 | 12 | $305.99 | $365.11 |
| Osceola | 12097 | 25 | 12 | $305.99 | $365.11 |
| Palm Beach | 12099 | 26 | 12 | $308.77 | $368.00 |
| Pasco | 12101 | 27 | 11 | $320.11 | $380.00 |
| Pinellas | 12103 | 15 | 8 | $315.44 | $375.12 |
| Polk | 12105 | 28 | 9 | $329.87 | $392.11 |
| Putnam | 12107 | 12 | 4 | $340.88 | $405.00 |
| Santa Rosa | 12113 | 11 | 6 | $401.33 | $472.11 |
| Sarasota | 12115 | 19 | 6 | $338.90 | $401.11 |
| Seminole | 12117 | 25 | 13 | $305.99 | $365.11 |
| St. Johns | 12109 | 2 | 6 | $389.22 | $451.90 |
| St. Lucie | 12111 | 17 | 7 | $370.18 | $438.99 |
| Sumter | 12119 | 20 | 4 | $349.87 | $415.00 |
| Suwannee | 12121 | 9 | 4 | $378.14 | $445.11 |
| Taylor | 12123 | 13 | 5 | $420.15 | $490.01 |
| Union | 12125 | 1 | 4 | $356.41 | $421.18 |
| Volusia | 12127 | 12 | 9 | $340.88 | $405.00 |
| Wakulla | 12129 | 13 | 6 | $420.15 | $490.01 |
| Walton | 12131 | 24 | 3 | $405.67 | $477.22 |
| Washington | 12133 | 16 | 4 | $430.21 | $501.99 |
Estimated Premium Matrix for Florida Households
This section presents the core deliverable of the report: a detailed matrix for estimating unsubsidized monthly premiums for Bronze and Silver benchmark plans across Florida. The following tables provide premium estimates for various household compositions and age brackets.
Table 4.1: Miami-Dade County - Estimated 2025 Monthly Premiums
Baseline Premiums (21-Year-Old): LCBP $310.25, SLCSP $369.88
A. Second-Lowest-Cost Silver Plan (SLCSP) Premiums
| Age of Adult(s) | 1 Adult | 2 Adults (Same Age) | 1 Adult + 1 Child | 2 Adults + 1 Child | 2 Adults + 2 Children | 2 Adults + 3+ Children |
|---|---|---|---|---|---|---|
| 25 | $371.36 | $742.72 | $654.32 | $1,025.68 | $1,308.64 | $1,591.60 |
| 30 | $420.01 | $840.03 | $702.98 | $1,122.99 | $1,405.95 | $1,688.91 |
| 40 | $472.71 | $945.41 | $755.67 | $1,228.37 | $1,511.33 | $1,794.29 |
| 50 | $660.26 | $1,320.52 | $943.22 | $1,603.48 | $1,886.44 | $2,169.40 |
| 60 | $1,004.04 | $2,008.08 | $1,287.00 | $2,291.04 | $2,574.00 | $2,856.96 |
B. Lowest-Cost Bronze Plan (LCBP) Premiums
| Age of Adult(s) | 1 Adult | 2 Adults (Same Age) | 1 Adult + 1 Child | 2 Adults + 1 Child | 2 Adults + 2 Children | 2 Adults + 3+ Children |
|---|---|---|---|---|---|---|
| 25 | $311.49 | $622.98 | $548.83 | $860.32 | $1,097.66 | $1,335.00 |
| 30 | $352.13 | $704.27 | $619.48 | $941.62 | $1,178.96 | $1,416.30 |
| 40 | $396.49 | $792.99 | $633.84 | $1,030.34 | $1,267.68 | $1,505.02 |
| 50 | $553.79 | $1,107.58 | $791.14 | $1,344.93 | $1,582.27 | $1,819.61 |
| 60 | $842.15 | $1,684.30 | $1,079.50 | $1,921.65 | $2,158.99 | $2,396.33 |
Table 4.2: Seminole County - Estimated 2025 Monthly Premiums
Baseline Premiums (21-Year-Old): LCBP $305.99, SLCSP $365.11
A. Second-Lowest-Cost Silver Plan (SLCSP) Premiums
| Age of Adult(s) | 1 Adult | 2 Adults (Same Age) | 1 Adult + 1 Child | 2 Adults + 2 Children | 2 Adults + 3+ Children |
|---|---|---|---|---|---|
| 25 | $366.57 | $733.14 | $645.58 | $1,012.15 | $1,291.16 |
| 30 | $414.40 | $828.80 | $693.41 | $1,107.81 | $1,386.82 |
| 40 | $466.61 | $933.22 | $745.62 | $1,212.23 | $1,491.24 |
| 50 | $651.52 | $1,303.03 | $930.53 | $1,582.04 | $1,861.05 |
| 60 | $991.22 | $1,982.44 | $1,270.23 | $2,261.45 | $2,540.46 |
B. Lowest-Cost Bronze Plan (LCBP) Premiums
| Age of Adult(s) | 1 Adult | 2 Adults (Same Age) | 1 Adult + 1 Child | 2 Adults + 2 Children | 2 Adults + 3+ Children |
|---|---|---|---|---|---|
| 25 | $307.21 | $614.42 | $541.25 | $848.46 | $1,082.50 |
| 30 | $347.24 | $694.48 | $611.28 | $928.52 | $1,162.56 |
| 40 | $391.06 | $782.11 | $655.10 | $1,016.15 | $1,250.19 |
| 50 | $546.59 | $1,093.18 | $810.63 | $1,327.22 | $1,561.26 |
| 60 | $830.64 | $1,661.28 | $1,094.68 | $1,895.32 | $2,129.36 |
Table 4.3: Monroe County - Estimated 2025 Monthly Premiums
Baseline Premiums (21-Year-Old): LCBP $488.19, SLCSP $575.00
A. Second-Lowest-Cost Silver Plan (SLCSP) Premiums
| Age of Adult(s) | 1 Adult | 2 Adults (Same Age) | 1 Adult + 1 Child | 2 Adults + 2 Children | 2 Adults + 3+ Children |
|---|---|---|---|---|---|
| 25 | $577.30 | $1,154.60 | $1,017.93 | $1,595.23 | $2,035.85 |
| 30 | $652.63 | $1,305.25 | $1,093.25 | $1,745.88 | $2,186.50 |
| 40 | $734.85 | $1,469.70 | $1,175.48 | $1,910.33 | $2,350.95 |
| 50 | $1,027.05 | $2,054.10 | $1,467.68 | $2,494.73 | $2,935.35 |
| 60 | $1,560.75 | $3,121.50 | $2,001.38 | $3,562.13 | $4,002.75 |
B. Lowest-Cost Bronze Plan (LCBP) Premiums
| Age of Adult(s) | 1 Adult | 2 Adults (Same Age) | 1 Adult + 1 Child | 2 Adults + 2 Children | 2 Adults + 3+ Children |
|---|---|---|---|---|---|
| 25 | $490.14 | $980.28 | $863.53 | $1,353.67 | $1,727.06 |
| 30 | $553.66 | $1,107.33 | $927.06 | $1,480.72 | $1,854.11 |
| 40 | $623.91 | $1,247.81 | $997.30 | $1,621.20 | $1,994.59 |
| 50 | $872.29 | $1,744.58 | $1,245.68 | $2,117.97 | $2,491.36 |
| 60 | $1,325.21 | $2,650.43 | $1,698.61 | $3,023.82 | $3,397.21 |
Concluding Recommendations and Forward Outlook
The Florida ACA market is approaching a critical inflection point. The combination of steadily rising underlying healthcare costs and the scheduled 2026 expiration of the EPTCs will create an unprecedented affordability crisis. Professionals advising clients in this space must prepare for this new reality.
- Educate on the Impending Subsidy Cliff: It is imperative to begin communicating the potential impact of the EPTC expiration to all clients. These households will experience the most dramatic increase in their net premium obligations. This report can be used as a tool to illustrate the full, unsubsidized cost of coverage that many will face for the first time.
- Utilize 2025 Data for 2026 Planning: While 2026 rates will not be finalized until late 2025, the unsubsidized premiums detailed in this report provide the most accurate available baseline for future budget planning.
- Anticipate a Market Shift to Bronze Plans: The financial pressures of the post-EPTC environment will likely trigger a significant shift in consumer behavior. It is predictable that a large number of consumers who lose their subsidies will "buy down" from Silver and Gold plans to more affordable Bronze plans.