Tools · Prototype
Carrier commissions by state
Per-member-per-month (PMPM) ACA commissions across carriers and states. Sort, filter, and drill into any carrier to see its full state breakdown.
Illustrative dataset for prototype purposes. Commission and PMPM values across various carrier-state combinations were extracted from public 2026 carrier schedules using AI-assisted parsing; specific values should be verified before use in production decisions. Methodology details available on request.
Market & payout overview
Addressable population · commission ranking
Market size by state
Addressable U65 population and demographic mix. U.S. Census ACS estimates.
| # | State | U65 population | Hispanic | Asian |
|---|---|---|---|---|
| 01 | CA California | 33.7M | 15.8M | 6.3M |
| 02 | TX Texas | 26.8M | 12.1M | 1.7M |
| 03 | FL Florida | 17.1M | 6.0M | 700K |
| 04 | NY New York | 16.6M | 4.0M | 2.0M |
| 05 | PA Pennsylvania | 10.7M | 1.1M | 510K |
| 06 | IL Illinois | 10.6M | 2.2M | 830K |
| 07 | OH Ohio | 9.7M | 520K | 310K |
| 08 | GA Georgia | 9.3M | 1.1M | 510K |
| 09 | NC North Carolina | 9.1M | 1.1M | 380K |
| 10 | MI Michigan | 8.2M | 560K | 380K |
| 11 | NJ New Jersey | 7.7M | 2.0M | 960K |
| 12 | VA Virginia | 7.3M | 910K | 680K |
| 13 | WA Washington | 6.7M | 1.0M | 900K |
| 14 | AZ Arizona | 6.1M | 2.4M | 270K |
| 15 | TN Tennessee | 5.9M | 520K | 150K |
| 16 | IN Indiana | 5.8M | 540K | 190K |
| 17 | MD Maryland | 5.2M | 700K | 420K |
| 18 | MO Missouri | 5.1M | 290K | 160K |
| 19 | CO Colorado | 5.0M | 1.3M | 230K |
| 20 | WI Wisconsin | 4.9M | 440K | 190K |
| 21 | MN Minnesota | 4.7M | 340K | 340K |
| 22 | SC South Carolina | 4.4M | 340K | 90K |
| 23 | AL Alabama | 4.0M | 250K | 80K |
| 24 | LA Louisiana | 3.8M | 280K | 100K |
| 25 | KY Kentucky | 3.7M | 210K | 90K |
| 26 | OR Oregon | 3.5M | 600K | 230K |
| 27 | OK Oklahoma | 3.3M | 480K | 110K |
| 28 | UT Utah | 3.1M | 500K | 100K |
| 29 | CT Connecticut | 2.9M | 640K | 190K |
| 30 | NV Nevada | 2.7M | 960K | 280K |
| 31 | IA Iowa | 2.6M | 230K | 100K |
| 32 | KS Kansas | 2.4M | 390K | 110K |
| 33 | MS Mississippi | 2.4M | 110K | 40K |
| 34 | NM New Mexico | 1.7M | 1.1M | 40K |
| 35 | NE Nebraska | 1.7M | 230K | 50K |
| 36 | ID Idaho | 1.6M | 250K | 30K |
| 37 | WV West Virginia | 1.5M | 40K | 20K |
| 38 | NH New Hampshire | 1.1M | 60K | 40K |
| 39 | ME Maine | 1.1M | 30K | 20K |
| 40 | MT Montana | 902K | 50K | 15K |
| 41 | DC District of Columbia | 580K | 80K | 35K |
| 42 | WY Wyoming | 471K | 60K | 10K |
Payout economics by state
Average new-business PMPM across all carriers and number of distinct carriers operating.
| # | State | Avg PMPM | Carrier choice |
|---|---|---|---|
| 01 | LA Louisiana | $25 | 2 |
| 02 | NC North Carolina | $24.75 | 4 |
| 03 | OK Oklahoma | $23.13 | 4 |
| 04 | NH New Hampshire | $23 | 1 |
| 05 | KY Kentucky | $22.5 | 2 |
| 06 | ME Maine | $22.5 | 2 |
| 07 | FL Florida | $21.83 | 6 |
| 08 | GA Georgia | $21.5 | 7 |
| 09 | MS Mississippi | $20.75 | 4 |
| 10 | IL Illinois | $20.2 | 5 |
| 11 | AL Alabama | $20 | 2 |
| 12 | AZ Arizona | $20 | 5 |
| 13 | PA Pennsylvania | $20 | 2 |
| 14 | WV West Virginia | $20 | 1 |
| 15 | NJ New Jersey | $19.5 | 2 |
| 16 | TN Tennessee | $19.4 | 5 |
| 17 | NE Nebraska | $19.33 | 3 |
| 18 | UT Utah | $19.33 | 3 |
| 19 | MO Missouri | $19.25 | 4 |
| 20 | CO Colorado | $19 | 4 |
| 21 | IA Iowa | $19 | 2 |
| 22 | TX Texas | $19 | 8 |
| 23 | NV Nevada | $19 | 4 |
| 24 | MI Michigan | $18.3 | 5 |
| 25 | IN Indiana | $18 | 4 |
| 26 | WY Wyoming | $18 | 1 |
| 27 | OR Oregon | $18 | 1 |
| 28 | MT Montana | $18 | 1 |
| 29 | KS Kansas | $17.5 | 2 |
| 30 | VA Virginia | $17.5 | 6 |
| 31 | MD Maryland | $16.25 | 4 |
| 32 | SC South Carolina | $16 | 3 |
| 33 | MN Minnesota | $16 | 1 |
| 34 | OH Ohio | $15.57 | 6 |
| 35 | WI Wisconsin | $14 | 5 |
| 36 | WA Washington | $13.25 | 4 |
| 37 | ID Idaho | $13 | 1 |
| 38 | DC District of Columbia | $13 | 2 |
| 39 | CA California | $12.33 | 3 |
| 40 | NM New Mexico | $12 | 2 |
| 41 | CT Connecticut | $5 | 2 |
| 42 | NY New York | $0 | 2 |
PMPY rates normalized ÷ 12. "% of premium" estimated using a $500 avg ACA premium. One-time bonuses excluded. U65 population estimates from U.S. Census ACS.
Carrier commission detail
Filter by product, state, or carrier
Used to convert "% of premium" rows into estimated PMPM. Leave blank to use per-state defaults.
Top 10 states by average commission
Mean PMPM across all carriers operating in the state
- 1.LouisianaLA$27.5
- 2.FloridaFL$26.9
- 3.South CarolinaSC$25.67
- 4.PennsylvaniaPA$25
- 5.North CarolinaNC$24.67
- 6.IllinoisIL$24.17
- 7.MontanaMT$24
- 8.TexasTX$23.75
- 9.NevadaNV$23.5
- 10.GeorgiaGA$23.3
Top 10 states by carrier choice
Number of distinct carriers offering ACA plans
- 1.FloridaFL10 carriers
- 2.GeorgiaGA10 carriers
- 3.TexasTX8 carriers
- 4.VirginiaVA7 carriers
- 5.ArizonaAZ6 carriers
- 6.IllinoisIL6 carriers
- 7.North CarolinaNC6 carriers
- 8.OhioOH6 carriers
- 9.TennesseeTN6 carriers
- 10.IndianaIN5 carriers
153 rows · avg $21.48 PMPM
On-exchange plans commission schedule
Last verified 2026-04-24
| State | Carrier | Est. PMPM | Notes | Actions |
|---|---|---|---|---|
| FLFlorida | Ambetter | $30 | — | |
| GAGeorgia | Ambetter | $30 | — | |
| LALouisiana | Ambetter | $30 | — | |
| PAPennsylvania | Ambetter | $30 | — | |
| SCSouth Carolina | Ambetter | $30 | — | |
| FLFlorida | Antidote Health | $30 | — | |
| TXTexas | Antidote Health | $30 | — | |
| MDMaryland | Carefirst | $28 | — | |
| DCDistrict of Columbia | Carefirst | $28 | — | |
| FLFlorida | Florida Blue | $28 | — | |
| FLFlorida | AvMed | $28 | — | |
| GAGeorgia | Antidote Health | $28 | — | |
| MOMissouri | BCBS KC | $27 | — | |
| NVNevada | Aetna CVS Health | $27 | — | |
| FLFlorida | UnitedHealthcare | $27 | — | |
| FLFlorida | Cigna | $27 | — | |
| FLFlorida | 22 Health Plan | $27 | — | |
| AZArizona | Aetna CVS Health | $26 | — | |
| GAGeorgia | Kaiser Permanente | $26 | 3 dependent cap | |
| ILIllinois | Ambetter | $25 | — | |
| NVNevada | Ambetter | $25 | BBSPs not eligible | |
| NCNorth Carolina | Ambetter | $25 | — | |
| OKOklahoma | Ambetter | $25 | — | |
| TXTexas | Ambetter | $25 | Premier $25 / Value $20 | |
| WAWashington | Ambetter | $25 | — | |
| KYKentucky | Anthem | $25 | — | |
| ILIllinois | BCBS IL | $25 | Tier 1 Blue Precision; max 5 members/policy | |
| MIMichigan | BCBS MI | $25 | — | |
| OKOklahoma | BCBS OK | $25 | — | |
| TNTennessee | BCBS TN | $25 | — | |
| FLFlorida | Aetna CVS Health | $25 | — | |
| TXTexas | Aetna CVS Health | $25 | — | |
| VAVirginia | Carefirst | $25 | — | |
| FLFlorida | Oscar | $25 | Min 10 lives | |
| GAGeorgia | Oscar | $25 | Min 10 lives | |
| ILIllinois | Oscar | $25 | — | |
| NCNorth Carolina | Oscar | $25 | — | |
| TXTexas | Oscar | $25 | — | |
| GAGeorgia | UnitedHealthcare | $25 | — | |
| LALouisiana | UnitedHealthcare | $25 | — | |
| NCNorth Carolina | UnitedHealthcare | $25 | — | |
| TXTexas | UnitedHealthcare | $25 | — | |
| NCNorth Carolina | Cigna | $25 | — | |
| MTMontana | BCBS MT | $24 | — | |
| NENebraska | BCBS NE | $24 | — | |
| NCNorth Carolina | BCBS NC | $24 | On & Off Marketplace | |
| SCSouth Carolina | BCBS SC | $24 | — | |
| GAGeorgia | Aetna CVS Health | $24 | — | |
| NCNorth Carolina | Aetna CVS Health | $24 | — | |
| ILIllinois | Aetna CVS Health | $24 | — | |
| WAWashington | Molina | $24 | — | |
| NMNew Mexico | Molina | $24 | — | |
| ILIllinois | UnitedHealthcare | $24 | — | |
| NHNew Hampshire | Anthem | $23 | — | |
| TXTexas | BCBS TX | $23 | Blue Advantage; $20 if <26 policies | |
| SCSouth Carolina | UnitedHealthcare | $23 | — | |
| WIWisconsin | Common Ground | $23 | — | |
| NVNevada | Anthem | $22 | — | |
| VAVirginia | Aetna CVS Health | $22 | — | |
| OHOhio | Aetna CVS Health | $22 | — | |
| GAGeorgia | CareSource | $22est | 4% of premium pre-APTC | |
| CACalifornia | Molina | $22 | — | |
| TXTexas | Molina | $22 | — | |
| FLFlorida | Molina | $22 | — | |
| MIMichigan | Molina | $22 | — | |
| UTUtah | Molina | $22 | — | |
| AZArizona | Cigna | $22 | — | |
| ILIllinois | Cigna | $22 | — | |
| INIndiana | Cigna | $22 | — | |
| MSMississippi | Cigna | $22 | — | |
| TNTennessee | Cigna | $22 | — | |
| VAVirginia | Cigna | $22 | — | |
| MIMichigan | Ambetter | $21 | — | |
| OHOhio | CareSource | $21 | Rating Areas 1 & 11: $10 PMPM; rest of OH: $21 | |
| ALAlabama | Ambetter | $20 | — | |
| AZArizona | Ambetter | $20 | — | |
| DEDelaware | Ambetter | $20 | — | |
| INIndiana | Ambetter | $20 | — | |
| IAIowa | Ambetter | $20 | — | |
| KSKansas | Ambetter | $20 | — | |
| KYKentucky | Ambetter | $20 | — | |
| MSMississippi | Ambetter | $20 | — | |
| MOMissouri | Ambetter | $20 | — | |
| NENebraska | Ambetter | $20 | — | |
| NHNew Hampshire | Ambetter | $20 | — | |
| NJNew Jersey | Ambetter | $20 | — | |
| OHOhio | Ambetter | $20 | — | |
| TNTennessee | Ambetter | $20 | — | |
| GAGeorgia | Anthem | $20 | 5 member cap per policy | |
| INIndiana | Anthem | $20 | — | |
| MEMaine | Anthem | $20 | 3 member cap per policy | |
| MOMissouri | Anthem | $20 | — | |
| OHOhio | Anthem | $20 | 2 member cap per policy | |
| VAVirginia | Anthem | $20 | — | |
| NVNevada | CareSource | $20 | + $100 one-time new business bonus | |
| WVWest Virginia | CareSource | $20 | — | |
| WIWisconsin | CareSource | $20 | — | |
| ALAlabama | Oscar | $20 | — | |
| AZArizona | Oscar | $20 | — | |
| IAIowa | Oscar | $20 | — | |
| KSKansas | Oscar | $20 | — | |
| MIMichigan | Oscar | $20 | — | |
| MOMissouri | Oscar | $20 | — | |
| MSMississippi | Oscar | $20 | — | |
| NENebraska | Oscar | $20 | — | |
| NJNew Jersey | Oscar | $20 | — | |
| OKOklahoma | Oscar | $20 | — | |
| PAPennsylvania | Oscar | $20 | — | |
| ALAlabama | UnitedHealthcare | $20 | — | |
| AZArizona | UnitedHealthcare | $20 | — | |
| COColorado | UnitedHealthcare | $20 | — | |
| NENebraska | UnitedHealthcare | $20 | — | |
| OHOhio | UnitedHealthcare | $20 | — | |
| OKOklahoma | UnitedHealthcare | $20 | — | |
| COColorado | Cigna | $20 | — | |
| MDMaryland | UnitedHealthcare | $19 | — | |
| MIMichigan | UnitedHealthcare | $19 | — | |
| MSMississippi | UnitedHealthcare | $19 | — | |
| MOMissouri | UnitedHealthcare | $19 | — | |
| NJNew Jersey | UnitedHealthcare | $19 | — | |
| TNTennessee | UnitedHealthcare | $19 | — | |
| VAVirginia | UnitedHealthcare | $19 | — | |
| WIWisconsin | UnitedHealthcare | $19 | — | |
| ARArkansas | Ambetter | $18 | — | |
| COColorado | Anthem | $18 | 5 member cap per policy | |
| AZArizona | BCBS AZ | $18 | — | |
| OHOhio | Oscar | $18 | — | |
| TNTennessee | Oscar | $18 | — | |
| VAVirginia | Oscar | $18 | — | |
| IAIowa | UnitedHealthcare | $18 | — | |
| WAWashington | UnitedHealthcare | $18 | — | |
| WYWyoming | UnitedHealthcare | $18 | — | |
| GAGeorgia | Alliant Health | $18 | — | |
| TNTennessee | Alliant Health | $18 | — | |
| COColorado | Kaiser Permanente | $18 | — | |
| OROregon | Kaiser Permanente | $18 | 3 dependent cap | |
| NMNew Mexico | UnitedHealthcare | $17 | — | |
| DCDistrict of Columbia | Kaiser Permanente | $16 | — | |
| MDMaryland | Kaiser Permanente | $16 | — | |
| VAVirginia | Kaiser Permanente | $16 | — | |
| MNMinnesota | Quartz | $16 | — | |
| WIWisconsin | Quartz | $16 | — | |
| CACalifornia | Anthem | $15 | — | |
| WIWisconsin | Anthem | $15 | — | |
| INIndiana | CareSource | $15 | — | |
| INIndiana | UnitedHealthcare | $15 | — | |
| KSKansas | UnitedHealthcare | $15 | — | |
| GAGeorgia | Cigna | $15 | — | |
| TXTexas | Cigna | $15 | — | |
| WAWashington | Kaiser Permanente | $15 | $180/yr; ~$15 PMPM equivalent | |
| CACalifornia | Kaiser Permanente | $12 | — | |
| CTConnecticut | Anthem | $10 | 2 member cap per policy | |
| NYNew York | Anthem | NA | Not paid 2026 |
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