Appearance
CMS Public Use Files (PUF)
Path B data source — 21+DC state-based marketplace states
Overview
CMS publishes standardized Public Use Files containing all plan data for every state-based exchange (SBE). Combined with the federal APTC formula, these enable subsidized premium calculations identical to what each state's marketplace shows consumers.
Source: https://www.cms.gov/marketplace/resources/data/state-based-public-use-filesFormat: ZIP containing 6 CSVs per state Refresh: Annually (typically Q4 before open enrollment)
Files Per State
| File | Records (est.) | Key Fields | Critical? |
|---|---|---|---|
| Rate PUF | ~50K/state | plan_id, age, rating_area, premium | YES |
| Plan Attributes PUF | ~300/state | plan_id, metal_level, deductibles, CSR variants | YES |
| Benefits PUF | ~3K/state | plan_id, benefit_name, is_covered | Partial |
| Service Area PUF | ~500/state | issuer, county, zips, rating_area | YES |
| Network PUF | ~100/state | plan_id, network_url | Nice to have |
| Business Rules PUF | ~50/state | rating methodology | Low priority |
States Covered
CA, CO, CT, DC, GA, ID, IL, KY, ME, MD, MA, MN, NV, NJ, NM, NY, PA, RI, VT, VA, WA
Schema Notes
- CSR variants use plan ID suffixes:
-01(standard),-02(zero cost),-03(limited),-04(73% AV),-05(87% AV),-06(94% AV) - Rating areas are state-defined geographic regions. Mapping from zip → rating area requires parsing the Service Area PUF.
- Benefits PUF has coverage flags but NOT copay dollar amounts. Copay data comes from the Plan Attributes PUF SBC columns or requires SBC PDF parsing.
- Age-rated premiums in the Rate PUF are per-individual, per-age (0-64), per-plan, per-rating-area. Household premium = sum of individual premiums for each member.
Validated Against
- Covered California 2026 website — 10 scenarios, 4/6 marketplace scenarios within $0.44-$8.29
- See validation docs for full results
