Blog · For Employers
Why 9 Ohio Counties Pay the Exact Same Premium
A company in Columbus and a company in Fayette County, ninety minutes south, are quoted exactly the same lowest-cost health insurance premiums for plan year 2026. Not similar. Identical, to the cent. Nine Ohio counties share that one price list, and it is not a data error.
The quick answer
Ohio sets health insurance premiums by rating area, not by county. Carriers file rates for a geographic area and every county inside it gets the same pricing. For plan year 2026 Ohio's 88 counties resolve to just 37 distinct premium tables. 19 counties have one to themselves; the rest share.
This matters commercially for one reason: if you are comparing quotes with a peer company one county over, you are not looking at a different market. You are looking at the same price list.
Nine counties, one premium
The largest shared group in Ohio contains 9 counties, and it includes both the state's biggest employment centre and some of its smallest.
| County | Population | Silver age-50 gap | Largest target sector |
|---|---|---|---|
| Franklin | 1,318,149 | $885 | Professional Services (6,801) |
| Delaware | 216,074 | $885 | Professional Services (1,406) |
| Licking | 178,844 | $885 | Construction (452) |
| Fairfield | 159,371 | $885 | Healthcare (436) |
| Union | 63,411 | $885 | Construction (150) |
| Pickaway | 58,809 | $885 | Construction (116) |
| Logan | 46,098 | $885 | Healthcare (97) |
| Madison | 43,961 | $885 | Construction (150) |
| Fayette | 28,901 | $885 | Construction (59) |
Franklin County has 1,318,149 residents and Fayette County has 28,901. Their health insurance prices are the same number.
Why Ohio prices this way
The ACA lets each state divide itself into rating areas, and carriers file one set of rates per area rather than per county. Ohio drew its areas around metropolitan statistical areas and groupings of the remaining counties, so a large metro pulls its surrounding counties into its pricing.
Small group coverage works the same way and adds community rating on top: your renewal reflects the claims experience of the whole small group pool in your area, not only your own workforce. That is why a healthy year for your team does not reliably produce a flat renewal.
What actually differs between them
The employer base, and it differs enormously. Inside that nine-county group, Franklin County has about 6,801 professional services establishments; Fayette County's largest target sector has 59. Same premiums, completely different market to sell into and hire from.
This is also why our own county pages repeat a figure across neighbours, and we would rather say so than present a shared number as if it were unique to one county.
What this changes for your company
- Moving offices within a rating area does not change your premiums. Crossing into a different area can.
- Staff spread across the area price the same. An employee in Fayette County shops the same marketplace prices as one in Franklin.
- Your competitors face identical economics. Whatever your benefits cost, the firm one county over is working from the same price list.
- The premium is not the whole decision. Census, ages, family mix and contribution strategy are company-specific, and two firms in one rating area can reach opposite conclusions.
Method and sources
Individual-market premiums come from the CMS Marketplace Public Use Files for plan year 2026. Small group benchmarks come from Ideon for the same plan year. Counties are grouped here when all six of their metal tier and age combinations match exactly, not when a single headline figure happens to round to the same number.
All figures are plan year 2026 estimates, expressed as ranges, and are not quotes, offers of insurance or guarantees of savings. Actual results depend on your employee census, ages, family composition, plan design and contribution strategy.
Questions
Why do neighbouring Ohio counties show identical health insurance premiums?
Because Ohio sets premiums by rating area, not by county. Carriers file rates for a geographic area, and every county inside it gets the same lowest-cost plan pricing. For plan year 2026 Ohio's 88 counties resolve to 37 distinct premium tables, so a figure you see for one county very often applies to several of its neighbours.
Which Ohio counties share Franklin County’s premiums?
Delaware, Licking, Fairfield, Union, Pickaway, Logan, Madison, Fayette. All nine carry the same lowest-cost individual and small group premiums for plan year 2026, so the same estimated $484–$885 per employee per month gap applies across tiers and ages in each of them.
If the premium is the same, does the ICHRA decision come out the same too?
Not necessarily. The premium is one input. Your census, ages, family mix, plan design and contribution strategy are the others, and those are company-specific. Two companies in the same rating area can reach opposite conclusions.
Do any Ohio counties have premiums of their own?
Yes. 19 of the 88 have a premium table that no other Ohio county we price matches exactly for plan year 2026.