Data Sources

Overview

The Opelyx Health Plans API aggregates data from two primary sources to achieve 50-state + DC coverage:

Source	States	Format	Update Frequency
CMS Public Use Files (PUF)	30 FFM states	CSV/XLSX	Annual (plan year)
State-Based Marketplace data	21 SBM states	Varies by state	Annual (plan year)

FFM States (30)

The Federally Facilitated Marketplace (FFM) serves 30 states through HealthCare.gov. CMS publishes comprehensive Public Use Files each year containing:

• Plan Attributes PUF — Plan metadata, benefits, cost-sharing
• Rate PUF — Age-rated premiums by plan and rating area
• Service Area PUF — Geographic availability
• ZIP-Rating Area crosswalk — ZIP code to rating area mappings

These files are publicly available and cover all plans sold on the federal marketplace.

SBM States (21)

Twenty-one states plus DC operate their own marketplace exchanges:

CA, CO, CT, DC, GA, ID, IL, KY, MA, MD, ME, MN, NJ, NM, NV, NY, PA, RI, VA, VT, WA

Each SBM publishes data in its own format. Opelyx normalizes this data into the same schema as the FFM data, so the API interface is identical regardless of data source.

Note

Data availability and freshness may vary slightly between FFM and SBM states. The source field in ZIP lookup responses indicates whether data came from the federal (d1) or a state source.

Data Pipeline

1. Download — Raw PUF files and state exchange data are downloaded annually
2. Parse — CSV/XLSX files are parsed and validated
3. Normalize — SBM data is mapped to the CMS PUF schema
4. Load — Normalized data is loaded into the D1 database
5. Verify — Row counts, state coverage, and sample queries are validated

Current Dataset

Plan Year 2026:

• ~22,000 individual market plans
• ~1.4 million rate records
• 51 jurisdictions (50 states + DC)
• All metal levels (Catastrophic through Platinum)