Relative Cost of Coverage
At $451 per month, Maine’s average Bronze premium is the 14th highest among the fifty states—65 % above New Hampshire (the least-expensive state at $273) and 47 % below Vermont (the most-expensive at $854). Because Maine’s premiums are higher than the U.S. average and incomes are lower than the U.S. median, the premium represents 7.1 % of household income—higher than the national average of 6.3 %.
| Avg Premium | Premium / Household Income | |
|---|---|---|
| Maine | $451 | 7.1% |
| United States | $425 | 6.3% |
Variation Within the State
Within Maine, average Bronze premiums for a 30-year-old vary from $425 to $509 across counties—a roughly 1.2-to-1 swing in sticker price.
- One-quarter of Maine residents live in counties where the average 30-year-old Bronze plan is $425 or less, and three-quarters live where it’s $469 or less.
- The lowest average Bronze premiums for 30-year-olds are typically found in counties such as Cumberland ($425), Sagadahoc ($425), and York ($425), clustering along the southern coast.
- Conversely, the highest average premiums are seen in counties like Aroostook ($509), Hancock ($509), and Washington ($509), each in the state’s northern and down-east regions.
- In Cumberland, the state’s most populous county, the average Bronze premium for a 30-year-old is $425.
Variation by Age
Premiums rise slowly in early adulthood—gaining only about $1 a year from age 21 to 30 and another $5 a year through the 30s—then the “hockey-stick” kicks in. Once a Mainer turns forty, costs climb roughly $20 a year throughout the 40s, and after fifty they surge by about $37 a year, carrying Bronze rates past $1,000 a month by age 60. Silver and Gold plans follow the same pattern, just 20 % and 30 % higher at each step.
| Age | Average Bronze | Average Silver | Average Gold |
|---|---|---|---|
| 21 | $397 | $478 | $541 |
| 30 | $451 | $543 | $614 |
| 40 | $508 | $611 | $692 |
| 50 | $710 | $855 | $967 |
| 60 | $1,078 | $1,299 | $1,469 |
The Role of Premium Tax Credits
Premium Tax Credits (PTCs) limit the share of household income that is spent on a marketplace plan.
They equal the difference between (a) the premium of the benchmark Silver plan for an employee’s age and county and (b) a sliding-scale contribution tied to household income. Because benchmark premiums rise with age, PTCs rise more or less in step; because the required contribution shrinks as income falls, credits grow even faster for lower-paid workers.
When a company offers affordable coverage—whether through a group plan, an ICHRA, or a QSEHRA—the employee forfeits the credit. If the employer’s benefit isn’t meaningfully higher than the federal subsidy it replaces, neither the business nor the worker comes out ahead. In practice, we’ve found that when most employees qualify for about $200 or more per month in PTCs, an employer-funded plan rarely delivers additional value.
For Maine, that $200 mark is reached at roughly $49,000 of wages for a 30-year-old and about $54,000 for a 40-year-old. If most of your team sits above those thresholds, consider skipping an affordable plan—or design an HRA that is affordable for higher-paid staff but intentionally unaffordable for lower-paid or older employees, letting each person keep whichever option (company benefit or federal credit) leaves them better off.
Why HRAs Usually Outperform Small-Group Insurance
For most small employers in Maine, reimbursing individual-market premiums through an ICHRA or QSEHRA offers clear advantages over buying a traditional group contract:
• Lower structural cost – Individual carriers must meet an 80 % medical-loss ratio, publish rates, and pay lower commissions; small-group carriers face looser caps and higher commissions, which show up in premiums.
• Employee choice and portability – Each worker selects the network, deductible, and metal tier that fits their situation and keeps the policy when changing jobs.
• Budget control – Employers set a fixed allowance. Marketplace premiums move predictably, avoiding double-digit renewal shocks common in the group market.
• Simpler compliance – HRAs eliminate participation minimums and most COBRA or Form 5500 obligations, and they are just easier to administer.
Run the Numbers for Your Team
Salusion makes it easy to estimate healthcare costs.
Simply enter an employee’s age, zip code, and annual salary into Salusion’s Cost-of-Insurance Calculator, and instantly see average premiums for Bronze, Silver, and Gold individual plans. The calculator also provides an estimated premium tax credit based on the entered household income, and will also tell you whether a proposed HRA allowance is considered affordable for an ICHRA and a QSEHRA.
