get_exchange_plan_profile

Get Exchange Plan Profile

What it answers

One ACA Marketplace (healthcare.gov / HIX) plan's profile for a plan year, every field tagged with the CCIIO PUF it came from. Give plan_id (the 14-character HIOS standard component id, e.g. 38344AK1060001) for the plan: issuer, metal level, plan type (HMO/PPO/EPO/POS), Individual vs SHOP, on/off exchange, network, county footprint, premium benchmarks at age 21/40/60 (min across the plan's rating areas, plus the age-40 max), the per-age premium curve from the Rate PUF (include_rate_curve, default true), headline cost shares (PCP / specialist / ER / urgent care / generic drug copay, inpatient coinsurance), CMS quality stars, and the issuer's individual-market MLR. Or give state (+ optional plan_year, metal_level, issuer_id, plan_type, on_off_exchange) for the bounded list of that state's plans, cheapest age-40 premium first. plan_year defaults to the latest year held (PY2014-2026). Deductible / MOOP are returned as not_available (not in the composed profile). FFM states only: a state-based marketplace (CA, NY, PA, GA, ...) is absent at source and the tool says so rather than returning nothing silently.

Inputs

include_rate_curve

boolean · optional

default: true

issuer_id

any · optional

default: null

limit

any · optional

default: null

metal_level

any · optional

default: null

on_off_exchange

any · optional

default: null

plan_id

any · optional

default: null

plan_type

any · optional

default: null

plan_year

any · optional

default: null

state

any · optional

default: null

Call it

From an agent: connect the Vlada MCP once (one click for Claude, ChatGPT, Cursor, VS Code) and ask in plain English; the agent selects get_exchange_plan_profile when the question fits. From code: the same tool over REST with an API key. The schema endpoint needs no key.

curl -X POST https://api.vladahealth.com/v1/tools/get_exchange_plan_profile \
  -H "Authorization: Bearer $VLADA_API_KEY" \
  -H "Content-Type: application/json" \
  -d '{}'

curl https://api.vladahealth.com/v1/tools/get_exchange_plan_profile/schema      # the JSON schema, no auth
# MCP endpoint (Streamable HTTP): https://mcp.vladahealth.com/mcp

What comes back

Typed rows plus provenance on every answer: the public source file, its vintage, the methodology, and a response_hash you can replay. Prove and replay tools turn any number into a re-runnable receipt. A number the data cannot support comes back as “not in the data”, never as zero.

Output schema

{
 "$defs": {
  "Quality": {
   "description": "Row-level quality signal. All flags precomputed at build time\n(stored on the gold mart) and passed through here.",
   "properties": {
    "is_outlier": {
     "default": false,
     "title": "Is Outlier",
     "type": "boolean"
    },
    "is_ghost_candidate": {
     "default": false,
     "title": "Is Ghost Candidate",
     "type": "boolean"
    },
    "n_similar_rates": {
     "default": 0,
     "title": "N Similar Rates",
     "type": "integer"
    },
    "confidence": {
     "default": 1,
     "title": "Confidence",
     "type": "number"
    }
   },
   "title": "Quality",
   "type": "object"
  },
  "Source": {
   "description": "Cell-level provenance. Every served value traces back here.\n\n`snapshot_id` is the Iceberg snapshot the tool read from. Two calls\nat the same snapshot MUST produce byte-identical responses —\nthat's the content-addressed caching guarantee.",
   "properties": {
    "table": {
     "title": "Table",
     "type": "string"
    },
    "rate_id": {
     "anyOf": [
      {
       "type": "string"
      },
      {
       "type": "null"
      }
     ],
     "default": null,
     "title": "Rate Id"
    },
    "source_files": {
     "items": {
      "type": "string"
     },
     "title": "Source Files",
     "type": "array"
    },
    "snapshot_id": {
     "anyOf": [
      {
       "type": "integer"
      },
      {
       "type": "null"
      }
     ],
     "default": null,
     "title": "Snapshot Id"
    }
   },
   "required": [
    "table"
   ],
   "title": "Source",
   "type": "object"
  }
 },
 "properties": {
  "value": {
   "default": null,
   "title": "Value"
  },
  "unit": {
   "anyOf": [
    {
     "type": "string"
    },
    {
     "type": "null"
    }
   ],
   "default": null,
   "title": "Unit"
  },
  "vintage": {
   "anyOf": [
    {
     "type": "string"
    },
    {
     "type": "null"
    }
   ],
   "default": null,
   "title": "Vintage"
  },
  "source": {
   "$ref": "#/$defs/Source"
  },
  "methodology": {
   "anyOf": [
    {
     "type": "string"
    },
    {
     "type": "null"
    }
   ],
   "default": null,
   "title": "Methodology"
  },
  "quality": {
   "$ref": "#/$defs/Quality"
  },
  "invariants_applied": {
   "items": {
    "type": "string"
   },
   "title": "Invariants Applied",
   "type": "array"
  },
  "caveats": {
   "items": {
    "type": "string"
   },
   "title": "Caveats",
   "type": "array"
  },
  "response_hash": {
   "default": "",
   "title": "Response Hash",
   "type": "string"
  },
  "semantic_version": {
   "default": 1,
   "title": "Semantic Version",
   "type": "integer"
  },
  "tool_version": {
   "default": "unknown",
   "title": "Tool Version",
   "type": "string"
  },
  "explanation": {
   "anyOf": [
    {
     "type": "string"
    },
    {
     "type": "null"
    }
   ],
   "default": null,
   "title": "Explanation"
  },
  "status": {
   "default": "complete",
   "title": "Status",
   "type": "string"
  },
  "refusal": {
   "anyOf": [
    {
     "additionalProperties": true,
     "type": "object"
    },
    {
     "type": "null"
    }
   ],
   "default": null,
   "title": "Refusal"
  },
  "failure": {
   "anyOf": [
    {
     "additionalProperties": true,
     "type": "object"
    },
    {
     "type": "null"
    }
   ],
   "default": null,
   "title": "Failure"
  },
  "as_of": {
   "anyOf": [
    {
     "type": "string"
    },
    {
     "type": "null"
    }
   ],
   "default": null,
   "title": "As Of"
  },
  "freshness_state": {
   "default": "unknown",
   "title": "Freshness State",
   "type": "string"
  }
 },
 "title": "ExchangePlanProfileResponse",
 "type": "object"
}

Sources behind it

medicare_silver.fact_exchange_plan_profile
medicare_silver.fact_rate_puf

tables: medicare_silver.fact_exchange_plan_profile · medicare_silver.fact_rate_puf

Known limits

FFM (healthcare.gov) states only; state-based marketplaces are absent at source.
Deductible / MOOP are not in the composed profile (untyped raw JSON in the Plan Attributes PUF today) and are returned as not_available.
premium_age21/40/60 are the MIN across the plan's rating areas (age-40 MAX also given); county-grain premium needs the rating area (use rate_curve / the Rate PUF).
Cost shares are the base variant (-01) as filed; CSR variants differ. Quality only for CMS-rated plans in PY2023/2024/2026; MLR only PY2019-2024; PY2015 premiums thin at source; medical plans only (v1).

As of the 2026-09-19 build of the served surface · machine-readable catalog · the live server may run a different version; the schema endpoint above is authoritative for what is deployed.