Mississippi was one of a few states to operate a hybrid exchange model, but the state's own small business exchange, One Mississippi, stopped accepting enrollees and transitioned to HealthCare.gov. The federal government continues to run the state's individual insurance exchange. Competition is healthy as four MCOs (Molina, Ambetter, Cigna, and Vantage Health Plan) offer plans. Meanwhile, the state is still a Medicaid expansion holdout. Medicare premium rates remained flat. Self-insured plans are responsible for most of the off-exchange growth in overall commercial enrollment, though there was a slight increase in fully-insured plans enrollment in the last cycle.