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eHealth eyes subsidy-eligible enrollment, waits out usability flaws

By Healthcare Finance Staff

About a year after pitching the option of serving as "web-based" broker for insurance exchanges, eHealth Insurance is getting closer to helping sell Americans subsidized health plans.

In early December, eHealth completed a limited number of "test enrollments" through a web-based integration with Healthcare.gov to model enrollment of subsidy-eligible consumers in public exchange-approved health plans.

The company is still selling mostly non-subsidized health plans, and a fairly huge variety of them, about 2,300 available from 100 insurers in total. "However, we believe all Americans, including those who need a subsidy, deserve to have choices when they shop for health insurance, and their experience should be simple, stable and secure," chairman and CEO Gary Lauer said in a media statement.

"Since early December we've helped a limited number of customers use their subsidies to enroll in a health insurance plan through our web-broker entity integration with Healthcare.gov," Lauer said.

For the time being, though, eHealth is not enrolling subsidy-eligible consumers because, while the test enrollments were successful, "the integrated user experience did not meet eHealth's standards for stability and usability," Lauer said.

"The company is actively documenting and working closely with the federal government to address these issues, but because they lie outside of the eHealth domain, it cannot control the timeline for resolution. Additionally, the company cannot ensure that these issues will be resolved in any specific timeframe," Lauer said, noting that eHealth is notifying subsidy-eligible consumers and advising them to consider other options if the want an ACA-compliant plan by January 1, 2014.

Although the consumer experience is "not yet a stable, easy to use and scalable solution for the general public," Lauer is bullish on eHealth acting as an alternative enrollment channel in the long-run for Healthcare.gov and potentially state insurance exchanges (although the company hasn't partnered with any states yet).

To meet the Obama Administration's enrollment objectives, Lauer said, "it is clear to us that a better solution through the federal government to enroll subsidy-eligible individuals needs to be supported and accommodated quickly."

After getting approval from the Centers for Medicare & Medicaid Services in July to serve as a web-based broker, eHealth has been adding a number of features and redesigns for when it can sell subsidy-eligible plans.

Since October, ehealth has added an anonymous window shopping feature showing qualified health plans available in the 36 states governed by the federal exchange, a health plan comparison tool, a subsidy calculator, and the ability to chat with brokers.

The agreement with CMS spells out eHealth's access to the federal data hub linking CMS, states, the Internal Revenue Service and other federal agencies to verify applicants' identity and income. Once eHealth is comfortable with the user experience, it may also be able to receive commissions from insurers for enrolling consumers, like traditional agents and brokers.

Despite or perhaps because of the uncertainty over public health insurance exchanges, eHealth, a company that largely launched the insurance exchange industry, has had one of the best performing healthcare stocks of the year. Its stock is up 68 percent in 2013 and up more than a 150 percent since the Affordable Care Act became law.

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