Individual Health Volume May Be Doing This Shocking Thing

October 11, 2019 at 01:57 AM
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George Kalogeropoulos (Photo: HealthSherpa) George Kalogeropoulos (Photo: HealthSherpa)

The head of a web-based health insurance broker is seeing early signs that 2020 individual health sales could be strong.

The regular open enrollment period for 2020 coverage will not start until Nov.1, but some consumers who have gone through major life changes can qualify to buy coverage through special enrollment periods.

George Kalogeropoulos, the chief executive officer of HealthSherpa, said in an email interview that HealthSherpa's Affordable Care Act (ACA) public exchange plan application submission volume was about twice as high this September as it was in September 2018.

The increase in volume could be due at least partly to HealthSherpa's own performance.

But the increase is probably not due to competitors pulling out of the ACA exchange plan market: Kalogeropoulos said the current list of ACA exchange plan web brokers appears to be similar to the list of web brokers who were in the market a year ago.

One change is a move by the Centers for Medicare and Medicaid Services (CMS) to add a new, streamlined Enhanced Direct Enrollment (EDE) system for web brokers that connect with the HealthCare.gov public exchange enrollment and account administration system.

The EDE system gives web brokers, and web brokers' affiliated agents and brokers, a way to enroll consumers directly in ACA exchange plan coverage with ACA premium tax credit subsidies.

In the past, web brokers had to pass consumers who qualified for ACA exchange plan subsidies over to HealthCare.gov.

Kalogeropoulos said the EDE is speeding up the enrollment process.

"The time it takes a consumer to renew their insurance on our site has gone from an average of 50 minutes to an average of only 15 minutes," Kalogeropoulos said.

HealthSherpa is now using the EDE system for 12 coverage issuers.

HealthSherpa has handled about 250,000 EDE apps this year, and that probably represents about 90% of HealthCare.gov's EDE application volume, Kalogeropoulos said.

Another change this year is the availability of short-term health insurance policies that can stay in force up to 364 days.

HealthSherpa has not been selling short-term health insurance, because its typical customer can use ACA premium tax credit subsidies to cut the net out-of-pocket of premiums for ACA-compliant major medical coverage to an average of $35 per month, Kalogeropoulos said.

But the issuers of short-term health insurance are offering high commissions, and some other web brokers are selling short-term health insurance, Kalogeropoulos said.

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