Open Enrollment Begins at eHealth on October 1
MOUNTAIN VIEW, CA, September 30, 2013 – On the eve of the new open enrollment period, eHealth, Inc. (NASDAQ: EHTH), parent company of eHealthInsurance.com, the nation's leading private online health insurance exchange for individual and family health insurance, announced that on October 1, 2013 it will be offering new health insurance plans that meet the requirements of the Affordable Care Act (ACA) for consumers not eligible for Federal subsidies. Consumers can start researching, comparing and enrolling in these plans for coverage with a January 1, 2014 effective date or later.
In addition, eHealth continues to work with the Federal government to launch subsidy-eligible qualified health plan enrollment capabilities for the states where the Federal government is operating an exchange. These subsidy-eligible plan options will not be available at eHealth until eHealth’s integration with the Federally-facilitated exchange (FFE) is completed and tested. eHealth has received necessary information for this implementation from the Centers for Medicare and Medicaid Services (CMS), the federal agency responsible for operating the FFE, but received it later than anticipated and is currently in the process of integration and testing. The company is working with CMS to provide eHealth customers access to subsidy-eligible plans during the new open enrollment period, in time for January 1, 2014 effective date coverage.
The first-ever open enrollment period for individual and family health insurance plans under the ACA begins October 1, 2013 and ends March 31, 2014. The new provisions of the ACA, also known as Obamacare, that become available in January, 2014 include the following:
- Pre-existing Condition Coverage: Anyone, in any state, can apply for a private, individual health insurance plan without worrying that their application may be declined because they have a pre-existing medical condition.
- Mandate: The “individual mandate” provision of the ACA will require most people without employer-based coverage to buy it on their own, or pay a tax penalty.
- Essential health benefits: ACA plans are required to include essential health benefits such as emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services; prescription drugs; preventive and wellness services and chronic disease management pediatric services, including oral and vision care; and more.
- Subsidies: Depending on income level, the ACA provides subsidies to make coverage more affordable for individuals and families who are required to buy it on their own.
Throughout the new open enrollment period, consumers will have a variety of health plans, enrollment resources and tools available to them through eHealth as they go through their decision-making process. These include:
2013 effective-date plans: Individuals and families wishing to enroll in major medical plans that are effective in 2013 will continue to find these plans available from major health insurance carriers. Consumers without current coverage will be able to enroll in 2013 effective-date plans as late as mid-December, depending on the health insurance carrier. These plans will still require medical underwriting and will not include all of the ACA-mandated benefits of 2014 plans. However, consumers may find that these plans more affordably meet their health care needs, depending upon their personal circumstances.
New non-subsidy-eligible, ACA-compliant plans: eHealth will have over 1,500 new ACA-compliant major medical plans from over 150 leading carriers nationwide available for enrollment on eHealthInsurance.com on October 1. These plans will include the essential health benefits as required by the ACA and are available for consumers not eligible for subsidies. Consumers will also be able to enroll in supplemental coverage such as dental, vision, accident, critical illness and others.
Subsidy-eligible plans: eHealth has entered into agreements with CMS that are necessary to enable the company to use its website as a Web-broker entity (WBE) to enroll individuals into subsidy-eligible qualified health plans (QHPs) through the FFE. Before launching this capability, eHealth needs to complete its technical integration with the FFE and implement a QHP shopping experience on its internet platform. eHealth will not be ready to enroll consumers in qualified health plans through the FFE on October 1 because of delays in receiving key information from CMS. eHealth is working with CMS to achieve full integration as soon as possible and will update customers regarding this availability.
Enrollment Resources and Tools:
Education resources: eHealth recently launched a new resource center designed to help consumers learn about the ACA and how to enroll in coverage after health care reform. The ACA Resource Center provides an open enrollment timeline and a broad selection of easy-to-understand videos, articles, and answers to frequently asked questions (FAQs) and a subsidy calculator to help estimate subsidy eligibility for government assistance in purchasing coverage.
Enrollment assistance: To provide consumers with unbiased advice on health plan decisions, eHealth’s customer care centers are staffed with licensed professionals, available via phone 8:00am – 12:00am ET and via email or chat 24/7. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia.
Mobile health insurance exchange: eHealth also offers consumers the ability to begin their health plan shopping on their smartphone or tablet device, either through its mobile-ready website or eHealth’s iPhone and Android-compatible mobile app. For more information, go to https://www.ehealthinsurance.com/mobile-health-insurance.
“October 1 is a significant and historic day for consumers because it’s the first nation-wide open enrollment period in America’s history,” said Gary Lauer, Chairman and CEO of eHealth. “This open enrollment marks the first time that anyone, in any state, can apply for a private, major medical individual health insurance plan, without worrying that their application may be declined because they have a pre-existing medical condition. Consumers will have six months to review their options and find the best plan for themselves or their family. We recommend that they take the time to do their research and ask lots of questions – eHealth is here and ready to help them.”
“We also look forward to soon providing subsidy-eligible plans to consumers in the states supported by the Federal exchange,” Lauer continued. “While we’re not able to offer these today as a result of delays in our receipt of information from the Federal government, we are working closely with the Federal government to implement this capability.”
“With the states that are building their own exchange, we continue to discuss solutions that will allow their subsidy-eligible residents to utilize resources like eHealth for enrollment,” said Lauer.
To learn more about open enrollment and the Affordable Care Act, visit eHealth’s new ACA Resource Center at www.ehealthinsurance.com/affordable-care-act.
eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, the nation's first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 200 of the nation's leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com.
For more health insurance news and information, visit the eHealth consumer blog: Get Smart – Get Covered.
This press release contains forward-looking statements, including statements regarding the availability of ACA-compliant health insurance plans and the timing of such availability; the availability of subsidy-eligible QHPs from eHealth and the timing of such availability; conditions to the availability of subsidy-eligible QHPs from eHealth; the timing and duration of the open enrollment period; the availability of health plans, enrollment resources and tools through eHealth throughout the open enrollment period; the availability of 2013 plans from eHealth and the ability of consumers without coverage to enroll in such plans; the availability of ACA-compliant major medical plans from over 150 carriers on October 1, 2013 and the benefits available under these plans; and the ability of consumers to enroll in supplemental coverages. These forward-looking statements involve certain risks and uncertainties that could cause actual results to differ materially from those indicated in such forward-looking statements, including, but not limited to, eHealth’s ability to maintain its relationships with insurance carriers; eHealth receipt of government permission to enroll individuals into QHPs; eHealth’s ability to enroll individuals in QHPs through the FFE; eHealth’s ability to timely satisfy and continued satisfaction of conditions and requirements contained in its agreements with CMS and in applicable laws, regulations and regulatory guidance, including without limitation, strict privacy and security rules that require the implementation of new policies and practices; potential changes in laws, regulations and regulatory guidance; eHealth’s development of a compliant web platform incorporating applicable CMS and other legal and regulatory requirements; eHealth’s ability to obtain qualified health plan information from eHealth’s health insurance carrier partners and CMS and incorporate it into its web platform; eHealth’s ability to successfully integrate with the FFE; the government’s readiness to allow enrollment from eHealth through the FFE; political opposition to the implementation and funding of the Affordable Care Act and eHealth’s ability to timely meet the applicable requirements and potential changes in laws, regulations and regulatory guidance. eHealth cannot assure that it will be able to enroll individuals into qualified health plans within any specific time frame. Other risks and uncertainties that can affect actual results are included under the captions “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in eHealth’s Annual Report on Form 10-K for the year ended December 31, 2012 and most recent Quarterly Report on Form 10-Q, which are on file with the SEC and are available on the investor relations page of eHealth’s website at http://www.ehealthinsurance.com and on the Securities and Exchange Commission’s website at www.sec.gov. All information provided in this press release is as of the date of this press release, and we undertake no duty to update this information unless required by law. In addition, the discussion of aspects of the Affordable Care Act and related regulations are merely summaries, are not complete and are qualified by reference to the Affordable Care Act.
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