Total Completed Applications and Individuals Who Completed Applications in States Using the HealthCare.gov Platform, By State, 2015
11-15-2014 to 12-15-2014
|Description||Total Number of Completed Applications for 2015 Coverage
|Total Individuals Applying for 2015 Coverage in Completed Applications (3)||Individuals Applying for 2015 Coverage
in Completed Applications By Status
|Have Selected a 2015 Marketplace Plan
|Have Been Determined Eligible to Enroll, but Have Not Selected a 2015 Marketplace Plan (5)||Have Been Determined or Assessed Eligible for Medicaid/CHIP (6)||Pending / Other
|Number||Number||% of Total||% of Total||% of Total||% of Total|
|States Using the HealthCare.gov Platform|
|State-Based Marketplaces (SBMs) Using the HealthCare.gov Platform (8)|
|Subtotal - SBMs Using the HealthCare.gov Platform||157,320||234,863||56%||14%||20%||11%|
|Federally-Facilitated Marketplace (FFM) States|
|TOTAL – States Using the HealthCare.gov Platform||3,392,182||4,990,439||68%||19%||9%||3%|
“N/A” means that the data for the respective metric are not yet available for a given state.
(1) Unless otherwise noted, the data in this table represent cumulative Marketplace enrollment-related activity for 11-15-14 to 12-15-14. These data also do not include any enrollment-related activity relating to individuals who may have applied for and/or selected a 2014 Marketplace plan during the reporting period, as a result of having been granted a Special Enrollment Period (SEP). This table only reflects data for the individual market Marketplaces. For additional technical notes, please refer to Appendix C of this report.
(2) “Completed Applications for 2015 Coverage” represents the total number of electronic and paper applications that were submitted to the Marketplace during the reference period with sufficient information to begin performing eligibility determinations for enrollment in a plan through the Marketplace and, if appropriate, sufficient information to begin performing eligibility determinations for advance payments of the premium tax credit and cost-sharing reductions, and eligibility assessments or determinations for Medicaid and CHIP.
(3) “Individuals Applying for 2015 Coverage in Completed Applications” represents the total number of individuals included in Completed Applications that were submitted to the Marketplaces during the applicable reference period. This number does not include individuals applying through the SHOP.
(4) “Has Selected a 2015 Marketplace Plan” represents the percentage of “Individuals Applying for 2015 Coverage in Completed Applications” who have selected a 2015 Marketplace medical plan for enrollment through the Marketplaces (with or without the first premium payment having been received directly by the Marketplaces or the issuer) during the reference period. This is also known as pre-effectuated enrollment. These data do not include: cancellations and terminations; standalone dental plan selections; or individuals who may have selected a 2014 Marketplace plan during the reporting period, as a result of having been granted a Special Enrollment Period (SEP).
(5) “Has Been Determined Eligible to Enroll, But Has Not Selected a 2015 Marketplace Plan” represents the percentage of “Individuals Applying for 2015 Coverage in Completed Applications” who have been determined eligible to enroll in a 2015 Marketplace plan, but have not yet selected a 2015 Marketplace medical plan.
(6) “Has Been Determined or Assessed Eligible for Medicaid / CHIP” represents the percentage of “Individuals Applying for 2015 Coverage in Completed Applications” who have been determined or assessed by the Marketplace as eligible for Medicaid or CHIP, based on their modified adjusted gross income (MAGI). In some states, completed applications for individuals, whom the Marketplace has assessed as potentially eligible for Medicaid or CHIP based on MAGI, are transferred to the relevant state agency for a final eligibility determination. In these “assessment states” the data include those accounts where a final decision is pending. In other states, the Marketplace has been delegated the final Medicaid/CHIP eligibility determination responsibility for these individuals. Thus, this data element includes FFM determinations and assessments, regardless of the state Medicaid/CHIP agency’s final eligibility determination, if applicable. These data may vary from accounts transferred via “flat file” to states by the FFM. Quality assurance continues on Medicaid assessments and determinations. Note: Marketplace Medicaid/CHIP eligibility determination and assessment data in this report cannot be added to eligibility determination data in the most recent monthly Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment report (available on Medicaid.gov), which covers data from October 2014. In the Marketplaces, some of the individuals assessed or determined eligible for Medicaid or CHIP by the Marketplace and reported in this report may also be reported in the monthly Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Report when the state has made an eligibility determination based on the information provided by the Marketplace. Total Medicaid & CHIP enrollment is reported in the monthly Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Report, and is a point-in-time count of total enrollment in the Medicaid and CHIP programs at the end of the monthly reporting period.
(7) “Pending/Other” is a derived estimate representing the percentage of “Individuals Applying for 2015 Coverage in Completed Applications” who either: 1) have a pending eligibility determination or assessment for a Marketplace plan or Medicaid/CHIP coverage; 2) have a completed eligibility determination or assessment for a Marketplace plan or Medicaid/CHIP coverage that is not captured in the relevant column in this table for a given state due to system issues; or 3) have been deemed ineligible for Marketplace plan coverage. The Pending/Other totals shown in this table are based on the sums of the corresponding state-level Pending/Other counts, which may differ slightly from the difference between the total number of individuals applying for coverage in completed applications and the total number of individuals with processed eligibility determinations.
(8) Nevada, New Mexico, and Oregon are using the HealthCare.gov platform for 2015.
Source: Centers for Medicare & Medicaid Services, as of 12-23-2014.