Health Insurance Marketplace 2015 Open Enrollment Period: January Enrollment Report

This issue brief highlights available national and state-level enrollment-related information for the first two months of the Health Insurance Marketplace 2015 open enrollment period (11-15-14 to 1-16-15) for all 50 states and the District of Columbia.

For the period: November 15, 2014 – January 16, 2015¹
January 27, 2015

Department of Health and Human Services
Office of the Assistant Secretary for Planning and Evaluation

 

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¹ Most of the data in this report are for the 11-15-14 to 1-16-15 reporting period with the following exceptions: the data for the State-Based Marketplaces that are using their own Marketplace platforms are for 11-15-14 to 1-17-15 (with the exception of California, which is reporting data for 11-15-14 to 1-18-15).

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Executive summary

The Health Insurance Marketplace (“the Marketplace”) plays a critical role in achieving one of the Affordable Care Act’s goals of reducing the number of uninsured Americans by providing affordable, high-quality health insurance for individual and small group consumers. This report provides data for enrollment-related activity in the individual market Marketplace during roughly the first two months of the 2015 Open Enrollment period for all 50 states and the District of Columbia.

Section I of the report focuses on the 37 states that are using the HealthCare.gov platform for 2015 (also known as “HealthCare.gov states”) for the first two months of the 2015 Open Enrollment and covers the period 11-15-2014 to 1-16-2015. The 37 HealthCare.gov states include 35 states that used the HealthCare.gov platform in both 2014 and 2015 and Oregon and Nevada, which are new to the HealthCare.gov platform in 2015.² These 37 states account for 75 percent of total Marketplace plan selections in this report.

The data available for these states include Marketplace plan selections for new consumers and consumers reenrolling in Marketplace coverage. The reenrollee data include both consumers who actively reenrolled in Marketplace coverage (i.e., people who returned to the Marketplace to select a new plan or actively renew their existing plan), and consumers who have been automatically reenrolled into coverage (i.e., people who retained coverage without returning to the Marketplace and selecting a plan, including some who may have subsequently returned to the Marketplace to actively select a plan).

The data included in this report cover the same reporting period as the most recent Weekly Enrollment Snapshot for the 37 HealthCare.gov states, and the metrics that are reported in both places are generally consistent (see Appendix Table D1 for additional information on how the data in this report compare with the data in the most recent Weekly Enrollment Snapshot).³ This report also includes data relating to completed applications, eligibility determinations, website visitors, and call center activity for the HealthCare.gov states; data on the overall distribution of Marketplace plan selections in these states by gender, age, metal level, financial assistance status (i.e., whether the consumer has been determined eligible for advance premium tax credits or cost-sharing reductions), race/ethnicity, and rural status.

Section II of the report focuses on the 14 states (including the District of Columbia) that are operating their own Marketplace platform for 2015 (see page 9). Most of the 14 states include activity for the period 11-15-2014 to 1-17-2015, but data for California are through 1-18-2015). These 14 states account for 25 percent of Marketplace plan selections in this report. The data available for these states include new consumers and reenrollees (please see Appendix Table D2 for additional information on the Marketplace plan selection data that are available for various states). Additionally, some data are available for certain states relating to completed applications, eligibility determinations, website visitors, call center activity; and the overall distribution of Marketplace plan selections by gender, age, metal level, and financial assistance status.(See Appendix Table D3 for a summary of which additional metrics are available for each state).

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² For more information about data on Marketplace plan selections for the 2014 coverage year, please see the Marketplace Summary Enrollment Report, which can be accessed at http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Apr2014/ib....

³ The Centers for Medicare & Medicaid Services publishes weekly Open Enrollment snapshots that provide preliminary point-in-time estimates for weekly data that could fluctuate based on consumers changing or canceling plans or having a change in status such as a new job or marriage; data revisions may mean that the weekly totals from the snapshots may not sum to the cumulative numbers. The weekly snapshots can be accessed at http://www.hhs.gov/healthcare/facts/blog/index.html.

Key Highlights

National plan selection data available to date show that as of mid-January, more than 9.5 million⁴ Americans had selected or been automatically reenrolled⁵ into a 2015 health insurance plan through the Health Insurance Marketplace, specifically:

• More than 7.1 million people have selected or been automatically reenrolled into 2015 Marketplace plans in the 37 states that are using the HealthCare.gov platform in 2015 as of January 16th, including plan selections for new consumers and reenrollees (including both active reenrollees and automatic reenrollees); and
• Nearly 2.4 million people have selected or been automatically reenrolled into 2015 Marketplace plans in the 14 states (including DC) that are using their own Marketplace platforms in 2015, based on data through January 17th, including plan selections for new consumers and active reenrollees, and in most states, automatic reenrollees.
• Among the plan selections in the 37 states that are using the HealthCare.gov platform in 2015, 87 percent qualify for premium tax credits and/or cost-sharing reductions, and 2.5 million are under the age of 35.

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⁴ It is important to note that these data generally represent the number of individuals who have selected, or been automatically reenrolled into a Marketplace plan, with or without payment of premium. This is also known as pre-effectuated enrollment, , because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. Data on effectuated enrollment are not yet available.

⁵ It is important to note that the preliminary reenrollment data in this report may include some individuals who were reenrolled in Marketplace coverage before 1-16-15, but who may ultimately decide not to retain Marketplace coverage for 2015 (for example, because they have obtained coverage through another source such as an employer or Medicaid/CHIP). We anticipate that to the extent possible, the plan selection data in future reports will exclude these individuals (e.g., due to the subsequent cancellation or termination of their coverage).

Section I. Data for the 37 States Using the Healthcare.gov Platform

• The Marketplaces in HealthCare.gov States are Continuing to Reach People Who Do Not Currently have Marketplace Coverage.

More than 7.1 million individuals have selected or been automatically reenrolled into 2015 Marketplace plans as of 1-16-15 in HealthCare.gov states (see Table 1). Of that total, 42 percent (3.0 million) are plan selections by new consumers who did not have a Marketplace plan selection as of November 2014, and 58 percent (nearly 4.2 million) are plan selections for consumers who are reenrolling in Marketplace coverage.

 

Table 1

Notes: Numbers may not add to totals due to rounding
(1) Total 2015 Marketplace Plan Selections represents cumulative data on the number of unique individuals who have selected or been automatically reenrolled into a 2015 Marketplace medical plan for enrollment through the individual market Marketplaces (with or without the first premium payment having been received directly by the issuer). This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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).
(2) Consumers reenrolling in Marketplace coverage includes data for consumers who actively reenrolled in Marketplace coverage, and data for automatic reenrollees. It is important to note that the preliminary reenrollment data in this report may include some individuals who were reenrolled in Marketplace coverage before 1-16-15, but who may ultimately decide not to retain Marketplace coverage for 2015 (for example, because they have obtained coverage through another source such as an employer or Medicaid/CHIP). We anticipate that to the extent possible, the plan selection data in future reports will exclude these individuals (e.g., due to the subsequent cancellation or termination of their coverage).
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

• Interest in the Marketplaces in HealthCare.gov States Continues to be High – During the first two months of the 2015 Open Enrollment period:
  • 21.8 million unique visitors used the HealthCare.gov and CuidadoDeSalud.gov websites;
  • 9.5 million calls were made to the Marketplace call center for the HealthCare.gov states;
  • 6.9 million completed applications for 2015 coverage were submitted; and
  • 9.4 million individuals were included in these completed applications.⁶

 

Figure 1

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⁶ A single completed application form that is submitted to the Marketplace can include multiple individual applicants from the same household.

Characteristics of 2015 Marketplace Plan Selections Compared to Similar Months of 2014

Generally, the demographic characteristics of consumers selecting plans in comparable periods of 2014 and 2015 are similar with the exception of somewhat higher rates of young adults, silver plans and financial assistance in 2015. We caution that it is premature to evaluate the demographic characteristics of the 2015 enrollment experience at this time, as we expect that some of these characteristics may change by the end of the Open Enrollment Period. For example, there was a surge of young adults at the end of the 2014 Open Enrollment Period, such that 35 percent of enrollees were ages 0-34 by the end of the period (note that Table 2 shows 30 percent in the earlier months of the 2014 Open Enrollment Period). As noted in the 2014 summary enrollment report,⁷ the data on race and ethnicity should be interpreted with great caution since more than one-third of enrollees do not provide this data.

Table 2

(1) Represents the cumulative number of unique individuals who have selected or been automatically reenrolled into a 2015 Marketplace medical plan for enrollment through the individual market Marketplaces (with or without the first premium payment having been received directly by the issuer). This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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). See Appendix D for additional technical notes.
(2) During the 2014 Marketplace coverage year, there were a total of 36 states using the HealthCare.gov platform, including one state (Idaho) that switched from using the HealthCare.gov platform in 2014 to using its own Marketplace platform in 2015.
(3) During the 2015 Marketplace coverage year, there were a total of 37 states using the HealthCare.gov platform, including 35 states that are states that used the HealthCare.gov platform in both 2014 and 2015, and two states which are new to the HealthCare.gov platform in 2015 (Oregon and Nevada).
(4) The data for the early months of the 2014 Open Enrollment period are for 10-1-13 to 2-1-14. This corresponds with the reporting period for the January Monthly Enrollment Report for the 2014 Open Enrollment Period.
(5) Percentages shown in this table are based on the total number of active Marketplace plan selections for which the applicable data are available, excluding plan selections with unknown data for a given metric (e.g., age, gender, race/ethnicity, etc.) Additional information on the number of plan selections with missing data for each metric can be found in Appendix Table A1.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

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⁷ For more information about data on Marketplace plan selections for the 2014 coverage year, please see the Marketplace Summary Enrollment Report, which can be accessed at http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Apr2014/ib....

Other Data on Marketplace Enrollment-Related Activity in the HealthCare.gov States

Interest in the Marketplaces in HealthCare.gov states has been high during the first two months of the 2015 Open Enrollment period, with 21.8 million visitors to the Marketplace websites, 9.5 million calls to the Marketplace call center, and 6.9 million completed applications in the HealthCare.gov states (see Table 3).

Table 3

Cumulative Marketplace Enrollment-Related Information in States Using The HealthCare.gov Platform	Reporting Period: First Two Months of the 2015 Open Enrollment Period (1)
Visitors to the Marketplace Websites (2)	21,782,302
Calls to the Marketplace Call Center (3)	10,253,918
Number of Completed Applications	6,879,362
Number of Individuals Included in Completed Applications	9,444,388
Number of Individuals Determined Eligible to Enroll in a 2015 Marketplace Plan	8,377,697

Notes:
(1) The data in this table are for the 11-15-14 to 1-16-15 reporting period. See Appendix D for technical notes.
(2) Visitors to the Marketplace Websites includes 21,007,513 unique visitors on HealthCare.gov and 774,789 unique visitors on CuidadoDeSalud.gov between 11-15-14 and 1-16-15. Visitors to the Marketplace Websites is the sum of monthly data and has been deduplicated to the extent possible.
(3) Total Calls to the Marketplace call centers includes 798,442 calls with Spanish-speaking representatives and 9,455,476 other calls between 11-15-14 and 1-16-15.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

Section II. Data for the 14 States Using Their Own Marketplace Platforms

Nearly 2.4 million individuals have selected 2015 Marketplace plans as of 1-17-15 in the 14 states (including DC) that are using their own Marketplace platforms for the 2015 coverage year.⁸ This includes:

• 287,181 Marketplace plan selections in 4 states reporting data on new consumers and consumers actively reenrolling in Marketplace coverage (Hawaii, Idaho,⁹ Maryland, and Massachusetts); and
• 2,095,823 Marketplace plan selections in 10 states reporting data on new consumers, consumers actively reenrolling in Marketplace coverage, and automatic reenrollees (California, Colorado, Connecticut, District of Columbia, Kentucky, Minnesota, New York, Rhode Island, Vermont, and Washington).

A complete breakdown of the 2015 plan selections between new consumers and consumers reenrolling in Marketplace coverage is not yet available for all 14 of these states. This includes several states (Maryland, Massachusetts, and Idaho) that are unable to separate out data for new consumers compared to consumers reenrolling in Marketplace coverage due to system vendor changes or other information technology system issues.

This report also includes available data relating to completed applications, eligibility determinations, website visitors, and call center activity (see Table 4); as well as the overall distribution of Marketplace plan selections by gender, age, metal level, and financial assistance status. (See Appendix Table A2 for a summary of available data on the characteristics of Marketplace plan selections in these states, and Appendix Table D3 for a summary of which data are available for each state. Additionally, Appendix Tables C1, C2, C3, and C4 include state-level data for several metrics).

 

Table 4

Cumulative Marketplace Enrollment-Related Information in States Using Their Own Marketplace Platforms	Reporting Period: First Two Months of the 2015 Open Enrollment Period (1)
Visitors to the Marketplace Websites Number of States Reporting: 13	8,103,949
Calls to the Marketplace Call Centers Number of States Reporting: 14	4,910,546
Number of Completed Applications Number of States Reporting: 11	1,202,649
Number of Individuals Included in Completed Applications Number of States Reporting: 11	2,260,927
Number of Individuals Determined Eligible to Enroll in a 2015 Marketplace Plan Number of States Reporting: 13	2,612,360
Number of Individuals Who Have Selected a 2015 Marketplace Plan (2) Number of States Reporting: 14	2,383,004

Notes:
(1) Most of the data in this table are for the 11-15-14 to 1-17-15 reporting period with the following exceptions: data for California are for 11-15-14 to 1-18-15.
(2) Total 2015 Marketplace Plan Selections generally represents cumulative data on the number of unique individuals who have selected a 2015 Marketplace medical plan for enrollment through the individual market Marketplaces (with or without the first premium payment having been received directly by the issuer). This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated (however, one state, Washington, has reported data on effectuated enrollment). These data do not include a count of the number of individuals who have selected a standalone dental plan. It also generally does not include data for 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); however, New York is unable to separate out the SEP data for the period 11/15-14-12-31-14.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

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⁸ Data for California are for 12-15-14 to 1-18-15.
⁹ Data for Idaho include some automatic reenrollees from their previous HealthCare.gov platform (Idaho used the HealthCare.gov platform during the 2014 coverage year); however, Idaho is treating all plan selections as new in 2015.

Section III. Methodological Overview

The data reported here have been obtained from the information systems of the Centers for Medicare & Medicaid Services (CMS), based on information collected for 37 states using the HealthCare.gov platform. We also obtained more limited data reported to CMS by the 14 states (including DC) that are using their own Marketplace platforms. Data for the Small Business Health Options Program (SHOP) Marketplaces are not included in this report.

This report includes data that are currently available on enrollment-related activity for the first two months of the open enrollment period – which generally corresponds with data from 11-15-14 to 1-16-15 for the 37 HealthCare.gov states; and from 11-15-14 to 1-17-15 in states that are using their own Marketplace platforms for the 2015 coverage (see Table 5 below).

Table 5

Marketplace Type	Reporting Period
States Using the HealthCare.gov Marketplace Platform (37 states)	11-15-14 to 1-16-15
States Using Their Own Marketplace Platform (14 states)
California	11-15-14 to 1-18-15
Other 13 States (including DC)	11-15-14 to 1-17-15

Data for certain metrics are not yet available for several of the states that are using their own Marketplace platforms.

It is important to note that some of the 14 states that are using their own Marketplace platforms are not separately reporting data for new consumers and consumers who are reenrolling in Marketplace coverage. Please refer to Appendix D for additional technical notes.

This report also includes available data on the characteristics of individuals who have selected a Marketplace plan for the 37 states that are using the HealthCare.gov platform for 2014, and the 14 states that are using their own Marketplace platforms. In some cases, the data for certain characteristics of Marketplace plan selections are not yet available in selected states.

We believe that the information contained in this issue brief provides the most systematic summary of enrollment-related activity in the Marketplaces for the first two months of the 2015 Open Enrollment period because the data for the various metrics are counted using comparable definitions for data elements across states and Marketplace types.

Section Iv: Appendices

Appendix A: Characteristics of Marketplace Plan Selections

A1 – Marketplace Plan Selections by Gender, Age, Metal Level, Financial Assistance Status, Race/Ethnicity, and Rural Status in States Using the HealthCare.gov Platform

Notes: Percentages in this table have been rounded.  Some numbers may not add to totals due to rounding.

(1) Unless otherwise noted, the data in this table represent cumulative data on the number of unique individuals who have been determined eligible to enroll in a Marketplace plan, and have selected a Marketplace medical plan (with or without the first premium payment having been received by the issuer).  Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections.  These data also do not include:  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).  For additional technical notes, please refer to Appendix D of this report.

(2) For each metric, the data represent the total number of “Individuals Applying for 2015 Coverage in Completed Applications” who have selected a 2015 medical Marketplace plan for enrollment through the Marketplace (with or without the first premium payment having been received directly by the issuer) during the reference period, excluding plan selections with unknown data for a given metric. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated.

(3) In some cases, the data for certain characteristics of Marketplace plan selections are not yet available.  For this reason, for each metric, we have calculated the comparable percentages based on the number of plan selections with known data for that metric.

(4) The subtotals for each metal tier type do not sum to the total number due to a small number of individuals (0.1%) who have multiple 2015 Marketplace plan selections in the system that will be resolved through data cleanup processes.  Data for standalone dental plan selections are shown separately in this section, but are not included in any of the other metrics in this table.

Source:  Centers for Medicare & Medicaid Services, as of 1-26-15.

A2 - Marketplace Plan Selections by Gender, Age, Metal Level, and Financial Assistance Status in States Using their Own Marketplace Platform

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Notes:
Percentages in this table have been rounded. Some numbers may not add to totals due to rounding.
(1) Unless otherwise noted, the data in this table represent cumulative data on the number of unique individuals who have been determined eligible to enroll in a Marketplace plan, and have selected a Marketplace medical plan (with or without the first premium payment having been received by the issuer). These data do not include a count of the number of individuals who have selected a standalone dental plan; 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), however New York was unable to separate out SEP data for the period 11/15-14-12-31-14. For additional technical notes, please refer to Appendix D of this report.
(2) For each metric, the data represent the total number of “Individuals Applying for 2015 Coverage in Completed Applications” who have selected a 2015 medical Marketplace plan for enrollment through the Marketplace (with or without the first premium payment having been received directly by the issuer) during the reference period, excluding plan selections with unknown data for a given metric. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. New York’s data also includes individuals applying for coverage during the SEP for 2014 coverage during the period 11-15-2014 – 12-31-2014.
(3) In some cases, the data for certain characteristics of Marketplace plan selections are not yet available. For this reason, for each metric, we have calculated the comparable percentages based on the number of plan selections with known data for that metric.
(4) The subtotals for each metal tier type do not sum to the total number due to a small number of individuals (0.1%) who have multiple 2015 Marketplace plan selections in the system that will be resolved through data cleanup processes. Data for standalone dental plan selections are shown separately in this section, but are not included in any of the other metrics in this table.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

Appendix B: Selected State-Level Tables – HealthCare.gov States

B1 – Marketplace Plan Selection by Enrollment Type, Marketplace Type and State

Marketplace Plan Selection by Enrollment Type in States Using the HealthCare.gov Platform, by State, 2015 (1) 11-15-14 to 1-16-15

Notes:
“N/A” means that the data for the respective metric are not yet available for a given state.
* Indicates that the data reported for the current month only include new consumers, and exclude reenrollees.
(1) Unless otherwise noted, the data in these tables represent cumulative data on the number of unique individuals who have selected or have been automatically reenrolled into a 2015 Marketplace medical plan for enrollment through the Marketplaces (with or without the first premium payment having been received directly by the issuer). This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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). This table only reflects data for the individual market Marketplaces. For additional technical notes, please refer to Appendix D of this report.
(2) “Distribution by Enrollment Type” represents the percentage of plan selections with available data on enrollment type that are new consumers vs. consumers reenrolling in Marketplace coverage.
(3) “New Consumers” are those individuals who selected a 2015 Marketplace medical plan (with or without the first premium payment having been received directly by the issuer) as of the reporting date, and did not have a Marketplace plan selection as of November 2014. Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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).
(4) “Consumers Reenrolling in Marketplace Coverage” are those individuals who had a Marketplace plan selection as of November 2014, and have either actively submitted a 2015 application and selected a 2015 Marketplace medical plan or have been automatically reenrolled in Marketplace coverage – with or without the first premium payment having been received directly by the issuer). Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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). It is important to note that the reenrollment data in this report may include some individuals who were reenrolled in Marketplace coverage as of 1-16-15, but who may ultimately decide not to retain Marketplace coverage for 2015 (for example, because they have obtained coverage through another source such as an employer or Medicaid/CHIP). We anticipate that to the extent possible, the plan selection data in future reports will exclude these individuals (e.g., due to the subsequent cancellation or termination of their coverage).
(5) For the HealthCare.gov states, the data on 2015 Marketplace plan selections includes data for new consumers and consumers who reenrolling in Marketplace coverage (including data for consumers who actively reenrolled in Marketplace coverage, and data for automatic reenrollees).
(6) Nevada, New Mexico, and Oregon are using the HealthCare.gov platform for 2015.
(7) Nevada and Oregon changed Marketplace platforms in 2015. Therefore, their 2015 Marketplace plan selections are generally being classified as new consumers for operational enrollment and reporting purposes. However, a small number of 2015 plan selections in these states may be classified as consumers reenrolling in Marketplace coverage in cases where an individual who had an active 2014 Marketplace plan selection in a HealthCare.gov state signs up for 2015 coverage in Oregon or Nevada.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

B2 - Total Completed Applications and Individuals Who Completed Applications in States Using the HealthCare.gov Platform, By State

Total Completed Applications and Individuals Who Completed Applications in States Using the HealthCare.gov Platform, By State, 2015
11-15-2014 to 1-16-2015

Notes:
“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 1- 16-15. 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 D 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) Nevada, New Mexico, and Oregon are using the HealthCare.gov platform for 2015.

Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

B3 - Total Marketplace Eligibility Determinations, and Marketplace Plan Selections in States Using the HealthCare.gov Platform, By State

Notes:
“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 1-16-15. 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 information, please refer to Appendix D of this report.
(2) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace” (i.e., enrollment through the Marketplaces for a 2015 Marketplace plan) represents the total number of individuals for whom a Completed Application has been received for the 2015 plan year (including any individuals with active 2014 Marketplace enrollments who returned to the Marketplaces and updated their information), and who are determined to be eligible for plan enrollment through the Marketplaces during the reference period, whether or not they qualify for advance payments of the premium tax credit or cost-sharing reductions. These individuals may or may not have enrolled in coverage by the end of the reference period. Individuals who have been determined or assessed eligible for Medicaid or CHIP are not included. Note: This number only includes data for individuals who applied for 2015 Marketplace coverage in completed applications. It does not include individuals who were automatically reenrolled. Thus, the number determined eligible for 2015 coverage may be lower than the total number of 2015 plan selections (which includes reenrollees).
(3) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace with Financial Assistance” (i.e., enrollment through the Marketplace for a 2015 Marketplace plan with Financial Assistance) represents the total number of individuals determined eligible to enroll through the Marketplace in a Marketplace plan who qualify for an advance premium tax credit (APTC), with or without a cost-sharing reduction (CSR) for the 2015 plan year (including any individuals with active 2014 Marketplace enrollments who returned to the Marketplace and updated their information). These individuals may or may not have enrolled in coverage by the end of the reference period. Note: This number only includes data for individuals who applied for 2015 Marketplace coverage in completed applications. It does not include individuals who were automatically reenrolled. Thus, the number determined eligible for 2015 coverage may be lower than the total number of 2015 plan selections with financial assistance (which includes reenrollees).
(4) “Individuals Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace” represents the number of individuals 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 through November 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.
(5) “Individuals With 2015 Marketplace Plan Selections” represents the total number of individuals determined eligible to enroll in a plan through the marketplace” who have selected a 2015 Marketplace medical plan for enrollment through the Marketplaces or, after December 15, have been automatically reenrolled in Marketplace coverage (with or without the first premium payment having been received directly by the issuer) during the reference period. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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).
(6) Nevada, New Mexico, and Oregon are using the HealthCare.gov platform for 2015.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

B4 - Total Marketplace Plan Selections by Financial Assistance Status in States Using the HealthCare.gov Platform, By State

Notes:
“N/A” means that the data for the respective metric is not yet available for a given state. Percentages in this table have been rounded. Some numbers may not add to totals due to rounding.
(1) Unless otherwise noted, the data in this table represent cumulative data on the number of unique individuals who have been determined eligible to enroll in a Marketplace plan, and have selected a Marketplace medical plan (with or without the first premium payment having been received by the issuer). These data do not include: Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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). For additional technical notes, please refer to Appendix D of this report.
(2) For each metric, the data represent the total number of “Individuals Applying for 2015 Coverage in Completed Applications” who have selected a 2015 medical Marketplace plan for enrollment through the Marketplace (with or without the first premium payment having been received directly by the issuer) during the reference period, excluding plan selections with unknown data for a given metric. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated.
(3) In some cases, the data for certain characteristics of Marketplace plan selections are not yet available. For this reason, for each metric, we have calculated the comparable percentages based on the number of plan selections with known data for that metric.
(4) Data on Marketplace plan selections with financial assistance includes plan selections for individuals who are receiving a premium tax credit and/or cost-sharing subsidy.
(5) For the HealthCare.gov states, the data on 2015 Marketplace plan selections includes data for new consumers and consumers who are actively reenrolling in Marketplace coverage (including data for consumers who actively reenrolled in Marketplace coverage, and data for automatic reenrollees).
(6) Nevada, New Mexico, and Oregon are using the HealthCare.gov platform for 2015.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

B5 - Total Marketplace Plan Selections by Age in States Using the HealthCare.gov Platform, By State

Notes:
“N/A” means that the data for the respective metric is not yet available for a given state. Percentages in this table have been rounded. Some numbers may not add to totals due to rounding.
(1) Unless otherwise noted, the data in this table represent cumulative data on the number of unique individuals who have been determined eligible to enroll in a Marketplace plan, and have selected a Marketplace medical plan (with or without the first premium payment having been received by the issuer). Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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). For additional technical notes, please refer to Appendix D of this report.
(2) For each metric, the data represent the total number of “Individuals Applying for 2015 Coverage in Completed Applications” who have selected a 2015 medical Marketplace plan for enrollment through the Marketplace (with or without the first premium payment having been received directly by the issuer) during the reference period, excluding plan selections with unknown data for a given metric. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated.
(3) In some cases, the data for certain characteristics of Marketplace plan selections are not yet available. For this reason, for each metric, we have calculated the comparable percentages based on the number of plan selections with known data for that metric.
(4) For the HealthCare.gov states, the data on 2015 Marketplace plan selections includes data for new consumers and consumers who are actively reenrolling in Marketplace coverage (including data for consumers who actively reenrolled in Marketplace coverage, and data for automatic reenrollees).
(5) Nevada, New Mexico, and Oregon are using the HealthCare.gov platform for 2015.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

Appendix C: Selected State-Level Tables – States Using Their Own Marketplace Platforms

C1 - Total Completed Applications and Individuals Who Completed Applications in States Using Their Own Marketplace Platforms, By State

Notes:
“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 1-17-15. 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 D 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.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

C2 - Total Marketplace Eligibility Determinations, and Marketplace Plan Selections in States Using Their Own Marketplace Platforms, By State

Notes:
“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 1-16-15. 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 information, please refer to Appendix D of this report.
(2) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace” (i.e., enrollment through the Marketplaces for a 2015 Marketplace plan) represents the total number of individuals for whom a Completed Application has been received for the 2015 plan year (including any individuals with active 2014 Marketplace enrollments who returned to the Marketplaces and updated their information), and who are determined to be eligible for plan enrollment through the Marketplaces during the reference period, whether or not they qualify for advance payments of the premium tax credit or cost-sharing reductions. These individuals may or may not have enrolled in coverage by the end of the reference period. Individuals who have been determined or assessed eligible for Medicaid or CHIP are not included. Note: This number only includes data for individuals who applied for 2015 Marketplace coverage in completed applications. It does not include individuals who were automatically reenrolled. Thus, the number determined eligible for 2015 coverage may be lower than the total number of 2015 plan selections (which includes reenrollees).
(3) “Individuals Determined Eligible to Enroll in a Plan Through the Marketplace with Financial Assistance” (i.e., enrollment through the Marketplace for a 2015 Marketplace plan with Financial Assistance) represents the total number of individuals determined eligible to enroll through the Marketplace in a Marketplace plan who qualify for an advance premium tax credit (APTC), with or without a cost-sharing reduction (CSR) for the 2015 plan year (including any individuals with active 2014 Marketplace enrollments who returned to the Marketplace and updated their information). These individuals may or may not have enrolled in coverage by the end of the reference period. Note: This number only includes data for individuals who applied for 2015 Marketplace coverage in completed applications. It does not include individuals who were automatically reenrolled. Thus, the number determined eligible for 2015 coverage may be lower than the total number of 2015 plan selections with financial assistance (which includes reenrollees).
(4) “Individuals Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace” represents the number of individuals 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 through November 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.
(5) “Individuals With 2015 Marketplace Plan Selections” represents the total number of individuals determined eligible to enroll in a plan through the marketplace” who have selected a 2015 Marketplace medical plan for enrollment through the Marketplaces or, after December 15, have been automatically reenrolled in Marketplace coverage (with or without the first premium payment having been received directly by the issuer) during the reference period. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. These data do not include a count of the number of individuals who have selected a standalone dental plan; 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), however New York was unable to separate out SEP data for the period 11/15-14-12-31-14.
(6) California: The data that are being reported for California are for the following reporting period 11-15-14 --1-18-15. As of 1/18/15, plan selections for CA have been processed for 947,000 of 1,120,000 enrollees who entered the renewal process. As of 1-18-14, 0f the 947,000, 360,000 actively renewed their plan selections. The remaining 2014 enrollees are being transitioned to the Medicaid program or continue to be processed for renewal.
(7) Minnesota reports total plan selection data and re-enrollment data, but cannot breakout data on new enrollments because of an inability to distinguish new enrollments from reenrollments that were manually processed. As a result, the system also undercounts reenrollments.
(8) Total Marketplace plan selections do not include automatic reenrollees for the following four states: Hawaii, Idaho, Maryland, and Massachusetts.
(9) Idaho is an SBM that changed Marketplace platforms for the 2015 coverage year (Idaho transitioned from using the HealthCare.gov platform to using its own platform). Additionally, Massachusetts and Maryland changed their eligibility and enrollment system vendors for the 2015 coverage year. All of the plan selections for these states are being treated as new consumers for operational enrollment and reporting purposes.
(10) New York is currently unable to distinguish between Marketplace plan selections for the 2014 coverage year and Marketplace plan selections for the 2015 coverage year during the period 11-15-2014-12/31-2014. Therefore, the plan selection data that are reported by New York may include a small number of plan selections from new consumers who were approved for a special enrollment period for 2014 Marketplace coverage between 11-15-14 and 12-31-2014.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

C3 - Total Marketplace Plan Selections by Financial Assistance Status in States Using Their Own Marketplace Platforms, By State

Notes:
“N/A” means that the data for the respective metric is not yet available for a given state. Percentages in this table have been rounded. Some numbers may not add to totals due to rounding.
(1) Unless otherwise noted, the data in this table represent cumulative data on the number of unique individuals who have been determined eligible to enroll in a Marketplace plan, and have selected a Marketplace medical plan (with or without the first premium payment having been received by the issuer). These data do not include a count of the number of individuals who have selected a standalone dental plan; 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), however New York was unable to separate out SEP data for the period 11/15-14-12-31-14. . For additional technical notes, please refer to Appendix D of this report.
(2) For each metric, the data represent the total number of “Individuals Applying for 2015 Coverage in Completed Applications” who have selected a 2015 medical Marketplace plan for enrollment through the Marketplace (with or without the first premium payment having been received directly by the issuer) during the reference period, excluding plan selections with unknown data for a given metric. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated.
(3) In some cases, the data for certain characteristics of Marketplace plan selections are not yet available. For this reason, for each metric, we have calculated the comparable percentages based on the number of plan selections with known data for that metric.
(4) Data on Marketplace plan selections with financial assistance includes plan selections for individuals who are receiving a premium tax credit and/or cost-sharing subsidy.
(5) California: The data that are being reported for California are for the following reporting period 11-15-14 --1-18-15. As of 1/18/15, plan selections for CA have been processed for 947,000 of 1,120,000 enrollees who entered the renewal process. As of 1-18-14, 0f the 947,000, 360,000 actively renewed their plan selections. The remaining 2014 enrollees are being transitioned to the Medicaid program or continue to be processed for renewal.
(6) Minnesota reports total plan selection data and re-enrollment data, but cannot breakout data on new enrollments because of an inability to distinguish new enrollments from reenrollments that were manually processed. As a result, the system also undercounts reenrollments.
(7) Total Marketplace plan selections do not include automatic reenrollees for the following four states: Hawaii, Idaho, Maryland, and Massachusetts.
(8) Idaho is an SBM that changed Marketplace platforms for the 2015 coverage year (Idaho transitioned from using the HealthCare.gov platform to using its own platform). Additionally, Massachusetts and Maryland changed their eligibility and enrollment system vendors for the 2015 coverage year. All of the plan selections for these states are being treated as new consumers for operational enrollment and reporting purposes.
(9) New York is currently unable to distinguish between Marketplace plan selections for the 2014 coverage year and Marketplace plan selections for the 2015 coverage year during the period 11-15-2014-12/31-2014. Therefore, the plan selection data that are reported by New York may include a small number of plan selections from new consumers who were approved for a special enrollment period for 2014 Marketplace coverage between 11-15-14 and 12-31-2014.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

C4 - Total Marketplace Plan Selections by Age in States Using Their Own Marketplace Platforms, By State

Notes:
“N/A” means that the data for the respective metric is not yet available for a given state. Percentages in this table have been rounded. Some numbers may not add to totals due to rounding.
(1) Unless otherwise noted, the data in this table represent cumulative data on the number of unique individuals who have been determined eligible to enroll in a Marketplace plan, and have selected a Marketplace medical plan (with or without the first premium payment having been received by the issuer). These data do not include a count of the number of individuals who have selected a standalone dental plan; 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), however New York was unable to separate out SEP data for the period 11/15-14-12-31-14. For additional technical notes, please refer to Appendix D of this report.
(2) For each metric, the data represent the total number of “Individuals Applying for 2015 Coverage in Completed Applications” who have selected a 2015 medical Marketplace plan for enrollment through the Marketplace (with or without the first premium payment having been received directly by the issuer) during the reference period, excluding plan selections with unknown data for a given metric. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated.
(3) In some cases, the data for certain characteristics of Marketplace plan selections are not yet available. For this reason, for each metric, we have calculated the comparable percentages based on the number of plan selections with known data for that metric.
(4) California: The data that are being reported for California are for the following reporting period 11-15-14 --1-18-15. As of 1/18/15, plan selections for CA have been processed for 947,000 of 1,120,000 enrollees who entered the renewal process. As of 1-18-14, 0f the 947,000, 360,000 actively renewed their plan selections. The remaining 2014 enrollees are being transitioned to the Medicaid program or continue to be processed for renewal.
(5) Minnesota reports total plan selection data and re-enrollment data, but cannot breakout data on new enrollments because of an inability to distinguish new enrollments from reenrollments that were manually processed. As a result, the system also undercounts reenrollments.
(6) Total Marketplace plan selections do not include automatic reenrollees for the following four states: Hawaii, Idaho, Maryland, and Massachusetts.
(7) Idaho is an SBM that changed Marketplace platforms for the 2015 coverage year (Idaho transitioned from using the HealthCare.gov platform to using its own platform). Additionally, Massachusetts and Maryland changed their eligibility and enrollment system vendors for the 2015 coverage year. All of the plan selections for these states are being treated as new consumers for operational enrollment and reporting purposes.
(8) New York is currently unable to distinguish between Marketplace plan selections for the 2014 coverage year and Marketplace plan selections for the 2015 coverage year during the period 11-15-2014-12/31-2014. Therefore, the plan selection data that are reported by New York may include a small number of plan selections from new consumers who were approved for a special enrollment period for 2014 Marketplace coverage between 11-15-14 and 12-31-2014.
Source: Centers for Medicare & Medicaid Services, as of 1-26-15.

Appendix D: Technical Notes

We believe that the information contained in this issue brief provides the most systematic summary of enrollment-related activity in the Marketplaces through the first two months of the 2015 Open Enrollment period because the data for the various metrics are counted using comparable definitions for data elements across states, and Marketplace platforms. However, data for certain metrics may not be available (including in states that changed their Marketplace platform between the 2014 and 2015 coverage years) due to information system issues. It is also important to note that the data that are included in this report may differ slightly from comparable data that are included in the weekly enrollment updates that are published by CMS (also known as the Weekly Enrollment Snapshots) because that data may be based on different time periods and/or reporting dates than those that are used in this report.

The following section provides additional information about the metrics used in this enrollment report, in addition to the information that is included elsewhere in the footnotes of the tables in this report.

Additional Information About the Metrics Used in this Marketplace Summary Enrollment Report

Reporting of Data on Activity Relating to the 2015 Marketplace Coverage Year – Except where otherwise noted, this report includes enrollment-related data on activity related to the 2015 Marketplace coverage year. The data that are being reported for 11-15-14 to 1-16-15 do not include activity associated with individuals who may have applied for and/or qualified for a Special Enrollment Period for 2014 Marketplace coverage.

Reporting Period – This report includes data that are currently available on enrollment-related activity for the first two months of the 2015 Open Enrollment period – which generally corresponds with data from 11-15-14 to 1-16-15 for the 37 HealthCare.gov states, and from 11-15-14 to 1-17-15 for the states that are using their own Marketplace platforms for the 2015 coverage, except California. The following table shows how the reporting periods for the data in this report compare with those for the most recent Weekly Enrollment Snapshot.

Appendix Table D1

2015 Marketplace Plan Selections – Represents cumulative data on the number of unique individuals who have selected a 2015 Marketplace plan for enrollment through the Marketplaces (with or without the first premium payment having been received directly by the issuer) during the reference period. This is also known as pre-effectuated enrollment, because enrollment is not considered effectuated until the first premium payment is made, and this figure includes plan selections for which enrollment has not yet been effectuated. These data represent the number of individuals with active plan selections for a Marketplace medical plan as of the reporting date. These data do not include stand-alone dental plan selections. These data also do not include any 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). Additionally, in the data for the HealthCare.gov states, individuals who have cancelled or terminated their Marketplace plans are not included in the total number of Marketplace plan selections. This table only reflects data for the individual market Marketplaces.

We are using the term “active Marketplace plan selections” to signify that the total number of Individuals Who Have Selected a Marketplace Plan that is reported in the monthly Marketplace enrollment reports excludes data for plan selections that have been cancelled or terminated. For example, if an individual selected a Marketplace plan during the first week of the open enrollment period, but selected a different plan during the third week of the open enrollment period, the active plan selections total would only include data for the most recent plan selection. This is consistent with the way that the Marketplace plan selection data were reported in the previous monthly enrollment reports for the 2014 Open Enrollment period.

Definitions of “New” and “Reenrolling” Consumers – The monthly enrollment reports for the 2015 Open Enrollment period distinguish plan selections by new consumers from plan selections by those who are reenrolling in Marketplace coverage:

• “New Consumers” are those individuals who selected a 2015 Marketplace plan (with or without the first premium payment having been received directly by the issuer) and did not have a Marketplace plan selection as of November 2014. These data do not include stand-alone dental plan selections. These data also generally do not include any 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); however, New York; however, New York is unable to separate out the SEP data for the period 11/15-14-12-31-14. Additionally, in the data for the HealthCare.gov states, individuals who have cancelled or terminated their Marketplace plans are not included in the total number of Marketplace plan selections. Additionally, some states are generally classifying all of their plan selections as new consumers for operational enrollment and reporting purposes due to changes in Marketplace platform (e.g., Idaho switched to using its own Marketplace platform in 2015, while Nevada and Oregon switched to using the HealthCare.gov platform in 2015), or changes in system vendors (Maryland and Massachusetts).
• “Consumers Reenrolling in Marketplace Coverage” are those individuals who had Marketplace plan selection as of November 2014, and have either actively submitted a 2015 application and selected a 2015 Marketplace medical plan, or have been automatically reenrolled in Marketplace coverage – with or without the first premium payment having been received directly by the issuer. Individuals who have cancelled or terminated their Marketplace plans are not included in the total number of plan selections. These data also do not include: 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). This category is consistent with the “consumers renewing coverage” category that is included in the HHS Weekly Enrollment Snapshots. Consumers Reenrolling in Marketplace Coverage includes the following two categories:
  • Consumers who are Actively Reenrolling in Marketplace Coverage – People who had a Marketplace plan selection as of November 2014, and return to the Marketplace to select a new plan or actively renew their existing plan; and
  • Consumers who are being Automatically Reenrolled into Marketplace Coverage (also known as “Automatic Reenrollees”) – People who had a Marketplace plan selection as of November 2014, and retain coverage without returning to the Marketplace and selecting a plan.

The categories of Marketplace plan selection data for the first two months of the 2015 Open Enrollment period that are included in this report vary by Marketplace type and state:

Appendix Table D2

Enrollment Type New Consumers	States Using Their Own Marketplace Platforms (14 states including DC) Included in this report	States Using the HealthCare.gov Platform (37 states) Included in this report
Consumers Who Are Actively Reenrolling in Marketplace Coverage	Included in this report *	Included in this report**
Consumers Who Are Being Automatically Reenrolled into Marketplace Coverage	Included in this report for the following 10 states: CA,CO,CT,DC , KY, MN***, NY, RI, VT, and WA	Included in this report

* Some states that are using their own Marketplace platforms are generally classifying all of their plan selections as new consumers for operational enrollment and reporting purposes due to changes in Marketplace platform (e.g., ID, which switched to using its own Marketplace platform in 2015), or changes in eligibility and enrollment system vendors (MD and MA).
** Some HealthCare.gov states are generally classifying all of their plan selections as new consumers for operational enrollment and reporting purposes due to changes in Marketplace platform (e.g., NV and OR, which switched to using the HealthCare.gov platform in 2015).
*** Minnesota undercounts its reenrollments because of technical issues with its manual enrollments.

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Automatic Reenrollments – In this report, data on automatic reenrollments are included in the overall Marketplace plan selection totals for Consumers Who Are Actively Reenrolling in Marketplace Coverage for the 37 HealthCare.gov states and 10 of the SBMs that are using their own Marketplace platforms for 2015 (see Appendix Table D2 for a list of these states). These data represent consumers who had a Marketplace plan selection as of November 2014, and retain coverage without returning to the Marketplace and selecting a plan because the applicable Marketplace has passively reenrolled them in 2015 Marketplace coverage. It is important to note that the reenrollment data in this report may include some individuals who were reenrolled in Marketplace coverage before 1-16-15, but who may ultimately decide not to retain Marketplace coverage for 2015 (for example, because they have obtained coverage through another source such as an employer or Medicaid/CHIP). We anticipate that to the extent possible, the plan selection data in future reports will exclude these individuals (e.g., due to the subsequent cancellation or termination of their coverage).

Categories for Reporting State-Level Marketplace Data – The Health Insurance Marketplace includes the Marketplaces established in each of the states (and the District of Columbia) and run by the state or the federal government. This report addresses the individual market Marketplaces that are using their own Marketplace platforms for the 2015 coverage year, as well as the individual market Marketplaces that are using the HealthCare.gov Marketplace platform for eligibility and enrollment for the 2015 coverage year (data for the small group Marketplace, also known as SHOP, is not included in this report).

Marketplace enrollment-for the 2015 Open Enrollment period, will be reported based on the following two major categories:

• State-Based Marketplaces (SBMs) Using Their Own Marketplace Platform – 14 states (including DC):

  California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont, and Washington.

• States Using the HealthCare.gov Platform – 37 states, including:

  • State-Based Marketplaces Using the HealthCare.gov Platform – 3 states

    Nevada, New Mexico, and Oregon (Note: one of these states (New Mexico) also used the HealthCare.Gov platform during the 2014 Open Enrollment period; however, Nevada and Oregon switched to using the HealthCare.gov platform for the 2015 Open Enrollment period).

  • Federally-Facilitated Marketplaces – 34 states

    Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming. (Note: all of these states also used the HealthCare.Gov platform during the 2014 Open Enrollment period).

Notes on Changes in Marketplace Platforms – The following states changed their Marketplace eligibility and enrollment platform between the 2014 and 2015 coverage years:

• Nevada and Oregon switched from using their own Marketplace eligibility and enrollment platforms in 2014 to using the HealthCare.gov platform for eligibility and enrollment for 2015 (as a consequence, people who select 2015 Marketplace plans in Nevada and Oregon are generally treated as new consumers for operational enrollment and reporting purposes because the system cannot identify or automatically reenroll individuals who previously had 2014 Marketplace coverage in these states); and
• Idaho switched from using the HealthCare.gov platform for 2014 to using its own Marketplace platform for 2015.

Additionally, Maryland and Massachusetts are continuing to use their own Marketplace platforms, but have implemented new eligibility and enrollment systems for the 2015 Open Enrollment period, and as a result, the Marketplaces in these states are unable to distinguish between new consumers and consumers reenrolling in Marketplace coverage for plan year 2015. Individuals who have 2014 Marketplace coverage in these states will need to return to the Marketplace to reenroll in coverage for 2015.

Idaho, Nevada, Oregon, Maryland and Massachusetts are generally classifying all of their plan selections as new consumers for operational enrollment and reporting purposes due to their changes in Marketplace platform (e.g., ID, NV and OR) or eligibility and enrollment system vendors (MD and MA).

Data on Total Number of Completed Applications and Total Individuals Applying for Coverage in Completed Applications – We are showing data on the number of completed applications and the total number of individuals applying for coverage in the completed applications in this report.

Data on Marketplace Plan Selections with Financial Assistance – Marketplace plan selections with financial assistance includes plan selections for individuals who are receiving a premium tax credit and/or cost-sharing reduction.

Data on Characteristics of Marketplace Plan Selections by Metal Level – The subtotals for each metal tier type do not sum to the total number of Plan Selections with Available Data on Metal Level due to a small number of individuals (0.1%) who have multiple 2015 Marketplace plan selections in the system that will be resolved through data cleanup processes. Data for standalone dental plan selections are shown separately.

Standalone Dental Plan Selections – Individuals who are shopping for health insurance coverage in the Marketplace have the choice of selecting:

• A medical Marketplace plan with integrated dental coverage,
• A medical Marketplace plan without integrated dental coverage, or
• A medical Marketplace plan and a separate standalone dental plan (it is not possible to select a standalone dental plan without also selecting a medical plan).

Individuals who have selected both a medical Marketplace plan and a standalone dental plan are only counted once in the total Marketplace plan selections metric. However, we report data on total standalone dental plan selections separately for the 37 states that are using the HealthCare.gov platform, including combined data for both the “High” and “Low” standalone dental plan types (see Appendix Tables A1 and A2).

Data on Additional Characteristics of Marketplace Plan Selections – This report also includes data on the characteristics of individuals who have selected a Marketplace plan in the 37 states that are using the HealthCare.gov platform by Race/Ethnicity and Rural Status. In some cases, the data for certain characteristics of Marketplace plan selections are not yet available. For this reason, for each metric, we have calculated the comparable percentages based on the number of plan selections with known data for that metric.

• Race/Ethnicity – The application for Marketplace coverage in the states using the HealthCare.gov platform contains questions on race and on ethnicity, which are both marked as optional. The share of unknown race/ethnicity in Marketplace plan selection data for HealthCare.gov states is higher than in federal survey data,¹⁰ but lower than that reported in administrative data sources in the healthcare industry.¹¹ Thus, while this information is provided for transparency purposes, its quality is low and its use should be limited. For example, it is also important to note that the racial/ethnic makeup of the individuals with unknown race and ethnicity who selected a Marketplace plan in the HealthCare.gov states may differ substantially from that among those who reported race and ethnicity. For example, if racial and ethnic minorities are more likely to skip the optional questions, they would be disproportionately under-reported in the overall totals.¹²
• Rural Status – The proportion of Marketplace plan selections in rural areas was derived by aggregating data for Marketplace plan selections with valid ZIP Code information based on the HHS Office of Rural Health Policy’s (ORHP) most current list of Rural Designated ZIPs, which has been updated using the 2010 Census data.

Number of Individuals Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace – 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 www.Medicaid.gov), which covers data through October 2014. 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.

Metrics Reported by SBMs Using Their Own Marketplace Platforms -- It is important to note that some of the 14 states that are using their own Marketplace platforms are not separately reporting data for new consumers and consumers who are reenrolling in Marketplace coverage.

 

Appendix Table D3

Metric	Number of States Reporting Data for this Metric
Visitors to the Marketplace Websites	13 States – California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Minnesota, New York, Rhode Island, Vermont, Washington
Calls to the Marketplace Call Centers	14 States – California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont, Washington
Completed Applications	11 States – Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Rhode Island, Vermont, Washington
Individuals Applying for Coverage in Completed Applications	11 States – Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Massachusetts, Minnesota, New York, Rhode Island, Vermont, Washington
Number of Individuals Determined Eligible to Enroll in a Marketplace Plan	13 States – California, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont, Washington
Number of Individuals Determined Eligible to Enroll in a Marketplace Plan with Financial Assistance	11 States –Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Minnesota, New York, Rhode Island, Vermont, Washington
Number of Individuals Determined or Assessed Eligible for Medicaid/CHIP by the Marketplace	12 States – California, Colorado, Connecticut, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont, Washington
Number of Individuals with 2015 Marketplace Plan Selections	14 States – California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont, Washington
2015 Marketplace Plan Selections by Financial Assistance Status	9 States – Colorado, Connecticut, Idaho, Kentucky, Maryland, New York, Rhode Island, Vermont, Washington
2015 Marketplace Plan Selections by Age	10 States –Connecticut, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont, Washington
2015 Marketplace Plan Selections by Gender	10 States –Connecticut, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont, Washington
2015 Marketplace Plan Selections by Metal Level	10 States –Colorado, Connecticut, Idaho, Kentucky, Maryland, Minnesota, New York, Rhode Island, Vermont, Washington

Effectuated Enrollment – Data on effectuated enrollment for the 2015 Open Enrollment period are not yet available. Therefore, the enrollment data in this report are generally based on pre-effectuated enrollment (plan selections). However, one state, Washington, has reported data on effectuated enrollment.

Additional Data Validation – CMS has been taking steps to enhance the processes for generating and validating Marketplace data. As such, some of the numbers in this report could be updated in future reports.

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¹⁰ The main Census surveys have missing data on 3 to 5 percent of respondents, and the National Health Interview Survey has missing information for about 5 percent of respondents. (Source: ASPE correspondence with U.S. Census and the National Center for Health Statistics regarding the American Community Survey, the Current Population Survey, and the National Health Interview Survey; February 2014.)
¹¹ For example, a study of administrative data from the Department of Veterans Affairs found that race/ethnicity information was missing from files for 36 percent of patients. Additionally, as of 2008, commercial plans that collected race and ethnicity data only had information for about 40 percent of their members. The health insurance company Aetna, which began collecting data on race and ethnicity for all its members in 2002 via enrollment forms, currently has information on race/ethnicity for about 35 percent of its membership. (Sources: Nancy R. Kressin, Bei-Hung Chang, Ann Hendricks, and Lewis E. Kazis, “Agreement between administrative data and patients’ self-reports of race/ethnicity,” American Journal of Public Health, vol. 93, no. 10 (2003), p. 1734-1739); José J. Escarce, Rita Carreón, German Veselovskiy, and Elisa H. Lawson, “Collection of race and ethnicity data by health plans has grown substantially, but opportunities remain to expand efforts,” Health Affairs, vol. 30, no. 10 (2011); and Aetna, “Aetna’s Commitment,” accessed April 25, 2014. Available at: http://www.aetna.com/about-aetna-insurance/initiatives/racial-ethnic-equ....
¹² For additional information on the methodology that was used to analyze the characteristics of individuals who selected a Marketplace plan in the HealthCare.gov states by race/ethnicity, please refer to Appendix C in the 2014 Marketplace Summary Enrollment Report, which can be accessed at http://www.aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Apr201....