Health Insurance Marketplace: December Enrollment Report. Details on Marketplace Enrollment-Related Activity to Date

12/11/2013

The following are additional details of enrollment-related activity in the Marketplaces during the first two months (10-1-13 to 11-30-13) of the initial open enrollment period (see Appendix A for state-level data).

Completed Applications – A total of 1,827,440 completed applications were submitted to the Marketplaces during the first two months of the initial open enrollment period (10-1-13 to 11-30-13). This includes 675,365 completed applications (37 percent of the combined SBM-FFM total) that were submitted to the SBMs, and 1,152,075 completed applications (63 percent of the combined SBM-FFM total) that were submitted to the FFM.

Online and Paper Applications -- Based on currently available data, electronically-submitted (online) applications (including applications submitted through the Marketplace websites, as well as any applications that were submitted online through in-person assisters or the call center) accounted for approximately 83 percent of the completed applications that were submitted to the Marketplaces during the reporting period. The remainder of the completed applications (17 percent) were submitted on paper (including applications that were submitted by mail, as well as any applications through in-person assisters or the call center that were filled out on paper). On average, 91 percent of the completed applications that were submitted to the SBMs were submitted electronically, and 80 percent of the completed applications that were submitted to the FFM were submitted electronically.

Number of Persons Applying for Coverage in Completed Applications – The 1,827,440 completed applications correspond to a total of 3,692,599 persons who have applied for coverage through the Marketplaces during the first two months of the initial open enrollment period (10-1-13 to 11-30-13). The total number of persons applying for coverage is higher than the total number of completed applications because each application can potentially include multiple persons (such as spouses or dependents). A total of 1,467,355 persons (40 percent of the combined SBM-FFM total) have applied for coverage through the SBMs, and 2,225,244 persons (60 percent of the combined SBM-FFM total) have applied for coverage through the FFM.

Number of Persons Determined or Assessed Eligible to Enroll in Coverage Through the Marketplace – Overall, the Marketplaces have processed eligibility determinations for 84 percent (3,110,360) of the 3,692,599 total persons who have applied for coverage through the Marketplaces during the first two months of the initial open enrollment period (10-1-13 to 11-30-13). Of these, 2,307,283 persons have been determined eligible to enroll in a plan through the Marketplace, representing 62 percent of the total persons who have applied for coverage through the Marketplaces as a whole, and 803,077 persons have been determined or assessed eligible for Medicaid or the Children’s Health Insurance Program (CHIP), representing 22 percent of the total persons who have applied for coverage through the Marketplaces as a whole. Additionally, approximately 41 percent of the 2,307,283 total persons who have been determined eligible to enroll in a plan through the Marketplace have also been determined eligible to enroll in a plan with financial assistance (944,531). The remaining 1,362,752 other Marketplace plan-eligible persons includes individuals who: didn’t apply for financial assistance; applied for financial assistance and were found ineligible; applied for financial assistance and their applications are pending.

  • Number of Persons Determined Eligible to Enroll in Coverage by the SBMs – The SBMs have processed eligibility determinations for 1,315,978 persons who have applied for coverage through the SBMs (representing 90 percent of the 1,467,355 persons who applied for coverage during the first two months of the open enrollment period); however, this percentage varies by state due to differences in processing times. Within the SBMs, 781,875 persons have been determined eligible to enroll in a Marketplace plan, and 534,103 persons have been determined eligible for Medicaid or CHIP using MAGI determination criteria (representing 36 percent of the total persons who have applied for coverage through the SBMs). Additionally, approximately 47 percent (363,973) of the 781,875 total Marketplace plan eligible persons in the SBMs have also been determined eligible to enroll in a plan with financial assistance.5
  • Number of Persons Determined or Assessed Eligible to Enroll in Coverage by the FFM – The FFM has processed eligibility determinations for 81 percent (1,794,382) of the 2,225,244 persons who have applied for coverage through the FFM during the first two months of the open enrollment period. Within the FFM, 1,525,408 persons have been determined eligible to enroll in a Marketplace plan (representing 69 percent of the total persons who have applied for coverage through the FFM), and 268,974 persons have been determined or assessed eligible for Medicaid or CHIP under MAGI determination criteria (representing 17 percent of the total persons who have applied for coverage through the FFM). Additionally, at least 41 percent (580,558) of the 1,525,408 total Marketplace plan eligible persons in the FFM have also been determined eligible to enroll in a plan with financial assistance.6

An additional 583,473 persons who applied for coverage through the Marketplaces (including approximately 152,611 in SBMs, and 430,862 in the FFM) have eligibility determinations in the Pending/Other category, including those who: 1) have a pending eligibility determination or assessment for a Marketplace plan or Medicaid/CHIP coverage; 2) have a processed 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 coverage.

Number of Persons Who Have Selected a Marketplace plan – Overall an estimated 364,682 (16 percent) of the persons who have been determined eligible to enroll in a plan through the Marketplace during the first two months of the initial open enrollment period (10-1-13 to 11-30-13) have already selected a plan (including both those who have paid the first month’s premium and those who have not yet paid the first month’s premium). An additional 1,942,601 persons who have been determined eligible have not yet selected a plan through the Marketplace.

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