Health Insurance Marketplace: December Enrollment Report. Highlights of Major Methodological Changes Since the November Marketplace Enrollment Report


Reporting of Cumulative Two-Month Data - This report includes cumulative data for the two month period (10-1-13 to 11-30-13) because some people apply, shop, and select a plan across monthly reporting periods. We believe that this cumulative data provides the best “snapshot” of Marketplace enrollment activity to date. We are working to eliminate “duplication” associated with counting people in more than one month – some SBM data systems are still working to unduplicate counts in their cumulative data, so all duplication has not yet been removed from this report. In the FFM, duplicate counts have been removed, so if a person applied for a Marketplace plan in October, and then selected a Marketplace plan in November, this person would only be counted once in the cumulative data.

FFM Medicaid / CHIP Eligibility Determinations and Assessments – The number of determinations previously reported for October included data on some applications received in October on which the applicant had not completed all steps required for a determination or assessment; these numbers have been updated here. Additionally, in “assessment states” this report now includes accounts where the final determination is pending, because these accounts will be transferred to the state agency to complete the determination. Additional quality assurance is taking place on Medicaid assessments and determinations in advance of transfers to states and these figures might alter further based on that review.

Direct Enrollments -- FFM and SBM data on the number of individuals who have selected a Marketplace plan include direct enrollments through issuer websites. It is not possible to differentiate this data by enrollment type at this time.

FFM Weekly Data on the Cumulative Number of Individuals Who Selected a Marketplace Plan – The data shown in Figure 1 represent counts of the cumulative number of individuals who selected a Marketplace plan during a given week. These data are unduplicated. Note: Comparable unduplicated weekly data are not available for the SBMs due to underlying duplication in the SBMs’ weekly data.

Website Visitors – The data on the cumulative number of website visitors have been unduplicated to the extent possible; however, we do not believe that all duplication has been removed.


Summary of Marketplace Monthly Enrollment-Related Information By Marketplace Type
(10-1-13 to 11-30-13)
Marketplaces Total (SBMs and FFMs) States Implementing Their Own Marketplaces (SBMs) States With Marketplaces that are Supported by or Fully-Run by HHS (FFM)
Number % of Total* Number % of Total* Number % of Total*
Completed Applications 1,827,440 n/a 675,365 n/a 1,152,075 n/a
Number of Individuals Applying for Coverage in Completed Applications 3,692,599 100.0% 1,467,355 100.0% 2,225,244 100.0%

Number of Individuals With Processed Eligibility Determinations or Assessments

3,110,360 84.2% 1,315,978 89.7% 1,794,382 80.6%

Eligible for Marketplace plan Enrollment

2,307,283 62.5% 781,875 53.3% 1,525,408 68.6%

Eligible for Marketplace plan with APTC (non-add)

944,531 25.6% 363,973 24.8% 580,558 26.1%

Other Marketplace plan-Eligible Individuals (non-add)

1,362,752 36.9% 417,902 28.5% 944,850 42.5%

Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace

803,077 21.7% 534,103 36.4% 268,974 12.1%

Pending / Other

583,473 15.8% 152,611 10.4% 430,862 19.4%
Total Individuals Eligible to Enroll in a Marketplace plan 2,307,283 100.0% 781,875 100.0% 1,525,408 100.0%

Marketplace Eligible Individuals Who Have Selected a Marketplace plan

364,682 15.8% 227,478 29.1% 137,204 9.0%

Marketplace plan Eligible Individuals Who Have Not Yet Selected a Marketplace plan

1,942,601 84.2% 554,397 70.9% 1,388,204 91.0%
* Percent of total represents the percent of total individuals applying for coverage in completed applications, or the percent of total individuals eligible to enroll in a Marketplace plan who have selected a Marketplace plan.
** Pending/Other does not sum to 100 percent due to differences in process flows and potentially missing data. (Note: The Pending/Other totals shown in this table represent the sums of the corresponding state-level Pending/Other counts in Appendix A, 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).
*** Total SBM and FFM data on the number of persons with processed eligibility determinations or assessments do not add to the total number of persons applying for coverage in completed applications due to missing data and differences in process flow for Marketplace plan and Medicaid/CHIP eligibility determinations / assessments.
Source: Centers for Medicare & Medicaid Services, as of 12-10-2013.

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