eHealth Applauds New CMS Guidance to Permit Consumers to Enroll in Qualified Health Plans with a Tax Credit through Web-Broke...
May 18 2017 - 9:00AM
Business Wire
Today eHealth, Inc. (NASDAQ:EHTH) applauded new guidance issued
yesterday by the Centers for Medicare and Medicaid Services (CMS)
Center for Consumer Information & Insurance Oversight to help
streamline and simplify the direct enrollment process for consumers
signing up for Affordable Care Act qualified health plan coverage
through the federal health insurance exchange, HealthCare.gov.
This new guidance makes it possible for web-brokers like eHealth
to implement a process for customers to enroll into a qualified
health plan and apply for advanced payment of premium tax credits
without leaving the web-broker’s website. This guidance applies to
the 39 states that rely on the Federally Facilitated Exchange (FFE)
for individual and family health insurance plan enrollment.
Under the current guidance, the process is scheduled to be
available for the 2018 annual open enrollment period, which is
scheduled to run from November 1, 2017 through December 15, 2017,
and is not for applications submitted outside the open enrollment
period. CMS advised in the guidance that it intends to further
improve the ability for web-brokers to work with CMS by eventually
implementing an enhanced direct enrollment pathway to replace the
process in the current guidance.
This change reduces the regulatory burden on businesses like
eHealth that help people who qualify for tax credits to purchase
their health insurance so they can more easily get their
prescriptions covered, keep their doctors, and otherwise save money
on health care.
The specific guidance that relates to eHealth and other web
brokers is located on the CMS web site at:
https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Guidance-for-the-Proxy-Direct-Enrollment-Pathway-for-2018-Individual-Market-Open-Enrollment-Period.pdf.
To take advantage of the newly authorized process, web-brokers
such as eHealth will need to implement and maintain procedures
specified in the new guidance to address security, privacy,
reliability, and other issues that CMS has identified. For example,
there are limitations on the types of applications that may be
completed through the new process and how such applications may be
submitted, as well as security procedures such as identity
verification required for each application. Each web-broker must
enter into a new agreement with CMS and allow CMS to verify that
all CMS-specified procedures are properly implemented before being
approved by CMS to use the newly authorized process.
“Low-income people deserve the same level of service that
middle-income families receive and this news signals a move toward
equal access for all Americans,” said Scott Flanders, eHealth’s
CEO. “Today, our customers have to endure a ridiculous process
where they bounce back and forth between eHealth.com and
Healthcare.gov to get a tax credit.”
He continued, “Today’s internet shopper expects world-class
technology and excellent customer service, which are hallmarks of
American business - not government websites.”
Mr. Flanders went on to say, “eHealth’s technology and our
customer care teams in California, Utah, and Massachusetts do
amazing work to help people find health insurance plans that meet
their needs, and we look forward to working with leaders at CMS to
develop and implement the new process for enrolling consumers into
qualified health plans.”
Forward-Looking Statements
This press release contains statements that are forward-looking
statements as defined within the Private Securities Litigation
Reform Act of 1995. These include statements regarding eHealth’s
ability to help customers apply for advanced premium tax credits
and enroll in qualified health plans through the FFE without
customers leaving eHealth’s website, the availability of the new
process for the next open enrollment period, and the possibility
that CMS may implement an enhanced direct enrollment pathway to
replace the current guidance. These forward-looking statements are
inherently subject to various risks and uncertainties that could
cause actual results to differ materially from the statements made,
including risks associated with: our ability to implement and
maintain the procedures required by CMS; our ability to pass
third-party audit and testing required by CMS; our ability to agree
to and enter into a new agreement with CMS; our ability to comply
with new privacy and security standards and other CMS requirements;
the timing of and our ability to receive and maintain CMS approval
for such newly-authorized process; our ability to enroll, service,
and retain members using the new process for interfacing with the
FFE; our ability to submit a large number of enrollments over a
short period of time; reductions in conversion rates as a result of
implementing CMS requirements; changes to guidance, regulations, or
requirements by CMS or other governmental entities; the performance
and reliability of such new process; the ability of the FFE to
handle traffic and the stability of FFE’s websites and systems,
eHealth’s systems, or other relevant computer systems; and other
factors that could cause operating, financial, and other results to
differ, which are described in eHealth’s most recent Annual Report
on Form 10-K or Quarterly Report on Form 10-Q filed with
the Securities and Exchange Commission and available on
the investor relations page of eHealth’s website
at http://www.ehealthinsurance.com and on the Securities
and Exchange Commission’s website at www.sec.gov. eHealth
undertakes no obligation to update any forward-looking statement to
conform to actual results or changes in intentions or
expectations.
About eHealth
eHealth, Inc. (NASDAQ:EHTH) owns eHealth.com, a
leading private online health insurance exchange where individuals,
families and small businesses can compare health insurance products
from leading insurers side by side and purchase and enroll in
coverage online. eHealth offers thousands of individual, family and
small business health plans underwritten by many of the nation's
leading health insurance companies. eHealth (through its
subsidiaries) is licensed to sell health insurance in all 50 states
and the District of Columbia. eHealth also offers educational
resources and powerful online and pharmacy-based tools to
help Medicare beneficiaries navigate Medicare health
insurance options, choose the right plan and enroll in select plans
online through Medicare.com (www.Medicare.com), eHealthMedicare.com
(www.eHealthMedicare.com) and PlanPrescriber.com
(www.PlanPrescriber.com).
For more health insurance news and information, visit
eHealth's Consumer Resource Center.
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version on businesswire.com: http://www.businesswire.com/news/home/20170518005347/en/
For media inquiries, please contact:DMA Communications
for eHealth, Inc.Sande Drew,
916-207-7674sande.drew@ehealth.comoreHealth, Inc.Nate Purpura,
650-210-3115nate.purpura@ehealth.com
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