Close Close
Popular Financial Topics Discover relevant content from across the suite of ALM legal publications From the Industry More content from ThinkAdvisor and select sponsors Investment Advisor Issue Gallery Read digital editions of Investment Advisor Magazine Tax Facts Get clear, current, and reliable answers to pressing tax questions
Luminaries Awards

Life Health > Health Insurance

3 off-exchange health market changes

Your article was successfully shared with the contacts you provided.

The biggest difference between the new, off-public exchange health insurance market and the old, traditional market is that outsiders can learn a little bit about what’s going on the market.

See also: 3 PPACA plan activity snapshots

Before the Patient Protection and Affordable Care Act (PPACA) exchange program and commercial coverage requirements lurched to life, the only to find out what was going on in the market was to call a large number of brokers and hope that they were giving reasonably representative answers.

Now eHealth Inc. (Nasdaq:EHTH) is trying to shed some light on the off-exchange market by posting reports on what its customers are doing.

The company does not give volume figures in the reports, but it does give some insights on which customers are buying which policies, and how much they’re paying.

The company says, for example, that monthly premiums for the family coverage purchased have averaged $751, or about 3 percent higher than what eHealth customers were paying for unsubsidized family coverage during the first half of the open enrollment period for 2014.

For PPACA-compliant off-exchange plans, as for exchange plans, open enrollment started Nov. 15 and is set to end Feb. 15.

For more about what eHealth is reporting, read on.


1. Deductibles are getting a little bigger

The size of the average deductible has increased 4 percent for individual plans and 6 percent for family plans, to $3,981 for individuals and $7,969 for families.

See also: Avalere: Exchange plan out-of-pocket costs vary widely

Parent with surprised baby.

2. The cost gap between individual coverage and family coverage has widened

Although the average cost of family coverage increased 3 percent, the average cost of individual coverage actually fell 2 percent, to $282 per month.

Premiums may fall as open enrollment goes on: eHealth notes that consumers who buy coverage early seem more likely to buy plans that offer richer benefits.

See also: GAO: How well do exchange plans serve kids?

Uneven barchart

3. In some states, the off-exchange market offers many more choices than the HHS exchange programs do. In other states, the number of choices is comparable

A health plan inventory for 33 states with PPACA exchanges run by the U.S. Department of Health and Human Services shows that eHealth offers 6,249 plans in those states and the public exchanges offer only 4,287 plans — suggesting that about 45 percent of all of the new, PPACA-compliant major medical plans available are off-exchange plans.

But the ratios vary dramatically from state to state.

In North Dakota, the HHS system offers 33 plans, and eHealth offers 34 plans. Similarly, eHealth sells 50 plans in Montana, and sells 49 plans in Montana.

In Indiana however, eHealth offers 338 plans, and offers just 137 plans. Other states in which eHealth offers many more plans than include Indiana, Kansas, Louisiana, Maine, Missouri and Virginia.

See also: Off-exchange dreams


© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.