Health Insurance Marketplace Open Enrollment Snapshot

Four weeks into Open Enrollment and consumers continue to show a strong interest in exploring their health care options and signing up for coverage. In the fourth week of Open Enrollment, almost 395,000 people selected plans using the HealthCare.gov platform, totaling over two million plan selections since November 1. In addition to national data, the Week 4 snapshot includes state-by-state plan selection estimates for those states using HealthCare.gov.

“Americans who need health coverage starting January 1st have just two weeks remaining before the

December 15 enrollment deadline,” Department of Health and Human Services Secretary Sylvia Burwell said. “Whether you are enrolling for the first time or an existing customer who is shopping for the best plan for 2016, now is the time to visit HealthCare.gov or CuidadoDeSalud.gov. We’re encouraged by the number of people who are returning to the Marketplace or are seeking coverage for the first time. More than 2 million consumers have selected a plan and over 700,000 are new Marketplace consumers.”

Similar to last year, each week, the Centers for Medicare and Medicaid Services (CMS) will release weekly Open Enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Marketplaces and State Partnership Marketplaces, as well as some State-based Marketplaces. These snapshots provide point-in-time estimates of weekly plan selections, call center activity and visits to HealthCare.gov or CuidadoDeSalud.gov. The final number of plan selections associated with enrollment activity to date could fluctuate as plan changes or cancellations occur, such as in response to life changes like starting a new job or getting married. In addition, the weekly snapshot only looks at new plan selections, active plan renewals and, starting at the end of December, auto-renewals and does not include the number of consumers who paid their premiums to effectuate their enrollment.

HHS will produce more detailed reports that look at plan selections across the Federally-facilitated Marketplace and State-based Marketplaces later in the Open Enrollment period.

Definitions and details on the data are included in the glossary.

Federal Marketplace Snapshot

Federal Marketplace Snapshot

Week 4 Nov 22 – Nov 28

Cumulative Nov 1 – Nov 28

Plan Selections (net) 394,732 2,040,430

New Consumers 36 percent 35 percent

Consumers Renewing Coverage 64 percent 65 percent Applications Submitted (Number of Consumers) 565,001 3,476,747

Call Center Volume 485,232 2,784,252

Average Call Center Wait Time 3 minutes 41 seconds 4 minutes 13 seconds

Calls with Spanish Speaking Representative 30,814 182,650

Average Wait for Spanish Speaking Rep 11 seconds 12 seconds

HealthCare.gov Users 1,879,546 8,701,171

CuidadoDeSalud.gov Users 33,687 182,762

Window Shopping HealthCare.gov Users 627,174 2,874,977

Window Shopping CuidadoDeSalud.gov Users 8,602 50,720

HealthCare.gov State-by-State Snapshot

Consumers across the country continued to explore their health insurance options by reaching out to a call center representative at 1-800-318-2596, attending enrollment events in their local communities, or visiting HealthCare.gov or CuidadoDeSalud.gov. Individual plan selections for the states using the HealthCare.gov platform include:

Week 4

Cumulative Nov 1 – Nov 28

Alabama 48,379

Alaska 4,356

Arizona 43,415 Arkansas 13,487

Delaware 5,471

Florida 444,711

Georgia 105,299

Hawaii 4,450

Illinois 66,793 Indiana 32,350 Iowa 11,811 Kansas 24,334 Louisiana 43,438 Maine 17,291 Michigan 63,334 Mississippi 16,515 Missouri 64,585 Montana 11,316

Nebraska 20,920

Nevada 23,248

New Hampshire 9,413

New Jersey 56,333

New Mexico 10,284

North Carolina 139,563

North Dakota 4,357

Ohio 42,564

Oklahoma 30,183 Oregon 35,704

Pennsylvania 102,041

South Carolina 56,006

South Dakota 6,901

Tennessee 62,922

Texas 224,791

Utah 37,816

Virginia 86,908

West Virginia 8,058

Wisconsin 54,346

Wyoming 6,737

Glossary

Plan Selections: The weekly and cumulative metrics provide a preliminary total of those who have submitted an application and selected a plan. Each week’s plan selections reflect the total number of plan selections for the week and cumulatively from the beginning of Open Enrollment to the end of the reporting period, net of any cancellations from a consumer or cancellations from an insurer during that time.

Because of further automation in communication with issuers, the number of net plan selections reported this year account for issuer-initiated plan cancellations that occur before the end of Open Enrollment for reasons such as non-payment of premiums. This change will result in a larger number of cancellations being accounted for during Open Enrollment than last year. Last year, these cancellations were reflected only in reports on effectuated enrollment after the end of Open Enrollment. As a result, there may also be a smaller difference this year between plan selections at the end of Open Enrollment and subsequent effectuated enrollment, although some difference will remain because plan cancellations related to non-payment of premium will frequently occur after the end of Open Enrollment.

Plan selections will include those consumers who are automatically re-enrolled into their current plan or another plan with similar benefits, which occurs at the end of December.

To have their coverage effectuated, consumers generally need to pay their first month’s health plan premium. This release does not include totals for effectuated enrollments.

New Consumers: A consumer is considered to be a new consumer if they did not have Marketplace coverage at the start of Open Enrollment.

Renewing Consumers: A consumer is considered to be a renewing consumer if they had 2015

Marketplace coverage at the start of Open Enrollment and either actively select the same plan or a new plan for 2016 or are automatically re-enrolled into their current plan or another plan, which occurs at the end of December.

Marketplace: Generally, references to the Health Insurance Marketplace in this report refer to 38 states that use the HealthCare.gov platform. The states using the HealthCare.gov platform are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana,

Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

HealthCare.gov States: The 38 states that use the HealthCare.gov platform for the 2016 benefit year, including the Federally-facilitated Marketplace, State Partnership Marketplaces and State-based Marketplaces.

Applications Submitted: This includes a consumer who is on a completed and submitted application or who, through the automatic re-enrollment process, which occurs at the end of December, had an application submitted to a Marketplace using the HealthCare.gov platform. If determined eligible for Marketplace coverage, a new consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to get covered (i.e., effectuated enrollment). Because families can submit a single application, this figure tallies the total number of people on a submitted application (rather than the total number of submitted applications).

Call Center Volume: The total number of calls received by the Federally-facilitated Marketplace call center over the course of the week covered by the snapshot or from the start of Open Enrollment. Calls with Spanish speaking representatives are not included.

Calls with Spanish Speaking Representative: The total number of calls received by the Federally-facilitated Marketplace call center where consumers chose to speak with a Spanish-speaking representative. These calls are not included within the Call Center Volume metric.

Average Call Center Wait Time: The average amount of time a consumer waited before reaching a customer service representative. The cumulative total averages wait time over the course of the extended time period.

HealthCare.gov or CuidadodeSalud.gov Users: These user metrics total how many unique users viewed or interacted with HealthCare.gov or CuidadodeSalud.gov , respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once.

Window Shopping HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users interacted with the window-shopping tool at HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once. Users who window-shopped are also included in the total HealthCare.gov or CuidadoDeSalud.gov user total.

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