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Why Insurance Agents Need Enhanced Direct Enrollment (EDE) Right Now

insurance agents need ede

Reading Time: 3 Minutes

Leveraging an EDE pathway helps make the quote-to-enrollment process for ACA-approved plans less painful and more profitable.

All things considered (one of them being an ongoing Pandemic), it’s been a banner year for enrollments in Affordable Care Act (ACA) health insurance plans.

So far this Open Enrollment Period (OEP), an estimated 4.6 million Americans have signed up for new health plans through the Federally Facilitated Marketplace (FFM) and state exchanges, with 20% enrolling as new customers. That surge comes on the tail end of a successful special enrollment period from February to August, during which 1.8 million people enrolled in FFM plans. 

More importantly, the uptick also helps close the gap on the country’s 15 million uninsured.

Thanks to a special OEP extension through Jan. 15, the number of on-exchange plans sold will no doubt continue to grow through the end of Open Enrollment Period 2022. Coverage will kick in on Feb, 1 for shoppers who sign up after Dec. 15—the traditional annual OEP cut-off date. But regardless, that leaves clients covered for most of 2022.  

Sounds good, right? But what do these numbers really mean, and how will it affect ACA enrollments overall, and what does that mean for your book of business?

Improving the Customer Experience

Making ACA enrollments more accessible and easier to navigate is a top concern for lawmakers, who have invested millions of tax dollars in the Marketplace's success as part of the Pandemic recovery.

Much of that investment also provides new opportunities for insurance businesses.

Just this month, Pres. Joe Biden signed an Executive Order that prioritizes improving service delivery and the customer experience across 35 high-impact service providers in 17 Federal Agencies, including the Centers for Medicaid & Medicare Services (CMS).

The order lays out a clear framework for each agency to provide a “simple, seamless, and secure customer experience,” for their customers. This will primarily be achieved by forklifting key services in high-impact areas to online hubs, as well as improving digital platforms that are already operational.

Key focus areas include providing enhanced digital tools and streamlining enrollment options for customer segments the order lays out, including:

  • Medicare-eligible retirees
  • Maternal and early pediatric patients
  • Survivors of natural disasters
  • Veteran Healthcare beneficiaries

Insurance businesses that have already begun investing in enhanced digital enrollment tools and customer management platforms will be able to more quickly align with the CMS and other affected Federal agencies as they begin implementing the changes called for in the order. 

Those that haven’t yet begun taking steps to increase their digital footprint, however, are more likely to find themselves behind the curve.

EDE As a Competitive Advantage

Every health insurance business has different needs and few insurance agent tools fall into the one-size-fits-all category. Access to an EDE-enriched platform, however, may prove to be the exception to that rule of thumb in 2022.

The FFM first introduced EDE in 2018. Connecting with an EDE pathway allows agents and brokers to seamlessly quote and enroll Marketplace insurance shoppers in on-exchange plans without having to redirect customers back to the Healthcare.gov website during the process. 

Both customer-friendly and expedient, EDE is being hailed as an unqualified success.

The CMS’ Center for Consumer Information and Insurance Oversight (CCIIO) calls EDE a “driving force” in Marketplace enrollments. The CCIIO credits EDE implementation and usage with an 87% increase in the number of new consumer plan selections in 2021 OEP as compared to the previous year. 

These encouraging numbers, combined with the White House’s initiative to raise the bar  on the healthcare customer experience make EDE not only a helpful tool for clients, but also a very real competitive advantage that empowers you to:

  • Optimize your customer experience with a wider range of coverage options
  • Maximize the efficiency of your enrollment process for on-exchange plans
  • Increase customer retention rates through superior service
  • Manage ACA clients year-round, including for qualifying events and special enrollment periods

To get started, you’ll need a third-party provider like Quotit, which offers the advantage of a powerful quoting engine and no carrier restrictions on EDE enrollments.

Ready to get the jump on 2022?


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