eHealth Insurance: Half of off-season enrollments due to coverage loss, 11% via moving

Hat Tip To: 
Esther F.

A couple of caveats: This report from private online insurance broker eHealth Insurance a) only reflects off-exchange enrollments, b) only includes people who enrolled through their brokerage, not directly via the companies themselves, and c) is, frankly, kind of difficult to actually read as presented, but contributor Esther F. noted an important section:

Outside of open enrollment, health insurance shoppers may only be able to purchase individual and family major medical coverage when they experience a qualifying life event such as marriage, divorce, the birth of a child, the loss of employer-based health insurance, etc. A June 2014 analysis of eHealth shoppers has shown that nearly half (49%) of those who reported a qualifying life event selected "loss of coverage" as the qualifying life event which they had experienced. More than one-in-ten (11%) indicated that they had moved to another city or state, while six percent (6%) indicated that they were recently married or divorced and three percent (3%) reported the birth or adoption of a child.

Add that up and you're at 69% of the total. What's especially interesting to me here is that the other 31% is divided up into the following categories:

  • Loss of eligibility for CHIP (Child Health Insurance Plan)
  • Gaining or losing a dependent (aside from birth/adoption)
  • Death of a family member
  • Change in disability status
  • Certain changes in your income
  • Changes in your household size (aside from birth/adoption)

I'd be fascinated to see the full report. While there's no guarantee that the breakdown on the ACA exchanges are similar to eHealth's, I see no reason why they wouldn't be, although I'd guess that "changes in income" would make up a significantly higher percentage of the on-exchange events.

UPDATE: Thanks again to Esther for finding more detailed info on eHealth's report, which gives more insight into the remaining 31%:

“Other” – Nearly a third (32%*) of eHealth shoppers who reported a qualifying life event selected “Other” and were then asked to describe their own qualifying event in a field provided.

Of those in the last category, many indicated life changes that may have been legitimate qualifying events, such as loss of coverage through work or through COBRA, aging off a parents’ plan, or changes in income or household size that affected their eligibility for subsidies. Others, however, reported personal challenges or life changes which did not meet the law’s criteria for qualifying events and which illustrate the need for continued consumer education. For example, some indicated that they were currently uninsured or had recently become pregnant, or that they had received a serious medical diagnosis.