Michael Mahoney, a senior vice president at GoHealthInsurance.com, said his company believes that the individual public exchange plan coverage it sold is working reasonably well.
GoHealthInsurance.com, a Web broker, connected its enrollment system as closely with the public exchange enrollment systems as the public exchange managers would allow. The company sold individual qualified health plan (QHP) coverage both from the state-based Patient Protection and Affordable Care Act (PPACA) exchanges and from the PPACA exchanges run by the U.S. Department of Health and Human Services (HHS).
Mahoney acknowledged in a telephone interview that he has read about some QHP users who bought their coverage through other channels having problems with paying for coverage and using the coverage.
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"We're used to system integrations," Mahoney said.
Because of that experience, GoHealthInsurance.com knew how to connect with the exchanges' enrollment systems, and it had a tracking system it could use to keep tabs of the QHP enrollees and identify problems quickly, Mahoney said.
GoHealthInsurance.com helps service the coverage it sells. At this point, the QHP users do not seem to be calling about problems much more frequently than users of other individual health insurance products call, Mahoney said.
The first individual QHP open enrollment period started Oct. 1, 2013, and ended in mid-April in most of the country. Insurance regulators, exchange managers and insurers now require consumers who want to buy individual coverage to show that they qualify for a special enrollment period (SEP). Individuals can get SEPs by showing that they have gone through major life changes, such as the birth of a child, or qualify for some reason, such as dealing with a serious mistake by a navigator or insurance broker.
Consumers can buy short-term health insurance — which fall outside the major medical coverage rules — without qualifying for a SEP.
See also: Exchange nap period numbers drip out
Major medical sales volume "is much lower than it was during open enrollment," Mahoney said. "A lot of people are buying short-term plans."
The percentage of site users who want major medical and end up buying short-term medical is high, but the conversion rates are lower than they would be if GoHealthInsurance.com could sell them major medical coverage, Mahoney said.
Many consumers are seeking major medical coverage during the individual QHP nap period because of life events not on the official list of qualifying life events, Mahoney said.
For consumers, one non-qualifying triggering event may be doing taxes, whether for the normal April 15 individual filing deadline or some other filing deadline.
Another non-qualifying triggering event is the start of the college year. Many college students are used to buying coverage in late August or early September, but, for now, at least, the start of a college academic year does not count as a reason to get a SEP, Mahoney said.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
