Nearly 2.5 Million Selected Health Plans Through Federal ACA Exchange, HHS Says

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By Sara Hansard

Dec. 16 — Nearly 2.5 million consumers have selected health plans through the federal government's website since the second open enrollment started Nov. 15 under the Affordable Care Act, according to a blog posting by the Department of Health and Human Services Dec. 16.

More than 1 million of the consumers selected plans in the past week, it said.

The figures covered the period through Dec. 12 and excluded the last three days before the Dec. 15 deadline for signing up for coverage that takes effect Jan. 1.

Peak volume on on Dec. 15 was more than 125,000 concurrent users, “and we did not run into capacity constraints,” Andy Slavitt, principal deputy administrator of the Centers for Medicare & Medicaid Services, said in a press call Dec. 16. “In other words, we are able to handle even more volume in the coming months ahead.” Open enrollment lasts through Feb. 15.

Automatic Re-Enrolling Beginning

On Dec. 16, the federally facilitated marketplace (FFM) began to automatically re-enroll people enrolled in 2014 plans who hadn't taken any action, Slavitt said. The FFM is getting information to issuers to renew people “and to ensure that there are no gaps in coverage.”

Of the approximately 2.5 million people who selected plans through midnight Dec. 12, 48 percent were new consumers and 52 percent were consumers renewing coverage, according to the HHS blog posting. Close to 4.1 million applications for coverage were submitted, it said.

Thirty-seven states are using the FFM for 2015, compared with 36 states in 2014.

Several hundred thousand people who called in through the call center shortly before Dec. 15 are going to be called back over the “next couple of days,” and they will be able to enroll effective Jan. 1, Slavitt said. There were more than 3 million unique users to from Dec. 13 through Dec. 15, and the call center had more than 1 million calls Dec. 15 alone, he said.

Consumers who are automatically re-enrolled in plans for 2015 can still change coverage through Feb. 15 for a later effective date, Chief Executive Officer Kevin Counihan said on the press call.

‘Cross-Walking' Some Enrollees

If consumers are in a plan that has been terminated for 2015, “we are cross-walking these enrollees to the issuers' new plans that most closely resembles the old plan that was sunsetted in the same metal tier,” he said. Consumers who want to make plan changes can do so for a Feb. 1 effective date, he said. That is expected to affect less than 5 percent of the FFM enrollees in 2014 plans, he said. About 6.7 million people were enrolled in FFM and state-based marketplaces in 2014.

For a “small minority” of consumers for whom plan information is missing, the HHS is planning a special outreach campaign to help them select a new plan, Counihan said.

Although enrollment information on state-based marketplaces isn't yet available, “the activity has been very high,” and 10 states have extended their open enrollment period as late as Dec. 23 for Jan. 1 coverage, Counihan said.

Over the previous weekend, the HHS held a pilot program to transfer “834” eligibility forms to issuers, and the system is working well, Counihan said. The “back end” of has been delayed while the HHS has focused on getting its consumer website working smoothly.

The HHS will release state and federal figures in monthly reports, Slavitt said. The next report on the FFM enrollment numbers will come out Dec. 23, a day early in advance of the Christmas holiday, he said.

Special Enrollment Periods

On Dec. 15, the Center for Consumer Information and Insurance Oversight, part of the CMS, issued a bulletin providing special enrollment periods for a “small number of Qualified Individuals affected by the passive re-enrollment process.” The special enrollment periods will allow people who may otherwise have a gap in coverage to enroll in a qualified health plan through the federally facilitated marketplace for coverage effective Jan. 1, it said.

“Bulletin #15: Guidance for Issuers on Special Enrollment Periods Related to the Passive Re-enrollment process during the 2015 Open Enrollment Period” listed four categories under which people would qualify for a special enrollment period: people eligible for passive re-enrollment but who weren't enrolled due to an error in the process; people whose 2014 plans were discontinued by issuers; people who receive information for plans that are different than plans on the renewal notice; and people who weren't passively re-enrolled because the 2015 plan was suppressed for such things as data errors.

The CMS said that people may become aware of their passive re-enrollment issue either by receiving enrollment confirmation or trying to use their coverage. Accordingly, the CMS said it is providing affected people 60 days to select a plan from the later of Jan. 1 or five days after the date provided on the enrollment confirmation message,

Plans Provide Payment Flexibility

As the first open enrollment deadline passed for coverage beginning Jan. 1, health plans announced they were voluntarily being flexible with payment deadlines for consumers buying coverage through the ACA federally facilitated marketplaces. America's Health Insurance Plans (AHIP) said Dec. 16 that health plans were taking the action “to provide a smooth transition in the first year of the auto-enrollment and renewal process.”

In a news release, AHIP said enrollees who made changes to their coverage by Dec. 15 will have those benefits start on Jan. 1. Those who didn't update their eligibility information by then “will be auto-renewed with their current health plan and current (2014) subsidy information,” it said. That is the process that the HHS has devised for automatic renewal of most 2014 enrollees who don't take any action for 2015.

In a separate release, AHIP said that once health plans have verified that a current customer has switched carriers, the plan will take steps to stop sending bills to the customer; send revised invoices; and “promptly refund excess payments.” Several plans are contacting current enrollees who have switched carriers “and are most at risk of gaps in coverage,” it said.

Avalere Health Estimates.

Meanwhile, Avalere Health LLC Dec. 16 released an analysis estimating that ACA exchange enrollment will total 10.5 million people by the end of 2015, with fluctuation of about 1 million up or down. The HHS Nov. 10 estimated that 9 million to 9.9 million people will enroll in the ACA marketplace in 2015.

The analysis by Avalere Vice President Caroline Pearson, “Exchange Enrollment Outlook: 10.5 Million to Sign Up by End of 2015,” said that total 2015 enrollment “is tracking between 9.5 and 11.5 million,” including people renewing their 2014 plans. While 2015 enrollment may fall short of previous Congressional Budget Office projections of 13 million enrollees in 2015, “it is still likely to exceed the Administration's projections.”

As of late 2014, 6.7 million people enrolled through state and federal exchanges. In the first three weeks of open enrollment, which runs from Nov. 15 through Feb. 15, 664,000 new consumers applied for coverage and selected a plan through the federal exchange website,, Avalere said.

“Since the federally-facilitated exchange has generally represented 68 percent of total exchange enrollment, Avalere estimates that roughly 977,000 individuals signed up for coverage across all exchanges between November 15 and December 5,” the health-care advisory company said. Based on the initial pace of sign-ups in the first three weeks of open enrollment Avalere estimated that new enrollment by Feb. 15 is likely to be between 4.5 million and 6 million people.

“However, based on 2014 exchange experience, about 16 percent of these individuals may drop out of coverage by the end of the year,” either by failing to pay premiums or disenrolling, Avalere said. It is also unclear what portion of 2014 enrollees will re-enroll in plans for 2015, it said.

To contact the reporter on this story: Sara Hansard in Washington at

To contact the editor responsible for this story: Janey Cohen in Washington at

The blog posting is at The bulletin is at The Avalere analysis is at

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