MOUNTAIN VIEW, Calif., July 23, 2019 /PRNewswire/ -- GetInsured, a market leader in individual health insurance e-commerce, today announced it is the first company to pass the official Center for Medicare & Medicaid Services (CMS) audit and has been approved to offer Phase 3 Enhanced Direct Enrollment (EDE) technology. Phase 3 is the most robust EDE option available, offering the most benefits to users and allowing all household compositions to take advantage of simplified health insurance enrollment. GetInsured is working with CMS to complete the final steps to go live with its Phase 3 EDE platform.
EDE is a new program that fixes issues consumers in Federally Facilitated Marketplace states have faced over the last few years in the former Direct Enrollment Process. Specifically it allows consumers — as well as agents and brokers on their behalf — to start and finish their health insurance enrollments on a single shopping site, eliminating the redirect to and from HealthCare.gov (the so-called "double-redirect") required in previous years. Before EDE, the direct enrollment process was cumbersome, often time consuming and plagued by high drop-off rates during the double-redirect, according to industry observers.
"The development of our EDE Application Programming Interface (API), as well as its subsequent CMS approval, demonstrates GetInsured's ability and commitment to lead the industry with trailblazing innovations that make health insurance enrollment easier. Additionally we're proud to be the first to release a phase 3 implementation, which ensures all Americans have access to simpler enrollment avenues," said GetInsured CEO and Co-Founder Chini Krishnan.
GetInsured was a pioneering participant in the early CMS discussions on how to best build an EDE pathway. The Phase 3 implementation enables all households — including populations such as American Indians, non-tax-filers and non-citizens — to take advantage of the new streamlined enrollment process. Beyond enrollment, consumers can also make changes to their plans through GetInsured's system during any special enrollment period (SEP) without having to log in to HealthCare.gov. Special enrollment periods are triggered by life events like moving, losing a job and having a baby.
With GetInsured's Phase 3 EDE-as-a-Service, health insurance carriers can streamline their enrollment processes for every individual and household, no matter how complex, across the FFM states where they are active. The system uses a simple, intuitive and carrier-branded interface for all consumers, whether they are Advanced Premium Tax Credit (APTC) eligible or off-Exchange enrollees. Self-service online enrollment conversion rates will be greatly improved as a result of the enhanced user experience. Additionally, it enables carriers to provide ongoing customer service, which was previously impossible because they had to send customers to the marketplace for assistance.
Brokers are able to utilize the API to service clients at previously unattainable levels. Not only does EDE support the quickest direct enrollment possible — reducing time by up to 35 percent — it gives brokers the power to service clients throughout the plan year. Instead of sending clients to the FFM call center, all enrollment and service tasks can happen within GetInsured's AgentExpress broker platform.
Additionally, GetInsured's EDE platform will support:
- Convenient pre-population of portions of the enrollment application, courtesy of the integration with existing plan shopping and renewal flows;
- Customizable branding so partners can maintain the look and feel of their website throughout the enrollment process; and
- Detailed data output supporting better reporting and analysis of the enrollment process.
To gain approval, GetInsured spent more than 10 months undergoing an exhaustive two-part independent audit; first completing a privacy and security review of the EDE application, then a meticulous business audit of the enrollment application. Even the smallest nuances of the application were reviewed for strict CMS compliance.
"The CMS audit process allowed us to take a very close look at all aspects of our enrollment application and policy management tools," said Sanjeev Jorapur, Vice President of Engineering at GetInsured. "We're proud to offer a fully compliant solution with privacy, security and quality at its core."
GetInsured has a roster of clients prepared to leverage EDE-as-a-Service once it has gone live, including national insurance carriers. The company expects the EDE technology will continue to evolve and improve as GetInsured, CMS and EDE partners collectively learn more about what works and as the U.S. Department of Health and Human Services continues to shape the Affordable Care Act.
Since its founding in 2005, GetInsured has built market-leading e-commerce platforms and tools that have made health insurance enrollment simple for millions of Americans. GetInsured's award-winning UX, UI, decision-support, and individual and group enrollment tools serve some of the world's largest brokers, state-based marketplaces, insurers, and—through GetInsured.com—consumers. The company delivers innovative agent marketing and client enrollment technology, as well as call center engagement bots and compliance tools. To learn more visit company.getinsured.com.