Preparing for 2019 Open Enrollment: Softheon Enhanced Direct Enrollment (EDE) delivers a better consumer experience and enables new consumer self-service policy management capabilities

As health plans consider implementing and launching an EDE solution for ACA 2019 Open Enrollment, it’s become clear that EDE is much more than an improvement to the Marketplace (or on-exchange) enrollment process and post- enrollment policy management for consumers – it’s the beginning of a real-time, API driven service to promote an improved healthcare consumer insurance benefit shopping experience with online self-service updates.

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Enhanced direct enrollment eliminates ‘double redirect’, establishes new policy management strategy

In June 2018, the Federally-Facilitated-Marketplace (FFM) is expected to launch new technology known as Enhanced Direct Enrollment (EDE) – which will allow consumers and agent/brokers to shop, enroll, and manage policy changes to Marketplace health products, without ever having to create an application on Healthcare.gov or contact Marketplace Customer Service. 

EDE is a unified enrollment experience that contains an updated, easy-to-use, portal for Marketplace members. EDE will eliminate the current “double redirect” to HealthCare.gov, using a series of CMS-based APIs to process eligibility and changes behind the scenes. This new portal will allow issuers and agent/brokers to establish and maintain relationships with members from initial enrollment, through mid-year changes, and into renewal. The goal of EDE is to provide consumers and health insurance brokers with alternatives to shop for and enroll in coverage, providing the data and tools needed to effectuate and maintain policies.  

In our new whitepaper former Executive Director for Aetna’s Exchange program and Founder, JGood Advisors, Jane Good discusses Enhanced Direct Enrollment (EDE) and this new policy strategy.

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