eHealth Obamacare Countdown: Your Fourth Step to Get Ready for Health Reform This Year

eHealth Obamacare Countdown: Your Fourth Step to Get Ready for Health Reform 
This Year 
MOUNTAIN VIEW, CA -- (Marketwired) -- 09/04/13 --  Today eHealth, Inc
(NASDAQ: EHTH) (, which operates, the nation's first and largest private online
health insurance exchange, published the fourth step in its six-step
guide to help consumers prepare for health care reform and this
year's new open enrollment period, which begins October 1, 2013.  
Uninsured Americans and many who already buy their own major medical
health insurance will need to purchase new coverage in 2014 that
meets minimum federal standards in order to avoid paying a tax
penalty -- "the mandate tax." In October of 2013, a new open
enrollment period will provide these Americans with their first
opportunity to research and compare new health insurance plans that
meet the federal standards for major medical health coverage.  
In order to educate consumers so that they can become better
shoppers, eHealth created this six-step approach. In Step 1, eHealth
detailed when consumers that already had health insurance might need
to enroll in a new plan. In Step 2, eHealth outlined how the mandate
tax and new subsidies would work under the Affordable Care Act (ACA).
Step 3 explained how new health insurance plans and their benefits
will be structured in 2014. Now, in Step 4, eHealth outlines some of
the differences in the health insurance plans that will be available
on state and federal health insurance exchanges and on private
exchanges like 
Step 4: Understand the new health insurance products that will be
available on private exchanges in 2014 - The ACA doesn't create a
one-size-fits-all health insurance market. Private online
marketplaces like offer a broad range of health
insurance plans from a number of different insurance companies to
meet your individual needs.  
Private exchanges will continue to offer major medical plans with
varying deductibles and benefit levels, tiered provider networks, and
other benefits that may not always be available on government
exchanges. Expect private exchanges to also sell health insurance
products you'd expect in most health benefit packages, like vision,
dental, accident, short-term, critical illness and life insurance.  
Qualified Health Plans vs. Health Plans with "Essential Health

--  Major Medical Plans with Essential Health Benefits - According to the
    Affordable Care Act (ACA), any major medical health insurance plan
    offered in 2014 must cover 10 Essential Health Benefits (EHBs),
    provide a minimum actuarial value of 60% (described in Step 3), and be
    certified by a state's department of insurance. Policyholders who
    purchase and maintain health insurance plans that meet these standards
    for the entire year may be exempt from the mandate tax, subject to
    certain exceptions and grace periods set forth in the regulations.
--  Qualified Health Plans Eligible for Subsidies - Under the ACA, a
    Qualified Health Plan (QHP) is a health insurance plan that meets EHB
    standards, is certified by an exchange and by the state's Department
    of Insurance. Those who are eligible for and wish to use a subsidy
    when purchasing a QHP need to enroll through a licensed agent who can
    work with the government exchange or through the state or Federal
    exchange. However, not all of the individuals applying for these
    health insurance plans qualify for a tax subsidy.
--  Catastrophic Health Plans - The health care reform law also creates
    "catastrophic" health insurance plans for people under age 30. These
    types of plans do not qualify for premium subsidies, but they do make
    those who qualify to purchase them exempt from the mandate tax.
    Catastrophic plans will provide fewer benefits and have higher
    deductibles and cost-sharing.

Plans Available on Government Exchanges and Private Exchanges 

--  Essential Health Benefit (EHB) Plans - Under the new law, those people
    who don't qualify for subsidies, or who do not want to use a subsidy,
    but wish to avoid the potential of being imposed the mandate tax have
    the option to still buy a QHPs through the government exchanges or buy
    a non-QHP plan that still meets the EHB standards through a private
--  Qualified Health Plans - People who qualify for and want to use a
    subsidy to pay for a QHP may be able to research QHP plan data on some
    private exchanges, and enroll in a plan, so long as the private
    exchange meets government standards for enrolling people in QHPs. In
    some states you may be able to do this online at a private exchange,
    and in others you might work with a licensed agent, or other
    authorized assister, to enroll offline.
--  Other Essential Benefits - Many consumers want benefits beyond what's
    provided in a major medical health insurance plan. Things like life
    insurance, dental insurance, vision insurance, critical illness
    insurance, and accident insurance are popular parts of many benefit
    packages offered by employers. Private exchanges like will offer these and other products, and some
    government exchanges may offer similar types of benefits.
--  Gap Insurance - Under the ACA a person may be uninsured for up to 3
    months without being subject to the mandate tax. The health care
    reform law also creates new "open enrollment" periods when a person is
    guaranteed to be able to enroll in a major medical health insurance
    plan. Outside of open enrollment, you may have to wait to get major
    medical insurance. Short-term medical insurance, or "gap" insurance
    plans, will be available on some private exchanges to help people
    supplement protect against illness or injury outside of any available
    enrollment window.

Defining the Ideal Essential Benefits Package - In 2014, and other private exchanges will continue
offering a variety of supplemental insurance products to help
consumers round out their benefit needs. Most people want to have a
choice when it comes to the types of insurance they need for their
families. eHealth surveyed 1,100 of its own customers in July of 2012
to determine which type of insurance -- outside of major medical
health insurance -- they felt was most important. While life
insurance was the clear winner, our customers had a wide range of
opinions as to what types of insurance were critical to have. 

                Most important insurance benefit after health  
                        Life                     36%           
                       Dental                    28%           
                      Accident                   20%           
                  Critical illness               13%           
                       Vision                     3%           

Tiered Provider Networks - Some Qualified Health Plans offered by
insurers on the exchanges (and off of exchanges) will have limited
provider networks in order to keep the plan's costs down. These lower
cost plans would limit the number of doctors a customer could at the
plan's "preferred rate" and may have higher copayments if you want to
see doctors out of the plan's network.  
The most widely publicized example is in California, where 13
insurers have filed to offer QHPs on California's state exchange,
with access to about 80% of California's practicing physicians and
hospitals. But, some of the state's larger insurers also plan to have
plans on the exchange with provider networks that cover as few as 36%
of the physicians in their entire physician network. 
Additional Consumer Resources:  

--  Visit eHealth's Affordable Care Act Resource Center at
--  Follow eHealthInsurance's consumer blog, Get Smart - Get Covered
--  Browse our answers to real-life health insurance questions on Yahoo
--  Follow eHealthInsurance on Facebook and Twitter

About eHealth
 eHealth, Inc. (NASDAQ: EHTH) operates, America's first and largest private health
insurance exchange where individuals, families and small businesses
can compare health insurance products from leading insurers side by
side and purchase and enroll in coverage online. eHealthInsurance
offers thousands of individual, family and small business health
plans underwritten by more than 180 of the nation's leading health
insurance companies. eHealthInsurance is licensed to sell health
insurance in all 50 states and the District of Columbia. eHealth,
Inc. also provides powerful online and pharmacy-based tools to help
Medicare beneficiaries navigate Medicare health insurance options,
choose the right plan and enroll in select plans online through ( and
For more health insurance news and information, visit the
eHealthInsurance consumer blog: Get Smart - Get Covered or visit
eHealth's Affordable Care Act Resource Center at  
Forward-Looking Statements  
This press release contains forward-looking statements, including
statements regarding the Patient Protection and Affordable Care Act
and related regulations, the need to purchase new coverage in 2014,
the timing of the new open enrollment period and the ability to
compare new health insurance plans during it, the types of plans that
will be offered in 2014 and their benefits, the types of plans
private exchanges will sell, the ability to research and enroll in a
QHP through a licensed agent, private exchange and a government-run
exchange, and the doctor network and other benefits of QHPs. These
forward-looking statements involve certain risks and uncertainties
that could cause actual results to differ materially from those
indicated in such forward-looking statements, including, but not
limited to, the ability of private exchanges to enroll individuals
into qualified health plans and to satisfy conditions and
requirements to do so; changes in laws and regulations relating to
health care reform; private exchanges ability to integrate with
government-run exchanges; government-run exchange readiness; and
government approvals of plans, rates, and other matters . Other risks
and uncertainties that can affect actual results are included under
the captions "Risk Factors" and "Management's Discussion and Analysis
of Financial Condition and Results of Operations" in eHealth's Annual
Report on Form 10-K for the year ended December 31, 2012 and most
recent Quarterly Report on Form 10-Q, which are on file with the SEC
and are available on the investor relations page of eHealth's website
at and on the Securities and Exchange
Commission's website at All information provided in this
Current Report on Form 8-K is as of the date of its filing, and we
undertake no duty to update this information unless required by law.  
Embedded Video Available: 
For media inquiries, please contact:  
Sande Drew
eHealth, Inc.
(916) 207-7674 
Kris Kraves
Cogenta Communications
(805) 527-7733 - direct 
Press spacebar to pause and continue. Press esc to stop.