You may have been hearing a buzz around Enhanced Directed Enrollment (EDE). Let us break down what it is, why it’s valuable for health plans, and how it’s different from direct enrollment. We’ll also share some information about mPulse’s EDE solution to give you an idea of how a software vendor can help.
What is Enhanced Direct Enrollment (EDE)?
In short, EDE removes the need for health consumers to navigate between healthcare.gov and the health insurer’s website when enrolling in a health plan. EDE is a program in which CMS provides direct enrollment (DE) organizations, such as carriers, a set of Application Program Interfaces (APIs) that allows organizations to communicate information about a consumer to the Marketplace and allows CMS to communicate information about a consumer back to the partner.
Why EDE?
EDE offers health plans several advantages, including:
- Subscriber acquisition & retention: EDE is like having your own brick-and-mortar retail store dedicated to your products and only your products, rather than being one shop out of hundreds at the mall. EDE encourages your prospective subscribers, enrollees, and potential members to shop for only your health plans.
- Consumer experience improvements: For health consumers, shopping, applying, and enrolling in health insurance can be a confusing experience wrought with friction. Creating a one-stop-shop for consumers to take all the steps of shopping and enrolling in a health plan creates a simpler, more consumer-friendly experience.
- Consumer insights: EDE allows health plans to capture consumer analytics along their shopping, applying, and enrollment journey. This data can be used by plans to optimize their UI, consumer acquisition, and enrollment strategy.
- Broker relationships: EDE enables brokers to do their jobs more efficiently and better serve their clients through a simpler, more user-friendly online enrollment process.
- Operational efficiency gains: EDE reduces the administrative burden on health plans to operate the on-exchange enrollment process.
What are the differences between direct enrollment (DE) and (EDE)?
How does mPulse’s EDE solution work?
mPulse is a CMS-approved partner for EDE. Our EDE solution works like this:
For Carriers
- mPulse sets up an online shopping and enrollment portal on behalf of the carrier to be used by its health consumers and brokers when they enroll in on-exchange and off-exchange plans
- Carriers can encourage their members, brokers, and health consumers to shop and enroll in a health plan, renew an existing plan, and update their enrollment
Individual subscribers
- Can renew their plan
- Can update their enrollment
- Can reverify their eligibility
Brokers
- Can shop for and enroll in plans on behalf of their clients
- Can actively renew their clients
- Can update enrollment on behalf of their clients
What are the takeaways I should know about EDE?
EDE is an impactful way to set your organization up for success today and beyond. It gives health plans your own storefront and allows you to improve relationships with consumers and brokers while boosting subscriber enrollment and retention.
Connect with one of our mPulse EDE experts to learn more.
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