What is Enhanced Direct Enrollment (EDE)?

What is Enhanced Direct Enrollment (EDE)?

Enhanced Direct Enrollment (EDE) is a service that allows approved entities, like INSXCloud, Inc., to help individuals and families directly enroll in health insurance plans offered on the health insurance Marketplace without the consumer needing to visit the HealthCare.gov web page.

How does EDE help consumers who need Marketplace health insurance?

EDE provides a comprehensive plan shopping and enrollment experience for consumers – including plan application and enrollment – with completion of all steps on a single web site.

Through the EDE process, an applicant can determine their eligibility for health coverage, as well their eligibility for premium tax credits (premium subsidies) and cost-sharing reductions.

After confirming their eligibility for a Marketplace plan, the consumer can select and enroll in the plan of their choice through the EDE entity. In addition, applicants can determine their subsidy eligibility and the size of their potential subsidy through an EDE entity – again, without needing to visit HealthCare.gov.

Through the EDE entity, consumers can also download notices from the health insurance Marketplace.

Consumers can choose to use the EDE features unassisted – or they can work with an agent or broker to shop, apply and enroll.

How does an EDE entity work with HealthCare.gov?

EDE organizations connect to the HealthCare.gov system using an application program interface (API). Through secure data transfers, the API allows an EDE organization to facilitate the consumer’s application for premium tax credits and cost-sharing reductions, sign the customer up for plans, upload required documents, and download notices from the health insurance Marketplace.

Can consumers use EDE in any state?

EDE has historically been available only in states that use the federally run Marketplace (HealthCare.gov). As of 2025, that includes 31 states.¹

However, as of the 2025 plan year, with enrollments starting in November 2024, Georgia switched to a fully state-run Marketplace platform and began operating the first state-run exchange to allow submissions through an EDE pathway.²

Although there are dozens of approved EDE entities, the number of EDE entities available to a particular consumer will depend on where they live. Some EDE entities will facilitate enrollments in all states that use HealthCare.gov, as well as Georgia. But the majority of the approved EDE entities are health insurance companies that offer coverage in either a single state or a limited number of states.³

What entities can provide enhanced direct enrollment (EDE)?

EDE entities can be web brokers, issuers (insurance companies), or direct enrollment technology providers. The majority of all approved EDE entities are issuers.³

When the EDE program started in 2018, there were only eight approved entities.⁴ As of August 2024, the number of approved programs has grown significantly to 73 EDE entities, like INSXCloud.³

Becoming an approved EDE entity is a lengthy process. According to the Centers for Medicare & Medicaid Services, it can take up to a year or longer to complete.⁵