Good afternoon, and thank you for participating in the Sidoti & Company's August virtual investor conference. The next company to present is eHealth, ticker EHTH. We have with us the CEO, Fran Soistman, and the Senior Vice President of Strategy and Investor Relations, Kate Sidorovich. As always, this will be a 30-minute presentation. We should have some time at the end for Q&A, so if you do have a question, you can type them into the Q&A tab at the bottom of your screen. With that, it's all yours, Fran.
Thanks. Thanks, Jim. Thanks for having us. Welcome, everyone. My name is Fran Soistman, CEO of eHealth. I joined the company as CEO in November 2021. Also joining, John Stelben, our Chief Financial Officer, has just joined. So I'll be deflecting all difficult questions to John later on in the program. You can go to the next slide, please. Okay, thank you. So a little bit about eHealth. We've been in business over 26 years. We went public in 2006. The origin of the company was really the prototype private health insurance marketplace. In fact, I think it was sort of the inspiration for the Obama administration and the ACA in terms of how a marketplace could work.
The company has evolved significantly post-Affordable Care Act, where previously the focus was on the individual under 65 market, and then, to a lesser degree, Medicare Supplement. When the Affordable Care Act came along, it created massive disruption in the industry, and the organization made a strategic pivot to focus on Medicare Advantage, which is private Medicare coverage that replaces Medicare Part A, Part B, and in most cases, Part D, the prescription drug program. And again, these are the benefits that are available to those who are 65 and older, as well as some under 65 that have disabilities that qualify. The Medicare Advantage business has grown dramatically over the past decade. It now stands at about 32 million Medicare Advantage members, of the 65 million Medicare eligibles.
And that represents 52% of the eligible population and is expected to grow through the end of the decade to about 60% penetration, as the Medicare rolls expand from 65 million to about 80 million. So that simple math would put you in the neighborhood of about 48 million-50 million Medicare Advantage members, versus where we are today at 32 million. eHealth's model, we characterize our capabilities as an omni-channel. We offer. And it really goes to the mission of the company, which really forms all of our strategies. We expertly guide consumers through their health insurance-related options when, where, and how they prefer, and that speaks to our capabilities. We have telesales, we have an Online Assisted platform, Online Unassisted platform, and strategic partnerships. The online capabilities are robust.
They're from shopping to education to buying, and then, of course, enrolling. We have APIs with over 50 Medicare Advantage health plans and health insurance companies across the country. That's different than our public company competitors and many of our smaller competitors. We believe that healthcare is local, and it's important that there's local representation in terms of brands that really resonate and are trusted in various states. So, local would be, could be a Blue Cross Blue Shield plan or a UPMC plan in Pittsburgh, for example. But we think that it's really important to offer, in addition to the Uniteds and Aetnas and Humanas and Cignas of the world, smaller state-based or regional-based companies. You can go to the next slide.
So when I joined the company, I was charged by the board to, number one, stabilize the organization, it was in a state of flux, to set a new strategic direction, and ultimately, to lead the company through a massive transformation. These categories here: cost, marketing, sales process, platform, retention, and foundation, are not all inclusive, these are the major components, but pretty much everything about eHealth has been through transformation, including technology, the leadership team, and the culture of the company. But we did need to take out and address our cost structure. We did that beginning in April 2022. The marketing needed to be reengineered. It's now, I would say, in a more optimal stage. We've got a great marketing team.
They know how to work the various channels, and channels would be defined as things like, DIREC TV, or direct mail, search engine marketing, paid search. So, you know, we have to generate leads in order to reach out to eligible beneficiaries to help them shop. We've made strategic investments in our platform, all aimed to improve the customer experience. We introduced chat, live chat, live agent chat capabilities two years ago. Utilizing an Online Assisted or unassisted platform is a more economic, more efficient approach, but this is one of those situations where, if you build it, many will come, but not necessarily all will come.
So, but that changes each year as more and more baby boomers age into Medicare eligibility and are accustomed to online shopping and enrollment, and then having the chat capability essentially provides a lifeline. We also introduced technology on the telesales side to make it more personal. We introduced co-browsing two years ago, where our agents can share their screens, so that the beneficiary is looking at the same thing that the agent's speaking to. And this year, we've introduced what we call our Live Advise. It's a one-way video, where the beneficiary can see our agent on video, but our agent can't see the beneficiary, and that's all about to protect privacy.
And the objective there, again, is to improve the customer experience, to accelerate that relationship building process, which is so critical to our selling and creating a memorable experience, as well as the early stages of the whole loyalty journey. We're very excited about this new capability, and we'll be scaling it in advance of the Medicare Annual Enrollment Period, which begins October 15 through December 7. In our business, retention is vitally important. We follow ASC 606 Lifetime Value accounting, and retention allows us to have higher Lifetime Value revenue. And when we outperform our assumptions on Lifetime Value retention, we actually see positive adjusted revenue that materializes in future years.
And in fact, since ASC 606 accounting came into place six years ago, we've recognized over $200 million of adjusted revenue, in our business. And then, fixing the fundamentals of the company and reengineering our sales and our entire operations has created a stronger foundation for the future. It's allowed us to begin to diversify, in ways that improves our margins, improves, our cash flow, performance. So we stick to our core capabilities, but we created, what we call our Amplify business, a little over a year ago, where we essentially become an extension of a health insurance company or health plans, sales operations. So we're not eHealth in that relationship, we're Amplify, and we sell their products based on the leads that they generate and the marketing dollars they spend.
And I'll share a little bit more of that shortly. Go ahead, next slide. So when you look at this journey we've been on in terms of the transformation, as I said, we started April 2022, and, it's been nothing short of a remarkable, turnaround. And I'd say we have great momentum. We announced our second quarter earnings results last week. We had, yet another strong quarter, and we beat consensus, and we're able to raise guidance for the full year. So there's certainly more to come on that, but, the organization is in a much better place today than it was three years ago, in terms of its top line, bottom line performance. Next slide. Looking out further, we've provided these targets, to the public, to our investors.
You can see what we've identified as target revenue objectives, EBITDA and cash flow. We can achieve margin expansion by scaling our business, but we only do that in a profitable way. And then, of course, diversifying along, you know, the Amplify business that I talked about, as well as some other product lines, including Medicare Supplement, which is for those who have original Medicare, but have a gap product to address deductibles and coinsurance. And we also offer individual and small group products, as well as some ancillary products. Last thing I would say on this page is that we embarked on a plan to improve our capital structure earlier this year.
We've hired advisors, the board's hired advisors to work with us, and I think we'll have more to share on that sometime later this year. Next slide. So I mentioned some of this already in terms of what we're all about in terms of the Medicare Advantage. But we play, we play a very important role in supporting carriers' growth requirements. Consumers wanna have an independent third-party expert. If they rely solely on going to a carrier, they're only gonna learn about that carrier's products, pricing, and networks. It's a lot of work to do comparative shopping. When they work with eHealth, we do that work for them.
We use generative AI based on the information they provide us that goes into our recommendation engine, and we'll produce two or three options that best align with what they told us they value or they need. And then, it's always the beneficiary's, pardon me, decision, but there's a lot of hand-holding that goes on. Health insurance can be overwhelming, even to people who've worked in the industry. So, you know, having a subject matter expert available, either on the phone, online, or by video, gives people that peace of mind that they're making the right decision. Next. So part of this transformation we've been through is on our marketing. And the marketing plays a very important role in our ability to attract prospective beneficiary consumer customers.
eHealth last year embarked on, first time in its history, a real branding initiative. Heretofore, we would always feature the brands of the carriers that we represent, but we featured eHealth, and we created a whole new message. We didn't use a former professional athlete or an actor. We used our carefully selected spokesperson, Eve. Instead of using actors for seniors, we used real seniors, unscripted. We talked about what eHealth does to help you find your Medicare match, so we referred to ourselves as a Medicare matchmaker, and that message really resonated. It stood apart from sort of the urgent message: "You got to call right now, time's running out." Everyone was saying the same thing and screaming, which really frustrated seniors. I...
myself, am Medicare eligible, and I heard it from my friends and family about the noise that they really find disturbing between October 15 and December 7. So we tried a very different approach, and the results have been nothing short of remarkable. Again, we wanna meet people where they wanna be met, when they wanna be met, how they wanna be met, and start that journey for a lifetime relationship, not just for their health insurance needs, but we can help them in other areas as well. Next slide. So I talked about the demographics. And you can see, you know, where we believe the opportunity lies in terms of growth. These numbers get larger through the end of the decade, so significant upside opportunity.
The Individual Coverage Health Reimbursement Arrangements, the ICHRAs on the right column there, they've been around for a couple of years. Think of an ICHRA as a, the healthcare equivalent, to what occurred with pensions and 401(k)s several decades ago. So this is an opportunity for employers to get out of the health insurance underwriting business, and instead, basically sponsor health insurance through paying their employees a stipend, a fixed amount, that they can buy coverage in the individual market. Coverage that meets their needs, not necessarily a group plan that is trying to represent the needs of hundreds of people. Rarely does it accomplish that. So it provides employers with greater predictability of their cost, and provides their employees with greater portability, so that their coverage isn't dependent upon them maintaining employment.
So this is an area that we have expertise in and expected to be a contributor to the growth story over the coming years. And that also goes hand in glove with the individual market, which continues to grow separate and apart from ICHRAs. Next slide. So we talked a little bit about the branding and what we did. By having the eHealth name out there, we have been able to jumpstart our marketing efforts, not just with TV, but with all of our channels. It provided lift with our direct mail, provided lift with our search engine marketing, with our paid search, with all of our marketing activities. The messaging has resonated, the brand is becoming more recognizable.
This is a multi-year journey to create that eHealth brand recognition, much like what Progressive did multiple decades ago, where everyone knows who Progressive is. We wanna be the equivalent with health insurance. Next slide. Our technology, again, we're really the only major distribution organization or private marketplace that provides a robust end-to-end shop -by -enroll experience. This platform has been around for many years, and it's continued to be improved upon and refined to meet the ever-changing needs of customers. So again, as I mentioned earlier, many of our investments are geared towards tools to improve the customer experience and allow them to navigate online efficiently, confidently, all the way through.
We continue to add new tools so that our advisors can be more efficient as they're working with beneficiaries by phone, by giving them tools to gather information quickly, efficiently, and accurately, and then to, excuse me, to ultimately eliminate or substantially reduce any redundancy of collecting information. And then we also provide. We have a wealth of data that we work with our carrier partners on. We've not monetized that to date, but there are opportunities in the future to monetize that. Next, please. So here are the major differentiations that we have. I mean, you see down the left-hand side, various capabilities, we check all the boxes, and then compare to our peers, they dwarf in comparison to what we can do online.
As well as expanding LTVs and the strength of our commissions receivable. We've had positive tail revenue over six years. Two of our public company competitors have had impairments, material impairments. You can also see how we compare to carriers' capabilities. Again, you know, we outperform them in terms of what we can do to provide a great customer experience. Next. So moving on to our growth strategies and opportunities, you know, we had to transform our Medicare Advantage business, check that box. We will continue to refine it, but the heavy lift is largely over, and we're now performing at a much more effective level. Medicare Supplement, again, that's oftentimes referred to as Medigap. It's for those beneficiaries who have Original Medicare, but want protection for deductibles and coinsurance.
That's what Medicare Supplement provides. We had capabilities a few years ago. We didn't invest in those capabilities, and we have resurrected them, and we see this as a very viable contributor to our top line and bottom line story. So, and this is, again, an opportunity with the demographics for that program to continue to grow. Same thing with the individual employer, as I talked about. And Amplify is relatively new, less than 10% of the company's revenues, but it has significant upward growth opportunities. Next slide. I know we're coming up on time, Kate, right?
So our strategy for driving these results, as I mentioned, we had a beat for the quarter , and a raise in guidance, which you see in that center column, is the updated guidance. We're very encouraged by the company's performance and are very committed to delivering these results, if not better. And then long term, 8%-10% revenue CAGR, likewise, with adjusted EBITDA margin. We want to get to free cash flow. That is the objective that we've set forth over the next two years. And I think we can... Kate, we can end there and maybe go to Q&A?
I think that sounds good.
Okay.
Great.
Jim, I'll turn it back to you.
All right, good, good. So I, I'm gonna start off with some of my questions, but, you know, your commentary on long-term values, it's very positive and different from, as you indicated, a lot of the peers in your industry, especially a couple of years ago. You know, what have you done differently that has allowed you to have success there?
Well, thank you. We are enjoying success, but we are not satisfied. You know, lifetime value starts with a relationship. You have to form a relationship with the customer. That means that very first encounter, you have to make sure that they're put in the plan that best fits their needs. If you drop it there, if you don't do that, no chance you're gonna have a long-term relationship. If they have to switch in a few months because, you know, it's not a good fit, that's not gonna reflect well on the company. So we're all about getting it right the first time, and then building on that relationship by other capabilities.
We work with our health plan and carrier partners to on board the members, help them schedule their first well -care visit. We can do health risk assessments, which is helpful to determine what part of the population has some chronic diseases or other issues that could lend themselves in the ER on a frequent basis. That's invaluable to carriers. The sooner you get that information, the more that they can intervene through social workers, and nurses, and physicians to work with patients. So we do a lot of different things to endear ourselves. We created a loyalty program and are building strategic partnerships with other organizations that complement what we do. So, for example, we brought on a wealth advisor that specializes in the middle class, not the upper class, the middle class.
Wealth and health are really. They go hand in glove. If you wanna protect your wealth, you're gonna have the right health coverage, because a catastrophic situation could absolutely wipe you out. We will continue to expand these strategic relationships in order to endear ourselves and to grow that trusted advisory relationship we wanna have with our customers.
All right. Now, this is a very highly regulated industry, and CMS hasn't done any favors to the carriers the last year or two with their rates. Have their regulations impacted your ability to sign up new customers and your profitability?
Well, two-part question, I'll take the first part first. It's, you know, we've been subject to new rules and regulations every year for the last several years. You know, CMS's mantra is protecting beneficiaries. Well, we share that. We wanna protect beneficiaries as well. The difference is before we roll out something new, we test it. We test to make sure it works, and that there are no unintended consequences. When CMS rolls out new rules or regulations, they never test them. But we're stuck with them, and we have to find a way to make them work.
So, for example, two years ago, a new rule came out that required us, within the first 60 seconds of a phone conversation, to tell the beneficiary that we may not offer every single Medicare Advantage option in their ZIP code. First 60 seconds. Now, remember, they're calling us, we're not calling them. So somebody's calling you, and they're calling for a reason. They've got, they've got something on their mind, they've got questions they want answered, and before you can even answer the first question, you've gotta give them this long statement, along with federal requirements about privacy.
So, CMS needs to go through their transformation, frankly, and I, you know, I've had a multi-decade relationship with them, and I can speak pretty candidly, respectfully, professionally, but candidly, about how they could be better partners if they tested things before they enforced them. So I'm hopeful that maybe in time that will change. I think you're gonna see more and more of existing regulations and rules challenged as a result of the Supreme Court overturning the Chevron Doctrine just recently, and I think that will be good for all. So, you know, we're cautiously optimistic that we'll see some victories in overturning rules, as well as perhaps having them to be more thoughtful about rules that they impose going forward, that they lack ambiguity and are tested.
Right. Now, can we move to seasonality? 'Cause this is a highly seasonal business, with the annual enrollment period coming in the fourth quarter. You and some of your peers are expecting quite a bit of a different fourth quarter this year than you had last year. You know, what's driving that?
Yeah, Jim, it's, you know, the industry, the carrier side, has been under significant rate pressures for the past two years. They've got rate decreases, at a time when they're experiencing pent-up demand following the COVID pandemic, so their utilization's gone higher at a time when their rates have gone lower. That combination is leading, certainly the public companies, to, you know, that does not endear themselves to investors to see their EPS going backwards. So they're now saying publicly that they're focusing on margin over membership. And the way they do that is they have to look at the benefit and the premium structure. The most popular products in the Medicare Advantage space are the $0 monthly premium products, so the only way you can affect them is to decrease the benefits. The minimum benefit is Original Medicare.
You have to have equivalent to Original Medicare, and then you supplement that based on your Star scores performance and your bid process. They've enriched them for about four consecutive years before the Biden administration. And then, when things started tightening up, now they're having to go the other way. So we expect reductions in the core benefits, reductions in the supplemental benefits. We expect to see some geographic exits where, you know, a certain carrier may not offer a product in four or five counties in a given state. That creates disruption. Some product withdrawals, where, you know, they may pull their PPO product and only offer an HMO in certain markets. So it's gonna be...
Medicare Part D will also be going through a lot of changes as a result of the Inflation Reduction Act, and the implications to the program. So it's gonna be a year of great change, and it's gonna be a very dynamic AEP. That represents opportunity for eHealth. This is how we demonstrate how much value we can offer to beneficiaries, to our current customer base, as well as prospective customers, at a time where there's been exits from our sector. Multiple companies have exited, so capacity is declining, providing us an opportunity to gain share.
Okay, so in short, I think what I heard you say is, there'll be more switching and less agents to handle the switching, which should be a positive for eHealth?
I think it'll be a positive for eHealth and others who do it the right way. Yes.
Okay. All right, well, we are out of time. I appreciate you presenting today, though. It was a very interesting presentation, and we hope to see you again at a future conference. Thank you.
Jim, thanks so much for having eHealth today. We appreciate it. Appreciate all of those who attended today.
We didn't even have a tough question for John.
Thank you.
We'll try for the next one. All right, thank you.
Bye, everyone.
Bye-bye.