eHealth, Inc. (EHTH): Business Model Canvas [Dec-2025 Updated]

You're looking right at the core engine of eHealth, Inc. as they make that critical pivot toward profitability in late $\text{2025}$, and honestly, the numbers tell a clear story of operational focus. We've mapped out the nine building blocks, showing how their carrier-agnostic marketplace, supported by over $\text{180}$ partners, is now being run leaner after that $\text{25}\%$ marketing spend reduction in $\text{Q}3$ $\text{2025}$. The real test is whether the $\text{\$12.1}$ million in positive tail revenue and the $\text{917.0}$ million commissions receivable can support the $\text{\$9}$ million to $\text{\$30}$ million GAAP net income guidance for the year, all while chasing that $\text{\$525}$ million to $\text{\$565}$ million revenue target. Dive in below to see exactly how their AI, like the Alice voice agent, fits into this new cost structure.

eHealth, Inc. (EHTH) - Canvas Business Model: Key Partnerships

You're looking at the core relationships that keep eHealth, Inc. running, especially as they navigate the complex Medicare landscape heading into 2026. These partnerships are the backbone of their distribution model.

The foundation of eHealth, Inc.'s reach is its extensive network of insurance providers. They maintain a broad network of over 180 national and regional health insurance carriers. This carrier-agnostic approach is a key resource, allowing them to offer consumers an attractive variety of coverage options.

The relationship with carriers is explicitly strategic, particularly for Medicare Advantage (MA). Carriers view eHealth, Inc. as a valuable partner in executing their targeted growth strategies. This alignment is crucial, especially as the company works to support profitable growth in its core MA segment.

A critical partnership is on the financial side, securing operational flexibility. eHealth, Inc. amended its existing term loan agreement with Blue Torch Finance LLC and its lender group, extending the maturity date to January 29, 2027. At the time of this extension in October 2025, the company was carrying a total debt of $93.76 million.

The company also partners with technology providers to drive its digital transformation, exemplified by the development and deployment of its AI voice agent, Alice. While specific technology partner names aren't detailed in public filings, the results of this internal/external development effort are quantifiable:

• Alice eliminated after-hours wait times, ensuring a 100% answer rate.
• 77% of callers assisted by Alice gave the agent an 'exceptional' rating (as of November 2025).
• Interest in purchasing a plan among after-hours callers increased to 30.9% when assisted by Alice, compared to 24.4% for human screeners.

The success of these relationships is reflected in the company's financial performance metrics, such as the growth in Lifetime Value (LTV) for managed products as of Q2 2025:

Metric	Q2 2025 YoY Change	Q2 2024 Value (Implied)
Medicare Advantage Constrained LTV	Increased 1%	Not explicitly stated
Medicare Supplement Constrained LTV	Increased 29%	Not explicitly stated
Q2 2025 Total Revenue	$60.8 million	$65.9 million (Q2 2024)

eHealth, Inc. works with various strategic partners, including financial service companies, to provide enrollment and educational services. The company's overall platform is designed to leverage these relationships to support profitable growth, with a focus on maximizing the value of its commissions receivable asset.

eHealth, Inc. (EHTH) - Canvas Business Model: Key Activities

You're looking at the core engine of eHealth, Inc. right now, which is all about moving volume through the platform while keeping a tight leash on spending. Here are the hard numbers reflecting those key activities as of late 2025, based on the latest reported figures.

• - Operating the online health insurance marketplace and enrollment platform.

The platform activity is centered on Medicare submissions, which is the main driver. For the third quarter ended September 30, 2025, Medicare submissions totaled 40,921, a year-over-year decrease of 36%. The company offers access to over 180 health insurers. Total revenue for Q3 2025 was $53.9 million, with the Medicare segment contributing $49.9 million of that total.

• - Executing the Annual Enrollment Period (AEP) for Medicare products.

Preparation for the AEP, the critical sales window, was finalized during Q3 2025. The underlying value metrics show mixed results leading into this period. For the second quarter of 2025, the constrained Lifetime Value (LTV) of commissions for Medicare Supplement increased 29% compared to Q2 2024, while Medicare Advantage LTV increased 1% year-over-year. However, the Q3 2025 Medicare Advantage LTV declined slightly by 1.5%.

• - Aggressive cost management and operational efficiency improvements.

Cost discipline is clearly a focus, shown by reductions in key spending areas during Q3 2025. Variable marketing spend was cut by 25%, and customer care and enrollment expenses dropped by 6% compared to the prior year period. For the second quarter of 2025, total operating costs and expenses were $83.8 million, an 11% decrease from $93.8 million in Q2 2024. The full 2024 total operating costs and expenses were $508,839 thousand.

Here's a quick look at the profitability improvement in Q3 2025:

Metric	Q3 2025 Amount	Prior Year Q3 Amount
GAAP Net Loss	$31.7 million	$42.5 million
Adjusted EBITDA Loss	$34.0 million	$34.8 million
Operating Cash Flow	Negative $25.3 million	Negative $29.3 million

• - Developing and deploying AI/technology for customer acquisition and care.

Technology deployment includes the expanded use of Alice, the AI-powered voice agent. The company recognized $12.1 million in positive TEL revenue (net adjustment revenue) in Q3 2025, a significant increase from $1.1 million the previous year. In Q2 2025, technology and content and general and administrative expenses collectively declined by $2.5 million, or 7%, year-over-year.

• - Managing and servicing the large commissions receivable asset.

Servicing the commissions receivable asset remains a significant balance sheet activity. As of September 30, 2025, the commissions receivable balance stood at $907.7 million. This followed a balance of $917.0 million at the end of the second quarter, June 30, 2025.

eHealth, Inc. (EHTH) - Canvas Business Model: Key Resources

You're looking at the core assets that power eHealth, Inc.'s operations as of late 2025. These aren't just line items; they're the actual engines driving revenue and customer interaction in a highly regulated market.

The most tangible financial resource supporting operations is the asset base built from sales. Specifically, the Commissions receivable balance stood at $917.0 million as of June 30, 2025. That's a significant amount tied up in receivables from the insurers, reflecting the volume of business written.

The company's cultural DNA is rooted in being a consumer-first technology platform. This platform is what allows eHealth, Inc. to function as an online health insurance comparison platform. It's critical in a market where full-year 2025 total revenue guidance is projected to be between $525.0 million and $565.0 million.

To manage the omni-channel experience-online, telephonic, and hybrid interactions-eHealth, Inc. relies on its licensed personnel and technology integration. As a leading independent licensed insurance agency and advisor, the firm maintains relationships with a broad set of carriers, offering access to over 180 health insurers, including national and regional companies.

Here's a quick look at some of these key quantifiable resources as of mid-to-late 2025:

Resource Category	Metric/Description	Context/Date
Financial Asset	Commissions Receivable Balance	$917.0 million (Q2 2025)
Technology Foundation	Platform Type	Consumer-first technology platform
Operational Scale	Health Insurer Access	Over 180 health insurers
AI Capability	Voice Agent Enhancement	Expanded voice agent capabilities

The investment in AI capabilities is a clear resource for scaling service without linearly increasing agent headcount. eHealth, Inc. advanced its AI strategy, with AI voice agents specifically noted for improving call center productivity and conversion rates during off-hours. The company launched a new AI-based voice in April 2025 to enhance customer experience during health plan selection. This focus on automation helps manage the high-volume periods, like the Medicare Annual Enrollment Period (AEP).

These key resources support the overall strategy, which is clearly focused on efficiency and profitability, evidenced by the raised full-year 2025 Adjusted EBITDA guidance, projected to be between $60 million and $80 million.

The essential components that define eHealth, Inc.'s operational capacity include:

• Proprietary technology platform and data analytics engine.
• Licensed insurance agents supporting the omni-channel approach.
• Significant asset base in commissions receivable.
• AI tools improving operational leverage.

Finance: draft 13-week cash view by Friday.

eHealth, Inc. (EHTH) - Canvas Business Model: Value Propositions

You're looking at the core reasons why customers and partners choose eHealth, Inc. as of late 2025. These are the tangible benefits we deliver, grounded in the latest figures from the Q3 2025 report.

Carrier-agnostic platform offering the broadest plan selection in the private sector.

eHealth, Inc. serves as a leading independent licensed insurance agency and advisor, providing access to over 180 health insurers, which includes both national and regional companies. This breadth is key to serving the diverse needs of the Medicare-eligible population and others shopping the individual market. The Medicare segment, which drives the bulk of the business, generated $49.9 million in revenue in the third quarter of 2025.

Simplified, personalized shopping experience for complex Medicare plans.

Navigating Medicare is tough, so the value proposition centers on making it manageable. While the company is actively piloting new technology like AI voice agents to streamline plan selection, the core business still saw Medicare submissions decrease by 36% year-over-year in Q3 2025, totaling 40,921 submissions. This drop reflects a more disciplined marketing spend, but the underlying value is reflected in the segment's improved gross loss, narrowing to $1.2 million from $5.6 million in the prior-year period. The profitability per customer, measured by Medicare Advantage Lifetime Value (MA LTV), stood at $907, representing a year-over-year decline of 4.7%.

The overall financial context for 2025 shows management is focused on efficiency, raising the full-year GAAP net income guidance to a range of $9 million to $30 million, up from prior expectations.

Here are the key financial metrics that frame the environment in which these value propositions operate:

Metric	Q3 2025 Actual	Year-over-Year Change	Full Year 2025 Guidance Range
Total Revenue	$53.9 million	Down 8%	$525 million to $565 million
GAAP Net Loss	$31.7 million	Improved by $10.8 million	$9 million to $30 million (Net Income)
Adjusted EBITDA Loss	$34.0 million	Improved by $0.8 million	$60 million to $80 million
Medicare Segment Tail Revenue	$12.1 million	Up from $1.1 million (Q3 2024)	N/A

Tailored distribution and enrollment strategies for carrier partners.

The value to carriers is demonstrated by the quality and recognition of revenue. The Medicare segment generated $12.1 million in positive net adjustment revenue, often called tail revenue, in Q3 2025. This is a substantial increase compared to the $1.1 million recognized in the same quarter last year. Year-to-date, the cumulative positive tail revenue across all segments reached $40.5 million. This indicates a strong alignment with carrier profitability expectations through member retention and accurate revenue recognition.

Solutions like Iris by eHealth for Individual Coverage Health Reimbursement Arrangements (ICHRA).

For the Employer and Individual segment, the Iris by eHealth platform offers a specific cost-saving value proposition for employers. Based on an analysis completed in February 2025, businesses using Iris saved an average of 17% per employee compared to traditional group insurance costs. In specific cases analyzed, the savings reached an average of 32% per employee for some businesses. The platform allows employers to set a fixed monthly contribution, and employees select plans from the individual market.

The broader ICHRA market is estimated to involve about 6 million U.S. residents using these or similar programs as of early 2025.

• Iris by eHealth potential employer cost savings: 17% average.
• Maximum reported per-employee savings via Iris: 32%.
• ICHRA/similar program users in the U.S. (estimate): 6 million.

eHealth, Inc. (EHTH) - Canvas Business Model: Customer Relationships

You're managing a business where customer retention directly impacts the recognition of future revenue, so understanding the mechanics of the relationship is key. For eHealth, Inc. (EHTH), the focus is clearly on a multi-pronged approach to keep members engaged, especially given the high-stakes nature of the Annual Enrollment Period (AEP).

Omni-channel Model: Self-Service, Agent Support, and AI Integration

eHealth, Inc. (EHTH) operates across several channels to meet the consumer where they are. The foundation remains self-service online tools, though specific 2025 online application percentages aren't public, the historical push was toward 45% to 50% of Medicare applications being submitted online back in Q4 2020. The evolution now heavily involves artificial intelligence. On November 12, 2025, eHealth, Inc. announced advancements in its AI strategy, specifically expanding its voice agent capabilities. This AI-powered voice agent, 'Alice,' has been deployed to handle not just initial enrollment but also post-enrollment and general service calls, resulting in reported improvements in call center productivity metrics and highly positive customer feedback as of Q2 2025. Furthermore, an AI screener was deployed at scale, which management views as an immediate operational efficiency win. This technology adoption is timely, as a November 2025 survey indicated that 71% of Americans are open to using AI agents for enrollment support.

Member Retention and Lifetime Value Maximization

The company defintely views lasting relationships as crucial, making retention a stated strategic priority for 2025. This focus is financially measurable through Net Adjustment Revenue, often called tail revenue, which comes from members staying enrolled. For the third quarter of 2025, Medicare segment tail revenue hit $12.1 million, a significant jump from just $1.1 million in Q3 2024. Year-to-date through Q3 2025, the cumulative positive tail revenue across all segments reached $40.5 million. The underlying unit economics, while showing some pressure, are still being closely managed:

Metric	Q2 2025 Value	Year-over-Year Change
Medicare Advantage (MA) LTV	$934	Up 1%
Medicare Supplement (Med Supp) LTV	$1,435	Up 29%

It is important to note that for Q3 2025, the Medicare Advantage LTV declined slightly by 1.5%. The dedicated customer loyalty team is tasked with strengthening these relationships, supported by proactive outreach efforts, such as increasing outbound calls by approximately 20% into the membership base ahead of the AEP in 2025.

High-Touch Support During the Annual Enrollment Period (AEP)

The AEP is the peak demand period, requiring intensive support. eHealth, Inc. (EHTH) is preparing for this high-volume window by investing in its advisor force and anticipating favorable carrier economics. Management noted that the environment created by carrier changes and plan terminations is leading to similar levels of demand as the prior year, meaning high shopper volume. To support this, the company is focused on optimizing its telesales organization. Furthermore, the financial structure of the AEP is improving; commission rates are expected to increase in the mid-single-digit range year-over-year during the AEP due to carrier rate adjustments. The company also raised its full-year 2025 GAAP net income guidance to a range of $9 million to $30 million, signaling confidence that the AEP execution will be strong.

eHealth, Inc. (EHTH) - Canvas Business Model: Channels

You're looking at how eHealth, Inc. gets its Medicare and other insurance products in front of consumers as of late 2025. The channel strategy is clearly omnichannel, blending digital self-service with human advice.

Direct-to-consumer online marketplace (eHealth.com).

The eHealth.com platform serves as the central hub, offering access to over 180 health insurers, including national and regional companies. This digital channel is critical for driving self-service enrollment. During the 2024 AEP, the company achieved an all-time high in submitted application volume within the online unassisted category. The company's Q2 2025 constrained Lifetime Value (LTV) of Medicare Advantage plans increased 1% compared to Q2 2024, reflecting retention driven partly by direct branded channels. For the full year 2025, eHealth, Inc. is projecting total revenue between $525 million and $565 million, with the online marketplace being a primary driver of volume.

Telephonic sales and customer care centers.

The telephonic channel remains vital for complex Medicare enrollments where consumer guidance is necessary. In the 2024 AEP, telephonic conversion rates were reported as being above expectations, showing meaningful year-over-year improvement. To enhance efficiency across the board, eHealth, Inc. reported a 6% decrease in customer care and enrollment expenses in Q3 2025 compared to Q3 2024. The company's strategy involves ensuring these centers convert high-quality leads efficiently, which is reflected in the LTV-to-CAC ratio metric.

Direct marketing channels (digital, TV, mail).

Direct marketing is a significant lever for driving traffic to both the online marketplace and the telephonic centers. In Q1 2025, there was strong year-over-year growth in submitted Medicare applications, with significant outperformance noted within direct marketing channels. This channel's spend is actively managed; for instance, in Q3 2025, the company implemented a 25% reduction in variable marketing spend compared to the prior year period. Based on 2023 figures, annual marketing spend was $42.6 million, which the company is clearly optimizing in 2025.

The following table summarizes some key operational metrics that reflect the performance across these customer acquisition channels through the first three quarters of 2025, where available:

Metric	Period Ending Q1 2025	Period Ending Q3 2025	Context/Comparison
Total Revenue	$113.1 million	$53.9 million	Full Year 2025 Guidance: $525M - $565M
Total Medicare Approved Members	Up 16% YoY	Data Not Explicitly Stated for Q3	Q3 2025 Medicare Submissions: 40,921
Total Acquisition Cost per MA-Equivalent Approved Member	Down 10% YoY	Data Not Explicitly Stated for Q3	2023 CAC was $352 per customer
Variable Marketing Spend Change	Data Not Explicitly Stated	Down 25% YoY	Customer Care/Enrollment Expenses Down 6% YoY in Q3 2025

Marketing partner channels for customer acquisition.

The use of marketing partners is integrated into the overall customer acquisition strategy, though specific financial breakdowns for this segment aren't detailed separately in the latest reports. The company focuses on the overall LTV-to-CAC ratio in the Medicare business, which suggests that all acquisition sources, including partners, are being measured against the value they bring. The overall goal is to drive enrollment growth at enhanced margins, a goal supported by the Q1 2025 Medicare unit margin expansion year-over-year.

Finance: draft 13-week cash view by Friday.

eHealth, Inc. (EHTH) - Canvas Business Model: Customer Segments

You're looking at the core groups eHealth, Inc. (EHTH) serves as of late 2025, based on their latest market focus and reported data. The business model clearly prioritizes the senior market, but the growth in the small business/ICHRA space is a key trend we're tracking.

Medicare-eligible consumers (primary focus: MA, Medicare Supplement, Part D)

This is the bedrock of eHealth, Inc. (EHTH)'s operations, serving the massive population eligible for federal health programs. The total pool of Medicare-eligible individuals is over 70 million people. Within that group, nearly 36 million are enrolled in Medicare Advantage (MA) plans.

Data from the Fall 2025 Annual Enrollment Period (AEP) for 2026 coverage, based on eHealth, Inc. (EHTH) customer selections, shows specific cost trends for this segment:

Metric	2026 Plan Data (from AEP 2025 shopping)	Year-over-Year Change
Average MA Monthly Premium	$5	Unchanged
Percentage of Selected MA Plans with $0 Monthly Premium	86%	Up from 85% last year
Average MA Out-of-Pocket Maximum	$6,240	8% increase (from $5,760 for 2025 plans)
Average MA Deductible	$4,105	2.8% decrease (from $4,225 for 2025 plans)
Average Part D Monthly Premium	$36	24% increase (from $29 for 2024 coverage)

eHealth, Inc. (EHTH)'s own enrollment activity reflects market dynamics; for instance, Q3 2025 saw 40,921 Medicare submissions, which was a 36% year-over-year decrease. Still, the MA program itself maintains a high satisfaction rating of 92% among enrollees.

Small-to-mid-sized businesses seeking Individual Coverage Health Reimbursement Arrangements (ICHRA)

This segment represents a structural shift in how smaller employers approach benefits. Research from eHealth, Inc. (EHTH) in August 2025 indicated that 89% of small to mid-sized businesses worry they won't afford traditional group health plans within three years. Furthermore, 93% believe the current model isn't working anymore. This pain point fuels the adoption of defined contribution models.

The interest is translating into action:

• ICHRA enrollment has increased by 52% this year (2025).
• 75% of surveyed business owners favor a defined contribution approach like ICHRA.
• However, 54% remain unfamiliar with ICHRA despite the interest.

Even among those with traditional employer-based coverage, 68% like the concept of employers offering stipends for them to shop for plans on their own, mirroring the ICHRA approach in the ACA market. That's a big signal for future growth in this area.

Individual and family plan shoppers (secondary focus)

While Medicare is the primary driver, the broader individual and family market remains relevant, often overlapping with the ICHRA-seeking employees who shop the ACA marketplace. Nationally, 88% of Americans report being satisfied with their current health insurance, but affordability is a major issue, with 73% saying they have delayed or skipped medical care due to out-of-pocket costs. This segment is highly sensitive to cost, which is why the ICHRA model-allowing employees to use employer funds for individual plans-is gaining traction.

Here are some general consumer statistics relevant to this market:

• 71% of Americans would be interested in working with an AI agent for more efficient shopping.
• Nearly half (49%) rate the overall U.S. health insurance system a 'C' or lower.

Finance: draft 13-week cash view by Friday.

eHealth, Inc. (EHTH) - Canvas Business Model: Cost Structure

You're looking at the cost side of eHealth, Inc.'s operations as of late 2025, and the story is clearly one of aggressive cost discipline following a challenging period. The primary lever pulled to improve the bottom line was dialing back on customer acquisition spending.

High variable marketing and advertising spend for customer acquisition saw a significant pullback. Honestly, this is where you see the immediate impact of management's focus on efficiency. For the third quarter of 2025, eHealth, Inc. reported a 25% reduction in consolidated and Medicare segment variable marketing spend when compared to the third quarter of 2024. This move was proactive, adjusting to market conditions, and it directly contributed to the narrowing of the adjusted EBITDA loss to $(34.0) million in Q3 2025 from $(34.8) million in the prior year period.

Customer care and enrollment expenses (CC&E) also came under review. This line item, which covers your licensed agents and support staff, saw a reduction of $2.5 million, which translates to a 6% decrease year-over-year in Q3 2025. The savings here came from executing a flexible staffing strategy within the telesales organization, though this was partially offset by costs related to a more tenured benefit advisor group and an increased number of retention advisors year-over-year. Overall, total operating costs and expenses for eHealth, Inc. decreased 6% year-over-year in Q3 2025.

To map out the structure for the second quarter of 2025, which gives us concrete dollar figures for the platform and overhead, here's how the major GAAP expense categories stacked up (amounts in thousands):

Cost Category	Q2 2025 GAAP Amount (in thousands)	Q2 2024 GAAP Amount (in thousands)	Year-over-Year Change
Marketing and Advertising Expense	$21,425	$26,783	Decreased by $5,358
Customer Care and Enrollment Expense	$27,910	$28,551	Decreased by $641
Technology and Content Expense	$11,354	$13,044	Decreased by $1,690
General and Administrative Expense	$21,582	$22,402	Decreased by $820

Technology and content development costs, which support the platform and any AI initiatives, showed efficiency gains in Q2 2025. The GAAP expense was $11,354 thousand, down $1,690 thousand, or 7%, compared to the second quarter of 2024. This reflects a concerted effort to manage the spend required to maintain and enhance the digital infrastructure that powers both e-commerce consumers and benefit advisors.

General and administrative (G&A) expenses also reflected cost control, coming in at $21,582 thousand in Q2 2025 on a GAAP basis. This was a 7% decline, or $2,279 thousand reduction when accounting for stock-based compensation, compared to the prior year's Q2. It's important to note that beginning in Q1 2024, eHealth, Inc. modified its methodology, reclassifying some facilities-related expenses from marketing and advertising into G&A, so direct period-over-period comparisons require looking at the recast prior periods. Any leadership transition costs, if material, would likely be absorbed within this G&A bucket, though specific dollar amounts for those costs aren't broken out in the standard reporting lines you see here.

Finance: draft 13-week cash view by Friday.

eHealth, Inc. (EHTH) - Canvas Business Model: Revenue Streams

You're looking at how eHealth, Inc. (EHTH) brings in the money, which is pretty concentrated in insurance placements. The biggest piece of the pie is definitely commission revenue from health insurance carriers for new enrollments you help facilitate. This is the core transaction: a consumer signs up for a Medicare Advantage or Medicare Supplement plan through the eHealth, Inc. (EHTH) platform, and the carrier pays a commission for that new member acquisition.

Still, another critical, though less consistent, stream is what they call positive net adjustment revenue, often referred to as tail revenue. This comes from member retention and other adjustments to commissions recognized in prior periods. For the third quarter of 2025, this tail revenue was a notable $12.1 million. To give you a sense of scale, the total revenue for that same third quarter was $53.9 million, so that tail revenue was a significant portion of the total for that period.

When you map out the full-year expectations, you see where management is placing its bets for 2025. The company has raised its outlook, which is a good sign of confidence, even with the market shifts we've seen. Here's the quick math on the updated full-year guidance as of late 2025:

Metric	Full-Year 2025 Guidance Range
Total Revenue	$525 million to $565 million
GAAP Net Income	$9 million to $30 million

The revenue stream is heavily weighted toward Medicare products, which makes sense given the annual enrollment period (AEP) cycle. The fact that they are maintaining the total revenue guidance of $525 million to $565 million while raising the GAAP net income guidance to $9 million to $30 million suggests they are getting more profit out of each dollar of revenue, likely due to those cost management efforts you've probably read about.

It's important to remember that the revenue recognition is tied to enrollment periods and member retention, not just the initial sign-up. This means the business model relies on both successful acquisition during peak times and effective retention efforts throughout the year to realize the full value of those commissions. The tail revenue component, like the $12.1 million in Q3 2025, is a direct reflection of that retention success.

The key revenue drivers, therefore, look like this:

• - Commission revenue from health insurance carriers for new enrollments.
• - Positive net adjustment revenue (tail revenue) from member retention, which hit $12.1 million in Q3 2025.
• - Full-year 2025 total revenue guidance is set between $525 million and $565 million.
• - Full-year 2025 GAAP net income guidance is projected from $9 million to $30 million.

Finance: draft Q4 2025 cash flow forecast by end of week.