Slide 12 and 13 in our Q1 2024 earnings deck outlined the key operating and financial differences between our agency and Amplify models. In the first quarter of 2024, Amplify generated approximately $7.2 million in Medicare revenue and approximately 13% of the approved Medicare BOR members in the quarter. To be clear, the large BPO arrangement we announced last year related to an existing carrier has remained BOR up until 3/31 of this year. This arrangement will move to a fee-based arrangement in Q2. In addition, we picked up a new carrier BPO arrangement that was BOR in Q1 and will be moving to fee-based in Q2 as well. The majority of first quarter Amplify revenue is from existing carriers, and we expect to grow these relationships, as well as add new carriers to the platform.
Customer acquisition costs per Medicare Advantage equivalent approved member, which is comprised of customer care and enrollment or CC&E costs and variable marketing cost was $834, up 12% year-over-year. First quarter CC&E per MA equivalent approved member grew 20% year-over-year, reflecting a higher number of advisers, including those advisers supporting our dedicated amplified fulfillment model, as well as retention staff who drive member engagement activities. While retention agents don’t typically generate application volume, their services are expected to result in improved LTVs over time, as well as non-commission revenues such as HRAs. Additionally, this year, we intentionally retained a larger percentage of our tenured advisers post-AEP in order to support first quarter OEP enrollment growth as well as to increase average tenure and productivity within our sales team in advance of AEP.
Variable marketing per MA equivalent approved member increased 5% year-over-year, driven primarily by channel mix. Our telephonic conversion rate was flat with Q1 of last year. Total non-GAAP customer care and enrollment cost of $32.4 million increased 32% year-over-year and total non-GAAP marketing costs of $38.1 million increased 18% year-over-year. On a per Medicare equivalent approved member basis, these increases were 20% and 5%, reflecting efficiency gains as the per unit increases are lower than the absolute dollar increases. Recall that in Q1 2023, we were still in our MA transformation process, and Q1 24 reflects eHealth’s return to profitable growth mode, hence the increased variable cost. First quarter Medicare Advantage LTVs increased 6% year-over-year to $952 reflecting favorable carrier and contract mix.
Total noncommission revenue was $12 million compared to $5.7 million in Q1 of 2023 driven primarily by carrier sponsorship programs for our Medicare business. Medicare segment profit was $8.3 million compared to a segment loss of $0.6 million in Q1 of 2023. This improvement was attributable to the year-over-year increase in non-commission revenue as well as greater scale in our Medicare segment as we return to enrollment growth year-over-year. I’ll now move to our employer and individual or E&I segment. This high potential business is currently undergoing a transformation process similar to the transformation that we successfully completed within our Medicare segment. ENI continues to generate strong profit margins and positive net adjustment revenue, driven primarily by favorable retention trends on our existing book of IFP enrollments.
First quarter E&I segment revenue was $10.6 million compared to $11.9 million in Q1 of 2023. Segment profit was $4.7 million compared to $7.7 million last year. These results reflect a 29% reduction in individual and family plan enrollments, a 16% reduction in ancillary enrollments and a 15% reduction in small business group enrollments. Similar to the cadence of our Medicare transformation last year, we expect to return to growth in E&I in the fourth quarter on an improved operational and cost foundation. Q1 results reflect $2.5 million in net adjustment or tail revenue across our business, including approximately $1 million from our Medicare business. Non-GAAP fixed costs, which we define as the combination of technology and content and general and administrative declined by 18% or $6.2 million, primarily for compensation, benefits and external vendor costs.
As we discussed on our last earnings call, we identified fixed cost reduction opportunities as part of our 2024 planning process and began realizing them in Q1 with additional reductions expected throughout the remainder of the year. On a consolidated basis, net loss for the first quarter was $17 million compared to a net loss of $19.9 million last year. In Q1, we recognized $6.3 million of impairment and restructuring charges, largely related to our leased office locations as we continue to reduce our physical footprint to align with our remote first model. It also includes $800,000 in severance costs. We did not have any impairment or restructuring charges in the prior year quarter. Excluding these costs, net loss would have been $12.2 million as compared to a net loss of $19.9 million a year ago.
Adjusted EBITDA for Q1 was negative $1.7 million compared to a negative $12.7 million a year ago. As we continue to reduce our physical footprint, we have consolidated all of our facilities-related costs under the G&A line item. Previously, some facilities costs were allocated to the CC&E, TNC and M&A line items before our change in Q1 of 2024. These changes have been reflected in Q1 2024 financials and applied retroactively to our historical statements. Operating cash flow for the first quarter was $70.8 million versus $60.8 million in Q1 of 2023. Trailing 12-month cash flow from operations at March 31 was positive $3.3 million, up from negative $13.2 million a year ago and exceeded our goal of breakeven operating cash flow for this period.
We ended the quarter with $188.9 million in cash, cash equivalents and marketable securities on our balance sheet, which we believe is more than enough liquidity to satisfy our operational and strategic needs for the foreseeable future. The ending position of our combined short- and long-term contract asset receivable was $845.3 million. As Fran mentioned during his remarks, we are reiterating our annual guidance ranges for fiscal year 2024. While there is still ambiguity in the potential interpretation of CMS final Medicare Advantage rule, our decision is based on the information we have collected through extensive conversations with our carrier partners and industry subject matter experts. Navigating regulatory change is a core competency of eHealth, and we have done it successfully for many years, and I am confident in our ability to continue to do so with respect to this rule.
