This week, two big pieces of the puzzle dropped into place for agents and brokers interested in working through the new health care exchanges.
The Obama Administration released a document detailing exactly how agents and brokers will enroll individuals and small businesses through federally facilitated exchanges (FFEs), as well as a few new details on the web-broker program. In addition, the Administration published revised and shortened applications for enrollment in coverage through the exchanges.
The Big “I” welcomed these developments, with producer training and registration through FFEs slated for later this summer and initial enrollment in exchanges scheduled to begin Oct.1, 2013.
Federal Exchange Enrollment
The Center for Consumer Information and Insurance Oversight (CCIIO) released a 12-page document that is divided into three sections. The first section provides an overview of the role of producers in FFEs and state-federal partnerships. The second section is a Q&A series on frequently asked questions regarding the role of agents and brokers in FFEs and state-based exchanges. The third section is also organized as a Q&A and provides new, but still fairly general, information on the web-broker program.
The main portion of the document describes two pathways for agents to use when enrolling consumers: one through the carriers’ websites and another through the exchange website. Agents will continue to be paid directly by the carriers, with the only stipulation that they must be paid the same both inside and outside of the exchanges for “similar health plans.”
Later this summer, the Centers for Medicare and Medicaid Services, which is the government body that CCIIO reports to, will begin a registration and training process for agents and brokers. During this process a producer will confirm his or her identity, complete an exchange-specific online training course and sign an agreement with the exchange. Once these steps are complete, the producer will receive an exchange user ID.
Both this user ID and the agent or broker’s national producer number (NPN) will be needed to identify a producer and ensure he or she is compensated no matter which enrollment pathway is used—the carrier website or the exchange website. Producers will also need to provide copies of their training certificates and user IDs to issuers as part of the appointment process.
To use a carrier’s website for enrollment, a producer will start by logging onto the issuer’s website. Once the producer and consumer decide on the best plan for enrollment, the producer will be securely redirected from the issuer’s website to the exchange website to complete the application. The agent or broker will then need to enter his or her user ID and NPN to receive credit for the completed enrollment.
To use the second option for enrollment, known as the marketplace pathway—the Administration’s new term for exchanges—the consumer, employer or employee will first need to log directly onto his or her own exchange account through the public website. The agent or broker will then go over the plan options and assist in deciding which best fits the needs of the client. Similarly to the carrier pathway, once the application for enrollment is completed the producer will be prompted to enter his or her user ID and NPN.
The “two pathway” method is a positive development and an idea that the Big “I” has been working on with CCIIO for some time. However, the association does anticipate there will be wrinkles to be ironed out and will continue to work with the Obama Administration to ensure a strong role for agents and brokers.
Revised Exchange Applications
This week, the Administration released final versions of applications for consumers to use when applying for coverage in the health care exchanges under the Patient Protection and Affordable Care Act. Each of the applications has been significantly simplified and shortened from previous drafts.
CMS released three forms: the individual short form, the family application and the application for individuals without financial assistance. Notably, the individual application is three pages long, which is a significant reduction from the 21-page original draft. Also, the family application is seven pages, which is a reduction of two-thirds.
The applications now contain added language to show, if applicable, that an agent or broker assisted in the process. The original draft only had a section for government entities such as navigators and certified application counselors.
Ryan Young is Big “I” senior director of federal government affairs.