Will There Ever Be a Day when Health Ins Agents Are No Longer Needed?

[CHUMPS FROM OXFORD]

$12 per month per enrolleee. Max three per family. Actually, I don't know.

If you didn't GET OUT by now, then your state will release the compensation numbers sometime in 2014.

I look forward to the Exchanges but each of our situations is different.

 

[somarco]

Let's play a game. Say you enroll someone in a Blue Cross exchange plan in January, 2014. Then a few weeks later they call the exchange and Shaquanda tells them there is a better plan that is cheaper from UHC.

What happens to your commissions?

While you are working off commissions or referral fees, Shaquanda gets paid just for showing up, gets sick leave, vacation, holidays, health insurance and a pension.

How does that make you feel?

 

[Ann H]

In AZ they are telling us that there will be no post-application changes in the exchange. The question was posed that, if a client submitted their app to the exchange, then changed their mind BEFORE the deadline, could they alter the plan choice, and the answer was a resounding "NO, our system is not set up to allow that."

Even though you might think that would make me feel secure about navigators not being able to take our commissions, it actually makes me concerned about arbitrary exchange rules that are made by government regulators who never spent a day in the business world.

 

[Yagents]

Much like Medicare, changes can only happen during open enrollment periods. Next, that's why they will use an agent, who will make sure they are in the best plan in the first place. If you don't know how to do your business correctly, I'll steal your business !!

Plus, I doubt call centers will be able to give that kind of advice. Oh, the liability with no E&O.

 

[FLM]

I work in both the U65 and Medicare markets and have no problems with Call Centers enrolling people for Medicare or for the Exchange plans when they are available.

As a personal producer, I want a book of about 500 subscribers, that's probably 200 families and 100 individuals. The presence of Call Centers isn't going to take away my ability to achieve these goals, particularly since my current book of business is between 250-300 and I have lots of local people that are under group plans now that will likely be coming off when companies with less than 50 employees realize that they can drop their group coverage and have their employees pick up their own plans for less than the current employee cost through the group.

Given that the Federal Exchange will be the gateway for about 30 states, my guess is that compensation for the 1st year will be in the same % range as Medicare Advantage, which pays $400 for an enrollment on about a $10,000 premium-I've used $250 per adult as a target for my own planning.

The big losers in the Exchange are all of the agencies-unless they convince their agents to stay with them and split commissions, they are essentially out of business in 2014.

 

[somarco]

there will be no post-application changes in the exchange.

From a consumer perspective, that sucks. Expect some pushback on that.

On the other hand, if the taxpayer is paying some or all of your premium you have to play by their rules.

Much like Medicare, changes can only happen during open enrollment periods.

Someone told me today that Obamaexchange AEP overlaps Medicare AEP.

Even if it plays out as you say, nothing to stop them from changing their mind during OEP.

I doubt call centers will be able to give that kind of advice.

I doubt they will either. But how long will it take buyers to put all the pieces together, they may be outside of OEP.

 

[foxmarble]

You guys a wacked:

Lower commissions on higher premiums, means rising commission income.

Commissions paid on subsidized, guarantee issued product means more business, less declines, and more agents coming into the market.

Brick and mortar? I work from my bedroom, no overhead, 80% profit margins.

Internet a threat? My business doubled/tripled with the internet. Haven't met a client face to face in months/years. Online apps or find someone else.

Order takers/call centers - no education, just taking orders and the rep will be gone the next month. Where's Joe at extension 2019? Personalized agents, service, hand held education will always be in need.

Need vs. want - I can count on one hand how many people I've had to convince to buy health insurance, plus they don't stay on the books if I do get the biz. Most every client of mine was a referral who wants insurance, and knows the value of it.

I agree..you guys are a bunch of chicken little the sky is falling squakers. I'm like Yagents here...im so stupid busy i need three of me. I'm not looking for anybody...they are busting my door down. My freakin phone rings of the hook all day. I had to open a new office and hire someone full time this year. Maybe you should all quit whining and turn this thing into an opportunity. PS I hate that dirt bag Obama but since he passed it Im gonna make him pay me.

 

[AllenChicago]

Here's the million dollar question: What is the compensation going to be on the exchange?

As I recall, when the Pre-existing Condition Insurance Plan (PCIP) was first introduced by the Affordable Care Act, it didn't pay any commissions. The Feds thought they could use their own pamphlets and state contacts to get the word out. It didn't work well at all. After about a year, HHS started to pay a one-time referral fee to qualified agents who helped people enroll in PCIP. Once agents helped to get the ball rolling, Health and Human Services cancelled the Agent Referral Fee initiative.

For the Federally Run and State Run exchanges, there are many more outreach agencies involved than there were for PCIP education. One of the biggest outreach agencies is known as "Enroll America" (Enroll America). If these type of organizations do a good enough job, HHS may just decide to not utilize the services of Independent Health Agents at all.

IMO, the extraordinarily high expenses associated with implementing and maintaining the ACA, combined with ACA budget cuts coming in the 2013 debt-negotiations might make agents a "fall-back plan" for Sebelius/HHS to use only if their primary outreach outlets fail to produce. Remember... Sebelius doesn't like agents. We remind her of the Republican brand.
-ac

 

[FLM]

As I recall, when the Pre-existing Condition Insurance Plan (PCIP) was first introduced by the Affordable Care Act, it didn't pay any commissions. The Feds thought they could use their own pamphlets and state contacts to get the word out. It didn't work well at all. After about a year, HHS started to pay a one-time referral fee to qualified agents who helped people enroll in PCIP. Once agents helped to get the ball rolling, Health and Human Services cancelled the Agent Referral Fee initiative.

For the Federally Run and State Run exchanges, there are many more outreach agencies involved than there were for PCIP education. One of the biggest outreach agencies is known as "Enroll America" (Enroll America). If these type of organizations do a good enough job, HHS may just decide to not utilize the services of Independent Health Agents at all.

IMO, the extraordinarily high expenses associated with implementing and maintaining the ACA, combined with ACA budget cuts coming in the 2013 debt-negotiations might make agents a "fall-back plan" for Sebelius/HHS to use only if their primary outreach outlets fail to produce. Remember... Sebelius doesn't like agents. We remind her of the Republican brand.
-ac

There is one big difference between 2014 and PCIP regarding commissions-in 2014 the insurance companies will be paying agents, not the Feds (according to Humana's recent agent webinar).

They will have the 80% MLR provision in place with much higher premiums, if there is room to pay agents in the 12-15% range for 1st year premiums now (including GA overrides and bonuses) and 4-5% on renewals you would have to assume there will be similar room in 2014.

As long as there is competition among the carriers there will be agent commissions-if there is a single payor system there is obviously no place for an agent-PCIP is a single payor system (and not a very good one at that) with limited funds in place to handle all of the claims (the only ones who enrolled had major health issues, not the case with the Exchange plans at all).

Again, this is all conjecture until the final rules are put in place but I'm cautiously optimistic about 2014 and beyond.

 

[Yagents]

We are now considered a liability in the fiscal cliff discussions. Will it be big bird or us agents?

CBO: Agent comp bill could add $1.1 billion to deficits | LifeHealthPro