Agent Exchange Application Process

[Yagents]

Ok, so I get this email from Black & Gould agency here in AZ, and it contained some info that I had not seen before from a recent conf call between NAHU and HHS.

1. It looks like we will still have our imbedded broker links with each of the carriers (a great thing)
2. Quote engines like Norvax, and the imbedded agent links will still be in business (these will act as our comparison marketplace still)
3. I think we will still have to determine subsidy eligibility through the FFE exchange first though, then redirect the client to our carrier link.
4. I hope they provide a unique agent ID, for those that continue through the FFE application process.

What am I missing??

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[FONT=times new roman, new york, times, serif]STAKEHOLDER CALL WITH HHS: Letter from NAHU
[/FONT]
[FONT=times new roman, new york, times, serif]By Jessica Fulginiti Waltman
Sr. V.P., Government Affairs
National Association of Health Underwriters
Dear NAHU Legislative Leaders,
I just wanted to let you know that Peter Nakahata from CMS asked to have a call with Janet and me this afternoon about
brokers and the federally facilitated exchange. The information on this call was only about federally facilitated and partnership
exchanges, not state-based exchanges. HHS still fully intends to use agents and brokers to sell and service individual
and group exchange products in the federally facilitated exchanges and partnership exchanges and they will certify and
register brokers beginning in August. However, they have decided for 2014 that they probably will not have the IT capabilities
for 2014 to have a standalone portal for broker-placed business on the individual side. Instead of using the FFE portal to
place business for all products, agents will use the regular consumer exchange to review products with clients and then place
the business directly through the carriers as you do now. Carriers will have their own interface with the federal exchange,
and brokers will work through each carrier’s online connection to the exchange to get subsidy determinations and actually
complete the enrollment. So from the agent perspective, it really means a status quo in the individual market with the added
benefit that exchange coverage may be subsidized for some applicants.
Navigators and assisters will not have a portal now either and they will not interface with carriers directly. They’ll just work
with consumers through the basic online exchange interface available to any consumer. Navigators /assisters are going to
probably have a unique identifier that will go on applications they submit through the traditional interface and we AGAIN
strongly suggested that brokers do too, since an individual could work with a broker and then submit the application themselves
online. CMS seemed very agreeable to this suggestion.
It seems like for now, web-based entities will have the ability to interface with the exchange as planned, but it wouldn’t
shock me if this piece also wound up being delayed for 2014 at some point before October.
As for the federally facilitated SHOP exchange, they probably will also delay the broker interface there but apparently that
is a little bit less final of a decision because of the potential enrollment impact. However, they have already decided to
delay aggregating premiums and choices of plans for employees in 2014, so I think the expectation is already clear at HHS
that employer enrollment will be significantly lower than originally hoped because those two factors too. Given the IT
concerns HHS indicated, I would be very surprised if there is a significant stand-alone broker SHOP interface for the federally
facilitated and partnership exchanges in 2014.
This also means that the long-planned agent/broker/navigator guidance we’ve been waiting for is now going to be delayed
further.
In any case, the change really just represents current market status quo for agents. I am not even sure most members will
even understand the difference, and in some ways it may even be easier for them, but since you all have been following
exchange development activities so closely, I wanted to let you know right away. If you have any questions, please let me
know.[/FONT]

 

[RayNY]

So in 3 years they couldn't make a portal for brokers, so they decide to make a portal for carriers instead, starting now and hoping to have it working in 6 months.

It's reassuring that after 3 years they finally admit brokers are important and finally indicate they want us to be a part of exchanges. My gut says they won't have it ready in time...

 

[Ann H]

Overall this is good news. I think HHS couldn't get the technology to work, but insurance companies can. It's interesting that navigators cannot have a portal, but they can help applicants with their own online apps. This should make it easier for agents.
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My gut says they won't have it ready in time...

They won't be ready. But they will be running anyway. From rumor I have heard, they are insistent on having SOMETHING running on 10/1/2013, whether it works well or not. The law requires these deadlines of 10/1/2013 for exchanges and 1/1/2014 for enrollment. If they don't meet the deadline(s), they are vulnerable. I don't understand all of this, but apparently there are things HHS can tweak because they are given power in the law to interpret and implement, and there are things which they cannot tweak because it is stipulated in the law.

 

[pahealthquotes]

What's missing is somehow during the application processes our producer identification is lost and we get screwed. Can't tell you how much money this has cost me but its quite substantial. Gotta love the clients who mail the apps directly to the carrier then call for status updates and questions about the benefits

 

[AllenChicago]

Excerpt from Final Letter from HHS to Issuers, dtd Friday April 5, 2013:

""The final letter states “CMS intends to make available a technical solution that allows a consumer to enroll through the Exchange using an issuer’s website or web-broker to initiate the enrollment process and complete plan comparison and selection.”"

Source: Implementing Health Reform: Final Letter to Issuers on Federally Facilitated and State Partnership Exchanges – Health Affairs Blog

The guy who writes this HealthAffairs.org blog doesn't like much of the wording contained in HHS's final letter on this subject, but it seems to confirm that brokers and insurers will have the flexibility needed to enroll clients using various web methods.
-ac

 

[Duaine]

Direct enrollment through an insurer and agent and broker oversight

Most of the letter’s long and highly technical chapter 4 on consumer enrollment and premium payment is identical to the proposed letter except for minor changes in wording. One troubling section of this chapter addresses direct enrollment through an issuer or web broker’s website.

Insurers would like to be able to enroll consumers directly for premium tax credits through their own websites without exposing consumers to the menu of plan choices that is the distinctive feature of the exchange and that will drive plan competition.

The final letter states “CMS intends to make available a technical solution that allows a consumer to enroll through the Exchange using an issuer’s website or web-broker to initiate the enrollment process and complete plan comparison and selection.” While the meaning of this is not wholly clear, it is to be hoped that consumers who enroll through an insurer’s website will not be deprived of the right to see all of the alternatives available to them in the market.

The section on agents and brokers in the final rule is much briefer than the corresponding section in the proposed letter and omits mention of an exchange-specific agent/broker agreement and of monitoring of compliance.

Apparently CMS intends to leave regulation of agent and broker conduct to the states and take no active role itself, a disturbing development given the problematic experience of CMS with broker and agent conduct in the similar Medicare Advantage program.

Finally, chapter 6 on consumer support is virtually unchanged from the proposed letter. CMS continues to promise further guidance on meaningful access for limited-English proficient speakers and people with disabilities. As implementation draws ever nearer, the need for this guidance continues to become more urgent. The final letter concludes with a chapter on tribal relations and support unchanged from the proposed letter. It also includes appendices on drug formularies, actuarial value, and cost sharing.

 

[Yagents]

Duaine, where did you get this information from?

It sounds like it's written by some consumer advocacy who thinks all agents were born the son of the devil.

 

[FLM2]

The CMS Training Module on Enrollment is pretty clear on this.

For specific carriers, you will have an embedded link that will allow direct enrollment.

If a consumer wants to enroll through the Marketplace, you can assist them but they have to create an account and enter your broker ID on the application-this is pretty easy for anyone used to enrolling by web conferencing or through an online application while meeting face to face.

I really don't see much of an issue here, others may disagree...

 

[Yagents]

for anyone used to enrolling by web conferencing or through an online application while meeting face to face.

I really don't see much of an issue here, others may disagree...

Which web conferencing website is best that you use? Which one doesn't require client to download software?

 

[FLM2]

Which web conferencing website is best that you use? Which one doesn't require client to download software?

joinme.com

It's free, I've never had a problem with it or a client joining my screen