Did HHS Just Wipe Out Most WBE's?

[Yagents]

BREAKING.......

Strong rumor and emails like the one below have been leaked stating that starting this monday, all WBE's will no longer be able to submit applications in the current method that all of us and consumers currently experience.

I'm not completely clear on the mechanics/tech aspect of this, but essentially, HHS is cutting off the current API submission method, and will now require that everyone go back to the old "double redirect" method, where you must start at the WBE, then go to HC.gov and fill out financial app, then come back to WBE to finalize plan selection.

IF TRUE, This has large ramifications on everyone's business, and once again in the middle of OEP. This doubles the time it takes to enroll someone. What in the world could be the reasoning?

1. Is it as plain as a complete government takeover of the private distribution of health insurance?

2. Pressure from carriers to slow down the volume of business? Specifically, broker sold business? (which we all know means just more losses)

3. They want to squash the only pleasurable O'care experience a consumer currently experiences (via a WBE)?

4. They don't like the idea of anyone making money in this industry from the law?

5. They want to take out the large distribution agencies? Or, are they going after the un-assisted business?

6. Or, the systems can't handle the new apps being created, and terminating the 15' app, or the auto 16' re-enroll app that's been pre-populated in many HC.gov accounts?


IF these rumors turn out to be true, and I believe they are true, what are we going to do about it? Industry publications and pressure? Time is money. We already are seeing a reduction in money, now we just lost the time side of the equation. An unworkable model for agents.

Agents lives matter..........

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Subject: Changes to _______ Enrollment Process for On-Exchange Submissions

Potential Change to Online Enrollment Process

On Friday afternoon, the Department of Health and Human Services released their annual regulation clarifications and proposed regulatory changes for the 2017 plan year. We wanted to inform you as soon as possible that this Notice of Benefit and Payment Parameters included in this release will likely affect the current Single-Site Enrollment process available through ______. While online enrollment will continue to be available, the process is likely to change due to the clarified regulations. We will be able to provide additional details regarding these changes by Tuesday, Dec. 1. Thank you for your continued support of ___________

 

[kgmom219]

Y...who did this come from?

Besides @HHS. @RhettButtle @Potus. @SecBurwell.

And does NAHU care???

 

[AllenChicago]

Any link to this Proposed Regulation? Comments from Stakeholders (You and Me!) are always allowed and encouraged, once the Proposed Regulation is published.

HHS must be discovering that the very guidelines they gave WBE's for enrolling consumers are leaving too many holes in an applicant's application. At the same time, the additional complexities with quoting at Healthcare.gov are driving more and more consumers to use Web Broker Entities. Add to that the additional millions of dollars CMS is spending to make Healthcare.gov more complicated, and you end up with yet another government boondoggle struggling to justify its existence.

Even though the new Republican President and Congress will get rid of the current system that uses Healthcare.gov, it won't be gone for 2017 Open Enrollment. To maintain the current WBE setup until it's terminated, HHS-CMS needs to hear loud and clear how we feel about this aspect of the proposed regulation.

 

[CHUMPS FROM OXFORD]

This may be a rather long weekend. Customers are ready to enroll. I guess no Sherpa...for now. Hope Sherpa works a way to continue to make life easier for us. Nobody else is.

 

[AllenChicago]

Here's a link to the proposed 381 page rule, in PDF format.

PPACA Benefit and Payment Parameters for 2017
https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-29884.pdf

Source website: https://www.federalregister.gov/art...e-act-benefit-and-payment-parameters-for-2017

I'm sure there are many other items in this Proposed Rule to upset the current apple cart. Ramping up chaos, premiums, narrow networks, etc.. another notch, increases the odds that Obama will get a Single-Payer bill in the works before he leaves office. (Don't freak kiddies. All of this is planned. Remember?)

 

[Yagents]

Here it is on page 134 of that PDF document


i. New Exchange Standards for Web-brokers.
134
As specified at §155.220(c)(1), an agent or broker who assists with an enrollment through
the Exchange must ensure that the applicant completes an eligibility verification and enrollment
application through the Exchange Internet website. Under this standard, agents and brokers that
use a non-Exchange website to assist consumers in the QHP selection and enrollment process
(“direct enrollment” through a “web-broker”) must redirect an applicant to go directly to the
Exchange website to complete the application and receive an eligibility determination. HHS is
considering an option under which an applicant could remain on the web-broker’s website to
complete the application and enroll in coverage, and the web-broker’s website can obtain
eligibility information from the Exchange to support the consumer in selecting and enrolling in a
QHP with Exchange financial assistance. The intent is to have this information exchange occur
through an Exchange-approved web service as described below, enhancing the direct enrollment
process. This option would provide Exchanges offering direct enrollment and web-brokers more
operational flexibility to expand front-end, consumer-facing channels for enrollment through a
seamless consumer experience.
HHS solicits comments related to the current consumer experience with web-brokers and
the potential integration of the streamlined eligibility application if a non-FFE website is used for
the entire process. We request comment on how much flexibility a web-broker should have
relative to the consumer experience on its website, using the direct enrollment channel, to
provide an end-to-end eligibility and enrollment experience. We propose that web-brokers be
required to use the FFE single streamlined application without deviation from the language of the
application questions and the sequence of information required for an eligibility determination or
redetermination. This will ensure that the information gathered when an applicant completes an
application on the Exchange website will also be collected to send to the Exchange for an
135
eligibility determination or redetermination that is accurate and consistent across any channel
used for enrollment. We seek comment on this standard. HHS is also considering how to ensure
that consumers understand that they are applying for Exchange coverage, such as through
specific branding or wording requirements if a non-FFE front-end website is used for the entire
application and enrollment process, and we seek comment on this as well.
Accordingly, we propose to revise §155.220(c)(1) to ensure that an applicant who
initiates enrollment directly with the web-broker for enrollment through the Exchange receives
an eligibility determination for coverage through the Exchange website or through an Exchangeapproved
web service via the FFE single streamline application. This maintains the role of the
Exchange in determining eligibility. We propose to adopt similar changes to the standards for
the use of QHP issuer websites under §156.265(b)(2)(ii). Please see section III.G.4.c for this
accompanying preamble discussion. We seek comment on this proposal.
We are also soliciting comments about the current agent and broker provisions in
§155.220 as applied to web-brokers. We are interested in feedback on consumer and
agent/broker experiences with enrollment through web-brokers, any concerns with privacy and
security of the information transmitted through web-brokers by expanding direct enrollment to
incorporate the FFE single streamlined application, and suggestions for improvements in the
future, such as increased monitoring and oversight activities. For example HHS is considering
expanding audits, requiring additional information display requirements (such as the lowest cost
plan at each metal level) beyond those outlined in §155.220(c)(3) to ensure that consumers
understand basic information about cost and availability of qualified health plans, and requiring
HHS approval of alternative enrollment pathway processes. Additional requirements to
safeguard consumer information or enhancements to improve the consumer and web-broker
136
experience are also being considered. These may include establishing more robust privacy and
security requirements, requiring adoption of cyber security best practices, additional web-broker
reporting requirements and specificity as to the collection and use of consumer information. We
note that the current oversight provisions for the general agreement, registration, training,
termination, and reconsideration in §155.220(d) through (h), as well as the changes in paragraphs
(f), (g), (j), and (k) proposed below, would apply to web-brokers.

 

[sman]

Yet another reason for me to not do on-exchange business.

 

[pbbaseball]

Say it ain't so!

 

[russelltw]

Confused, is this for 2017 or from Monday moving forward? Either way, it's just another reason ACA is becoming less and less of my business. May have to start telling clients that next year they are on their own.

 

[AllenChicago]

Confused, is this for 2017 or from Monday moving forward? Either way, it's just another reason ACA is becoming less and less of my business. May have to start telling clients that next year they are on their own.

Why confused? The Rule Summary itself says that this is proposed for 2017.

"SUMMARY: This proposed rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional standards for the annual open enrollment period for the individual market for the 2017 benefit year; essential health benefits; cost-sharing requirements; qualified health plans; updated standards for Exchange consumer assistance programs; network adequacy; patient safety standards; the Small Business Health Options Program; stand-alone dental plans; acceptance of third-party payments by qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; guaranteed availability; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics."