PPACA: Feds Say Their Exchanges Will Love Agents

[FLM]

PPACA: Feds Say Their Exchanges Will Love Agents | LifeHealthPro

If you are interested in learning more about the potential broker role under ACA this article is definitely worth reading.

In particular, I was encouraged by this:
"...HHS will provide licensed agents and brokers with a portal to the FFE Web site if those producers meet HHS standards, officials say.
Producers can use the portal to help individuals apply for eligibility for enrollment in a QHP and for insurance affordability programs, and if applicable, select and enroll in a QHP through an FFE, officials say."

Humana is on record as saying that the insurance companies, not the Exchange, will set broker commissions.

If you consider that premiums will be increasing by 100-300% under the exchange system and the MLR will remain at 80%, it would seem like there is ample room for fair broker commissions-I've posted on another thread that even 4-6% (flat) would be the equivalent of today's 1st year commissions after accounting for the increased premiums.

This isn't a slam dunk but at least there seems to be some light at the end of the tunnel. For me, who relies on local networking and referrals, I would be fine with simply being able to work with many more people who don't have current coverage (and who will get signficant subsidies) or those on groups that are being cancelled by their employers plus my current book of business.

I still would prefer to see the bill go away but, as a businessman, you have to take what is offered and, should there be a flat commission structure similar to Medicare I can not only deal with it but find positives in the long term.

 

[taterpeeler]

and not to pat the govt on the head but i also see this: i spend hours jacking with underwriting... telling prospects they dont qualify and having exclusions and rate up based on their medical probs... give me a GI situation with no time spent on uncontrolable outcomes and fickle underwriting and its game on....

 

[FLM]

and not to pat the govt on the head but i also see this: i spend hours jacking with underwriting... telling prospects they dont qualify and having exclusions and rate up based on their medical probs... give me a GI situation with no time spent on uncontrolable outcomes and fickle underwriting and its game on....

I agree 100%, it always nice to do a Medicare application for someone turning 65 or Medicare Advantage during AEP and know you are getting both approved and paid in timely fashion.

 

[pcbinsurance]

That article is 6 months old. A lot has changed in the past 6 months.

 

[VolAgent]

If you consider that premiums will be increasing by 100-300% under the exchange system and the MLR will remain at 80%, it would seem like there is ample room for fair broker commissions-I've posted on another thread that even 4-6% (flat) would be the equivalent of today's 1st year commissions after accounting for the increased premiums.

Something that never gets answered, who is going to pay these premiums after a 300% increase? Sure subsidies will help the lower end, but what about everyone else? The people who can qualify but choose to go without coverage now surely aren't going to be signing up. In fact, you might well see people dropping coverage versus adding.

 

[FLM]

That article is 6 months old. A lot has changed in the past 6 months.

why not share some of the things that changed instead of just saying they have and leaving it to the imagination.

A Humana agent webinar on October 25th essentially said the same thing I posted.

 

[AllenChicago]

Something that never gets answered, who is going to pay these premiums after a 300% increase? Sure subsidies will help the lower end, but what about everyone else? The people who can qualify but choose to go without coverage now surely aren't going to be signing up. In fact, you might well see people dropping coverage versus adding.

We were talking about this after our agency meeting this morning. Using the latest formulas in the Kaiser Subsidy Calculator, (Health Reform Subsidy Calculator - Kaiser Health Reform )

Family of 4 - Head of Household is Age 45.
Annual Premium in 2014 will be $14,700
Subsidy from broke Uncle Sam will be $7,200
Family's Monthly Responsibility = $625

Not bad, eh? Consider that the Deductible/Coinsurance add another $8,300 of potential out-of-pocket to this family's burden every year!

I was under the impression that the Exchange plans would have almost rediculously low out-of-pocket exposure. Yet it seems that it will be much higher than the plans we sell today, for essentially the same family premium.

Since there's an 80% chance that the subsidies will be scaled back to save the Govt money, the Affordable Care Act will be far from "Affordable". It's too bad that Romney/Ryan didn't do what forum member VolAgent suggested and harp on this and the penalty-tax with more intensity, because the Affordable Care Act will affect everyone (who works for a living) in a very bad way financially.

It's also a good bet that Exchanges will only LOVE AGENTS if their other outreach efforts don't bear fruit. Insurance companies barely "love" us even though we're their primary source of new clients. The Obama Admin is totally anti-agent and facing big budget cuts. But I have heard (maybe here?) that the insurance companies will compensate agents DIRECTLY for policies we help sell on an exchange. If so , that would be a BIG relief!
-ac

 

[Yagents]

I was under the impression that the Exchange plans would have almost rediculously low out-of-pocket exposure. Yet it seems that it will be much higher than the plans we sell today, for essentially the same family premium.
----------
But I have heard (maybe here?) that the insurance companies will compensate agents DIRECTLY for policies we help sell on an exchange. If so , that would be a BIG relief!
-ac

Due to actuarial value requirements, you will see deductibles of 1k/2k/3k with coinsurance, with max OOP tied to HSA OOP's for individual and families.

In AZ and CA at least, they've realized that the exchanges have to be financially self supporting, so to create systems that carriers already have, and staffing that carriers already have to pay agents would be duplicating and costly. DUH!! Just like the concept of an exchange is duplicating and costly. I am an exchange, I have a quoting system comparing plans side by side. The ONLY difference is subsidies. This whole fricken law is a joke.

 

[Ann H]

We were talking about this after our agency meeting this morning. Using the latest formulas in the Kaiser Subsidy Calculator, (Health Reform Subsidy Calculator - Kaiser Health Reform )

Family of 4 - Head of Household is Age 45.
Annual Premium in 2014 will be $14,700
Subsidy from broke Uncle Sam will be $7,200
Family's Monthly Responsibility = $625

Not bad, eh? Consider that the Deductible/Coinsurance add another $8,300 of potential out-of-pocket to this family's burden every year!

I was under the impression that the Exchange plans would have almost rediculously low out-of-pocket exposure. Yet it seems that it will be much higher than the plans we sell today, for essentially the same family premium.

Since there's an 80% chance that the subsidies will be scaled back to save the Govt money, the Affordable Care Act will be far from "Affordable". It's too bad that Romney/Ryan didn't do what forum member VolAgent suggested and harp on this and the penalty-tax with more intensity, because the Affordable Care Act will affect everyone (who works for a living) in a very bad way financially.

It's also a good bet that Exchanges will only LOVE AGENTS if their other outreach efforts don't bear fruit. Insurance companies barely "love" us even though we're their primary source of new clients. The Obama Admin is totally anti-agent and facing big budget cuts. But I have heard (maybe here?) that the insurance companies will compensate agents DIRECTLY for policies we help sell on an exchange. If so , that would be a BIG relief!
-ac

Allen, thank-you for a very good and informative post.

As you said, "Since there's an 80% chance that the subsidies will be scaled back to save the Govt money, the Affordable Care Act will be far from 'Affordable'." Somarco has been posting repeatedly that this still hinges on the govt being able to afford the subsidies. Although the govt can just print money or borrow it, sooner or later China will become tired of paying for all of this, and so will the American taxpayer and consumer. It's going to be like Medicare and Medicaid where they trim benefits over and over, manipulate the funding and run in the red. If the government can't keep solvent in Medicare and Medicaid and can't control the costs in their own workers' insurance programs, why do they think they can now? When the public sees the prices, the subsidies, the required benefits and the taxes, there will be an upheaval.

I heard Art Laffer say that this was a great election for Ryan to lose. Paul Ryan can do so much good in Congress, then perhaps run again in 2016.

 

[somarco]

Paul Ryan can do so much good in Congress, then perhaps run again in 2016.

Boehner needs to step aside and promote Ryan for Speaker. Same for McConnell and endorse Marco Rubio for Minority Leader.

Time for the Republican party to have new leadership and a new direction.

As for the exchange, Obama admin is showing signs of taking on water by moving the goalpost on the exchanges. The feds realize they don't have the money to fund the exchange and want to give states more time to pony up.

States Get Extra Time On Health Insurance Exchanges - Kaiser Health News

Why would a state want to raise taxes to build an exchange when the feds will do it for them?