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Web-Based Entities: An Alternative To HIX? - Health Insurance Exchange
ABOUT HIX
HIX is an information resource and marketplace of ideas for the next generation of benefits delivery professionals.
Then
Web-Based Entities: An Alternative To HIX?
BY: BRUCE SHUTAN
DECEMBER 10, 2013
"Most independent agents and brokers “are counting on using web-based access provided by subscription-based technology companies or general agencies and direct enrollment through carrier broker portals as their primary point of access to the federally facilitated marketplace,” explains Jessica Waltman, SVP of government affairs at the National Association of Health Underwriters (NAHU)."
Full story... FYI
Web-Based Entities: An Alternative To HIX?
by: Bruce Shutan
December 10, 2013
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The 2014 open-enrollment season has seen the addition of public and private health insurance exchanges, but there’s also a little-known third solution that connects both of those options.
Private health insurance exchanges, brokers or agents can be authorized as “web-based entities” (WBEs) or “alternative enrollment channels” to help enroll individuals eligible for a tax credit subsidy in certified qualified health plans through their own online health insurance marketplace. The arrangement is sanctioned under formal agreements with the U.S. Centers for Medicare and Medicaid Services (CMS) or state-run marketplaces.
Allowing experienced and licensed industry practitioners to play a meaningful role in online marketplace enrollments could help public exchanges reach more consumers following Healthcare.gov’s shaky start, according to one published report. However, the recently announced yearlong delay in online enrollment in the Small Business Health Options Program (SHOP) in 36 states that are part of the federally facilitated marketplace effectively removes small businesses as potential customers of WBEs in 2014.
“In 2015, employers will be on the hook for providing coverage or paying penalties, so they can either buy coverage through old channels, such as offline brokers, or new channels, such as private online exchanges,” explains J.D. Kleinke, an economist and advisor of GetInsured. He says a third option would be for small businesses to earmark a certain amount of money to their employees to buy their own insurance on a public exchange.
Kevin Kuhlman, manager of legislative affairs at the National Federation of Independent Business, recently expressed disappointment over the yearlong delay of online enrollment in SHOP. Lamenting that “small businesses continue to be low on the priority list during the Obamacare implementation process,” he added in a prepared statement: “The continued delays add to uncertainty and contribute to the decision of many owners to take early renewals of their small-group plans.”
WBEs were largely tucked away in 166 pages of HIX rules the U.S. Department of Health and Human Services (HHS) published last March – an option that wasn’t included in the Affordable Care Act. Instead, it was suggested by various stakeholders with an interest in becoming a WBE and turned out to be a welcomed surprise for HIX entrepreneurs.
There were 38 agreements in place by early December, with more expected on a regular basis. Some of the leading WBEs include GetInsured, eHealth, Quotit and GoHealth, which recently issued a news release about becoming “the first WBE to publicly announce the capability to process direct enrollments for consumers through their own platform, which interacts with a recently updated feature of the federally facilitated marketplace on HealthCare.gov.”
CMS declined to reveal other names with approved contracts. WBEs would be compensated for their assistance, but in keeping with guidelines for navigators and assisters, must give equal weight to marketing all HIX plan options without any bias.
Bob Hurley, eHealth’s senior VP of carrier relations, told Healthcare Payer News: “It just didn’t seem fair that subsidy-eligible consumers had to go to a state-based exchange and couldn’t go to a private exchange.”
Linking private and public exchanges “could have increasing appeal as employers consider private exchanges, especially if some of their employees will be better off on the public exchange due to subsidies,” observes Barbara Gniewek, a principal in the health care practice of PricewaterhouseCooper, which recently formed the Private Exchange Evaluation Collaborative (PEEC) with four leading employer health coalitions across the U.S.
She says a public option could be particularly valuable to part-time or early retirees who might not be eligible for employer-sponsored health benefits, employees. “While some private exchanges are already considering that approach,” she adds, “the delay in the employer mandate penalties may encourage others to follow.”
With WBEs focused on individual-market plans, Gniewek says larger employers associated with the PEEC that provide health coverage to employees seeking some clarification on the private HIX market may give the option a closer look in a few years as they’re able to join the public exchanges. She considers WBEs “a cost effective way to increase enrollment in the public exchanges,” since they’re already set up to market and sell insurance.
Most independent agents and brokers “are counting on using web-based access provided by subscription-based technology companies or general agencies and direct enrollment through carrier broker portals as their primary point of access to the federally facilitated marketplace,” explains Jessica Waltman, SVP of government affairs at the National Association of Health Underwriters (NAHU).
After Healthcare.gov’s technical glitches, the molasses pace of paper applications and call center’s unwillingness to accept agent information on a routine basis, she hopes HHS is “devoting resources to get these enrollment mechanisms up and running as soon as possible.”
NAHU expressed concern earlier in the year about Section 155.220(c)(4) of the proposed rule from HHS, warning in a letter to CMS that unless it’s modified, there could be “millions of missed enrollment opportunities for consumers by severely hampering the ability of independent agents and brokers to access and market exchange-based individual coverage in federally facilitated and partnership exchange states via web-based entities.”
Most independent agents and brokers lack “the technological and/or financial resources to meet the federal exchange’s web-based broker criteria on their own,” according to the NAHU letter, which also noted that large online enrollment entities, very large independent agencies and captive producers employed by issuers would have an unfair competitive advantage. The group made several suggestions for technical improvements to the rule that would help its membership.
Shutan is a Los Angeles freelance writer.
ABOUT HIX
HIX is an information resource and marketplace of ideas for the next generation of benefits delivery professionals.
Then
Web-Based Entities: An Alternative To HIX?
BY: BRUCE SHUTAN
DECEMBER 10, 2013
"Most independent agents and brokers “are counting on using web-based access provided by subscription-based technology companies or general agencies and direct enrollment through carrier broker portals as their primary point of access to the federally facilitated marketplace,” explains Jessica Waltman, SVP of government affairs at the National Association of Health Underwriters (NAHU)."
Full story... FYI
Web-Based Entities: An Alternative To HIX?
by: Bruce Shutan
December 10, 2013
inShare
2
The 2014 open-enrollment season has seen the addition of public and private health insurance exchanges, but there’s also a little-known third solution that connects both of those options.
Private health insurance exchanges, brokers or agents can be authorized as “web-based entities” (WBEs) or “alternative enrollment channels” to help enroll individuals eligible for a tax credit subsidy in certified qualified health plans through their own online health insurance marketplace. The arrangement is sanctioned under formal agreements with the U.S. Centers for Medicare and Medicaid Services (CMS) or state-run marketplaces.
Allowing experienced and licensed industry practitioners to play a meaningful role in online marketplace enrollments could help public exchanges reach more consumers following Healthcare.gov’s shaky start, according to one published report. However, the recently announced yearlong delay in online enrollment in the Small Business Health Options Program (SHOP) in 36 states that are part of the federally facilitated marketplace effectively removes small businesses as potential customers of WBEs in 2014.
“In 2015, employers will be on the hook for providing coverage or paying penalties, so they can either buy coverage through old channels, such as offline brokers, or new channels, such as private online exchanges,” explains J.D. Kleinke, an economist and advisor of GetInsured. He says a third option would be for small businesses to earmark a certain amount of money to their employees to buy their own insurance on a public exchange.
Kevin Kuhlman, manager of legislative affairs at the National Federation of Independent Business, recently expressed disappointment over the yearlong delay of online enrollment in SHOP. Lamenting that “small businesses continue to be low on the priority list during the Obamacare implementation process,” he added in a prepared statement: “The continued delays add to uncertainty and contribute to the decision of many owners to take early renewals of their small-group plans.”
WBEs were largely tucked away in 166 pages of HIX rules the U.S. Department of Health and Human Services (HHS) published last March – an option that wasn’t included in the Affordable Care Act. Instead, it was suggested by various stakeholders with an interest in becoming a WBE and turned out to be a welcomed surprise for HIX entrepreneurs.
There were 38 agreements in place by early December, with more expected on a regular basis. Some of the leading WBEs include GetInsured, eHealth, Quotit and GoHealth, which recently issued a news release about becoming “the first WBE to publicly announce the capability to process direct enrollments for consumers through their own platform, which interacts with a recently updated feature of the federally facilitated marketplace on HealthCare.gov.”
CMS declined to reveal other names with approved contracts. WBEs would be compensated for their assistance, but in keeping with guidelines for navigators and assisters, must give equal weight to marketing all HIX plan options without any bias.
Bob Hurley, eHealth’s senior VP of carrier relations, told Healthcare Payer News: “It just didn’t seem fair that subsidy-eligible consumers had to go to a state-based exchange and couldn’t go to a private exchange.”
Linking private and public exchanges “could have increasing appeal as employers consider private exchanges, especially if some of their employees will be better off on the public exchange due to subsidies,” observes Barbara Gniewek, a principal in the health care practice of PricewaterhouseCooper, which recently formed the Private Exchange Evaluation Collaborative (PEEC) with four leading employer health coalitions across the U.S.
She says a public option could be particularly valuable to part-time or early retirees who might not be eligible for employer-sponsored health benefits, employees. “While some private exchanges are already considering that approach,” she adds, “the delay in the employer mandate penalties may encourage others to follow.”
With WBEs focused on individual-market plans, Gniewek says larger employers associated with the PEEC that provide health coverage to employees seeking some clarification on the private HIX market may give the option a closer look in a few years as they’re able to join the public exchanges. She considers WBEs “a cost effective way to increase enrollment in the public exchanges,” since they’re already set up to market and sell insurance.
Most independent agents and brokers “are counting on using web-based access provided by subscription-based technology companies or general agencies and direct enrollment through carrier broker portals as their primary point of access to the federally facilitated marketplace,” explains Jessica Waltman, SVP of government affairs at the National Association of Health Underwriters (NAHU).
After Healthcare.gov’s technical glitches, the molasses pace of paper applications and call center’s unwillingness to accept agent information on a routine basis, she hopes HHS is “devoting resources to get these enrollment mechanisms up and running as soon as possible.”
NAHU expressed concern earlier in the year about Section 155.220(c)(4) of the proposed rule from HHS, warning in a letter to CMS that unless it’s modified, there could be “millions of missed enrollment opportunities for consumers by severely hampering the ability of independent agents and brokers to access and market exchange-based individual coverage in federally facilitated and partnership exchange states via web-based entities.”
Most independent agents and brokers lack “the technological and/or financial resources to meet the federal exchange’s web-based broker criteria on their own,” according to the NAHU letter, which also noted that large online enrollment entities, very large independent agencies and captive producers employed by issuers would have an unfair competitive advantage. The group made several suggestions for technical improvements to the rule that would help its membership.
Shutan is a Los Angeles freelance writer.
