For months now, my advice to brokers has been “stop reading and watching the news – it’s always wrong.” Seriously, I’ve never seen so much incorrect and incomplete information. First, there were the death panels. Incorrect. Then the story about subsidies not being available in states that choose not to develop their own exchange. Also wrong. And then the “news” about the SHOP being delayed a year. Yep, you guessed it.
The latest in a long line of articles that will cause panic in the broker community and cause the HPA phones to ring off the hook is yesterday’s piece from CNBC about delayed web marketplaces, which the NAHU News decided to make their top story today with the headline “Web-Based Insurers Still Blocked From Selling On Exchanges”. Here’s my response.
First, the NAHU News headline is misleading. Insurance agencies, online or otherwise, are not insurers – there’s a difference. Second, they’re not blocked, at least not in most states. It is true that many states that have opted to develop their own exchange are having some growing pains and have decided not to create the interface that would allow web-based entities to sell the exchange-based plans – yet. They’re behind, so adding this to the to-do list before the rapidly-approaching October 1st deadline would just add to the stress levels of the states that are scrambling to finish the job. That’s the same reason HHS decided to relax the income verification standards in those states. As Janet Trautwein, NAHU’s CEO, explained at the Benefits Selling Expo in San Diego a couple months ago, “must haves are being moved to the nice-to-have list”. I believe many of these states will re-evaluate their decision once they’ve cleared the first hurdle and their exchanges go live.
The federal government is in the same boat. They’re running behind in getting the Federally Facilitated Exchange – now being referred to by HHS as the Federally Facilitated Marketplace (FFM) – up and running by October 1st. So sort of like a body that’s in severe distress, they’re likely to shut down all non-essential functions and focus on the stuff they have to do. And I’m not convinced that setting up the application programming interface (API) that will allow web brokers to sell subsidized plans by the official start date is something they consider an essential function at this point.
But reading the article, you would think that the government has no intentions of working with web-based entities: “Less than 90 days before Obamacare’s government-run health exchanges are due to open up shop, Web insurers are still being locked out of helping sign up uninsured individuals.”
If a restaurant opens at 6pm and you show up at 5 to find the doors locked, are you being “locked out” or are you just there too early? Because if web brokers are being locked out, then so are brokers since our online certification classes won’t start until sometime after August 15th. Nobody can sell a subsidized plan until October 1st, so the fact that it isn’t yet done is no reason to panic. Patience, grasshopper.
The federal government has made it very clear that they intend to work with web brokers, first in the final exchange rules issued in March of 2012, then in the general guidance issued May of 2012, and most recently in the guidance issued May 1st, 2013 about the “Role of Agents, Brokers, and Web-brokers in Health Insurance Marketplaces”. In the guidance, CMS says:
“To the extent permitted by a state, beginning in October 2013, CMS intends to work with web-brokers that meet all applicable requirements to provide an alternate option to help consumers select QHPs online. Web-brokers will provide an additional channel for Federally-facilitated Marketplaces to reach consumers and to help them enroll in QHPs. CMS is developing the capability to support integration between the web-broker’s website and the Federally-facilitated Marketplace’s website using secure redirect and application programming interface mechanisms. The application programming interface will allow a qualified individual to initiate his or her shopping experience on the web-broker’s website, connect securely to the Federally-facilitated Marketplace website to complete the eligibility application and determination process, and return securely to the web-broker’s site to compare plans and select a QHP.”
Does that mean they’ll actually be done in time? No, of course not. We’ve said for months that we expect this API feed to be delayed a bit – not because HHS doesn’t want to work with web brokers, but because they’re running behind. But to say that web brokers are being “blocked” or “locked out” is completely incorrect and, in my opinion, disrespectful to HHS, which has shown a willingness to work with agents to get consumers enrolled in qualified, subsidized plans. There’s a huge opportunity here, so I think we should quit beating up on the people who are trying to make this thing work.
The good news for anyone who has partnered with Health Partners America is that our private exchange solution is not dependent on the API feed being set up by October 1st or, in states that are developing their own exchange, a decision by the state to work with web brokers at all. Your private exchange site allows you several options for capturing and routing leads and gives either you or the call center multiple options for selling the subsidized plans. If web brokers are not permitted by October 1st, no problem. The site can be set up as a lead capture tool and either you or the call center can follow up by phone to assist the consumer with the enrollment process. Brokers can still help people enroll directly through the federal or state exchange websites, and the May 1st guidance added an “issuer-based pathway” as an option, so brokers or the fulfillment center can select a specific plan to recommend to their clients and sign them up through the carrier’s site – much as they do today.
Listen, there’s no way the federal government can do it without us – they NEED the help of brokers, and they recognize that fact. That means there’s an opportunity. A private exchange site can help make a broker more efficient, but this was never going to be a self-service model for the consumer. People will need guidance, and, depending on how you choose to operate your business, either the broker or the call center will provide that guidance. And we’ll earn a commission for doing so. Life is good.
Download the Private Exchanges 101: The Essentials on Understanding, Using, and Selling Them whitepaper now and see how you can take advantage of this opportunity to help your employer groups save money while offering more options for their employees.
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