Health Insurance Exchanges Changed by Agents and Brokers

Posted on: June 22nd, 2012 by SamTabes No Comments

Cindy Gillespie from HealthAffairs.org wrote a very interesting article, “Little-Noted Provision On Agents and Brokers Could Mean Big Changes For Exchanges”, which talks about an important decision made by the Department of Health and Human Services (HHS) in regards to the role brokers and agents will play in health insurance exchanges.

Basically, HHS has opened the door for states to allow an agent or broker to enroll individuals, employers and employees in Qualified Health Plans (QHPs) through their own website.  If the individual is eligible for a refundable tax credit for a QHP purchased on the exchange’s website, they are then eligible to access the credit for purchases through the broker or agent’s private web portal.

This regulation sets out multiple requirements brokers or agents must meet in order for their clients to access credits for purchases through their web pages.  Brokers and agents must be registered with the exchange in advance and all QHPs must be sold and the agents and brokers assisting the consumer must be trained on all of the options.  A single-carrier exchange will not be able to qualify as an example.

The article goes into more detail on the various requirements for brokers and agents, but the bottom line implies that consumers never have to go near the state or federally-facilitated exchange website to buy the product they are looking for and access the tax credit in many cases.  All information transfers between the private broker site and the ACA exchange as well as the insurance carriers are visible to the consumer which is crucial in smart shopping.

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