Many exchange budgets are being cut at the same time states are struggling to reach their remaining uninsured, and some are looking to brokers to provide assistance in filling that gap.

In Maryland, reaching the uninsured is a “huge challenge,” and that population — almost all whom have never had coverage — wants to pick up a phone and talk to folks, said Carolyn Quattrocki, executive director of the Maryland Health Benefit Exchange at the World Health Care Congress Monday in Washington.

Call center volume remains high in the state, but resources are being reduced, she said. Therefore, Maryland is considering rotating brokers into their call centers, which Quattrocki called a win-win for all. The exchange did not immediately respond to an e-mail seeking further information on that possibility.

Also see: Burwell: Insurance industry’s ‘expertise is critical’

Alan Schulman, president of the Maryland Association of Health Underwriters (MAHU) says MAHU recently met with Quattrocki and the secretary of the state’s health department to “build on our record of success by enabling the exchange to continue to utilize the resources of licensed producers.”

“While I am personally unaware of the proposed participation of producers in call centers, I would urge Maryland officials to consult with us about the highest and best use for health insurance producers in the operations of the exchange,” Schulman, principal of Insurance Benefits and Advisors in Rockville, Md., adds.

Meanwhile, Kentucky’s Carrie Banahan, executive director of that state’s exchange, told a similar story of reduced funding requiring her office to eliminate or reduce marketing contracts. “It’s going to be a challenge for us,” she said of reaching the uninsured and others. Last year, the Kentucky Health Benefit Exchange had one retail store in Lexington staffed with connectors, state employees and three-to-four agents each day who rotated in two shifts.

She said agents and brokers became so popular in this retail store that the state had a waiting list of brokers who wanted to participate. Some brokers and agents were hoping others would be sick so they could work in the store, she added. As the state continues to work to reach the uninsured, Kentucky is considering opening additional stores following a similar model in Louisville and Northern Kentucky in 2015.

Broker’s role

In Kentucky, brokers enrolled 44% of people in qualified health plans in 2014 through the exchange. Banahan called the exchange’s relationship with agents “a great working relationship,” that includes a subcommittee that meets on a regular basis to advise on policy issues and website changes.

Also see: Healthcare.gov CEO: Brokers are ‘integral’ in post-ACA world

In Washington D.C., where SHOP is included with individual coverage, 60% of employer customers use a broker, explained Mila Kofman, the exchange’s executive director. She doesn’t know how the other 40% get information because, “they are not getting advice from us and I do worry about that.” D.C. exchange officials are forbidden from giving advice on what plan is best.

And in Maryland, brokers have been “pivotal,” Quattrocki said. Her state adopted the Connecticut public exchange model after theirs failed and she said one reason they did that was because it had a broker portal to allow a connection between a broker and consumer.

“We also had brokers at our events,” she said. “In year one, when we were struggling, brokers came to us and offered to stand up a referral service so people could call and get referred to a local broker.

“We are trying to think creatively about ways to engage [brokers] even further,” she added.

Schulman, the MAHU president, explains that since “many of our members are licensed health insurance producers located throughout Maryland, [they] could provide the names of qualified individuals who could assist callers.”

“Since then our producer referral service has successfully matched several hundred Maryland insurance consumers with licensed producers,” he adds.

The help is much needed, as the remaining uninsured are that much harder to reach, Quattrocki explains. She said during the Maryland exchange’s first year when the media labeled it a “debacle,” the exchange was on the news nightly and it was “hard to imagine a person left in Maryland who hadn’t heard about the marketplace.” But surveys showed many consumers were still unaware.

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