Broker participation in federal exchanges nearly doubles

The Centers for Medicare and Medicaid Services estimates that more than 77,000 brokers and agents assisted with enrollments on the federally-facilitated marketplace in year two open enrollment, up 46% from the year prior.

In year one open enrollment, CMS estimates 53,271 agents and brokers participated in FFM enrollment, rising to 77,600 for year two, which ended June 2015. CMS has previously declined to discuss specifics on the number of agents and brokers participating in the federally-facilitated marketplace, but these numbers were released in a CMS document discussing collecting agent/broker data for future years.

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In order to serve as “facilitators to enrollment,” CMS requires agents and brokers to register with the federally-facilitated marketplace, complete a training course covering eligibility and enrollment criteria for assisting with qualified health plan enrollment and sign an agreement that formalizes the agents/brokers “understanding and commitment to adhere to the rules of the program.” These rules apply to the FFM, which CMS oversees. State-based marketplaces follow their own set of rules.

CMS says extrapolating the 46% growth from year one to two over the next three years results in an estimate of 517,575 respondents, or brokers assisting with the marketplace, with an average of 172,525 per year. The Office of Management and Budget original estimate for year one was 350,000 brokers and agents.

In February at a National Association of Health Underwriters conference, Kevin Counihan, CEO of the FFM, said that “the broker is integral … as integral as it can be in the sale and distribution of our product.”

But he added, “that does not mean the role of the broker doesn’t evolve” and said the Department of Health and Human Services needs to provide more tools for brokers, such as a helpline for brokers during open enrollment. “That’s something we’re investigating right now,” he said at the time. A change will also be made on Healthcare.gov to better connect consumers with local brokers, Counihan said.

CMS did not immediately respond to a request for comment on an update to these programs.

Costs

CMS estimates labor rates on a mean hourly wage and includes 35% of base compensation for fringe and other benefits. The agency estimates completing the registration to sell on the FFM will take approximately 26 minutes annually and estimates each broker’s salary at $35.30 an hour.

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B. Ronnell Nolan, president and CEO of agent lobbying arm Health Agents for America, questions how CMS can determine how long it will take agents and brokers to enroll, “not to mention that we will make $35.30 in cash and fringe benefits — what fringe benefits?,” she says. “Agents and brokers are spending many hours enrolling consumers and I can promise you, at the end of the day, at times the compensation may be negative.”

CMS further estimates that operations and maintenance costs for this data collection will cost the federal government $387,284 on an annual basis.

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