Brokers and assisters must collaborate during 2015 ACA open enrollment

 

Looking toward 2015 open enrollment on the public health care exchanges, industry insiders say brokers and assisters will need to work closer together to help consumers, but agree that will involve overcoming some critical underlying issues.

Kaiser Family Foundation Senior Fellow Karen Pollitz said Tuesday at a Capitol Hill briefing in partnership with Alliance for Health Reform that in Kaiser’s conversations with assisters some have “expressed some wariness about working with agents and brokers because they felt like [their] missions were different, in part because the brokers do receive commission checks from the insurance companies for plans they sell.”

However, “other assisters found collaborating with agents and brokers to be quite useful because of the expertise brokers have with understanding the health plan choices available to consumers,” Pollitz said.  

“We do know [brokers and agents] played an important role in helping consumers sign up for coverage,” added Jessica Waltman, senior vice president of government affairs at the National Association of Health Underwriters, who noted that partnership between brokers and assisters and navigators is important because brokers can provide year-round help to the volatile population who typically enroll through the exchanges.

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NAHU does not know how many brokers will participate with the 2015 open enrollment, although a June survey of NAHU leaders indicated that 69% plan to sell and service individual exchange policies in 2015. That’s a slight decrease from the 75% of NAHU leaders who planned to do so during 2014 open enrollment, a decrease Waltman attributes to concerns brokers have expressed about participating in 2015. Those concerns include:

  • Challenges and much greater time than anticipated spent physically enrolling consumers
  • Ongoing authorization issues to act on a client’s behalf
  • Payment difficulties
  • Liability concerns because lack of payment/client relationship means brokers are not covered by E&O insurance, but still legally liable for advice given

 

Also speaking at the briefing, Lisa Stein, VP of work and family supports at the national non-profit Seedco — which enrolled people in exchanges in New York, Maryland, Tennessee and Georgia as a navigator —  said the greatest challenge they encountered during the 2014 open-enrollment period was the low health literacy of those being enrolled, including not understanding words such as ‘premium.’

Continuous training was necessary, Stein said.

Looking toward 2015, Stein said there is some concern as the open enrollment period is 50% shorter than 2014 and “only overlaps with the first four weeks of tax preparation season at free … tax preparation clinics.”

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