Brokers must work for carrier commissions on ACA exchanges

When it comes to paying broker commissions on the Affordable Care Act’s public health insurance exchanges, no one carrier is standing out as particularly good or bad. However, one thing is clear when it comes to getting paid for this work: Brokers need to put in effort to receive their payments.

A recent EBA article reported that in some cases, benefit brokers and advisers who have enrolled consumers on the exchanges during open enrollment 2014 have still not been paid for their work by carriers in certain states. But is there a pattern to the carriers who are delinquent in this way?

One commentator on the EBA website about the article, Gregory J. from Florida, said he still hasn’t been paid by Blue Cross and Blue Shield of Florida for enrollments in January, February and March with “no solution in sight.”

But on the other hand, Guy Furay, an independent broker at The Insurance Source in Greenville, S.C., says Blue Cross in his state has been the “best” with broker commission payouts, while Coventry has required “spreadsheet after spreadsheet” to prove that he’s the agent of record on many consumer accounts to be able to continue to service them, as well as get paid.

See related: Some brokers still not paid on ACA exchanges

‘A fluke’

While Marcus Woodward, a broker in Ashland, Ky., and member of the governor-appointed advisory board for Kentucky’s state-run exchange called Kynect, agrees there are some extreme cases of brokers not receiving their due pay from carriers across the country, but he says this is not a new problem created by the ACA.

“As a broker, I’ve been selling insurance for more than 30 years and I’ve been stiffed by insurance carriers many, many times,” he says. “You have to have a handle on your business, but sometimes there’s a fluke and you don’t get [a commission].”

Other than a few “bumps in the road with other agents having some lag time,” Woodward says he’s not aware any “systemic problem” with any of the four exchange carriers in his state paying brokers. In Kentucky, those insurers include Anthem Blue Cross Blue Shield, Humana, a local carrier called Blue Grass Family and the state’s CO-OP.

David C. Smith, broker and vice president at Ebenconcepts in Fayetteville, N.C., says that errors have always occurred, and may continue to occur, on the part of both insurers and brokers when it comes to commissions, so it’s best to always be prepared to back up your business activities to safeguard your income.

Be prepared
“The thing we’ve done and encouraged others to do is to have a process in place so you clearly know the applications you write, that you get credit for them, and that you get paid for them,” he says. “It’s incumbent on agents that if they’re predominantly group agents and see [branching into exchange enrollment] as an opportunity, they need to learn how it works.”

He adds: “You have to have good business processes in place to make sure you get paid. We have our folks actually doing screenshots in the enrollment process so they know they’ve got that record.”

There are success stories of brokers who were able to establish these sorts of processes who are now satisfied with payments from carriers. In California, Kevin Roberts is a broker at KR Benefits Insurance Services in the Walnut Creek area who says that while it took a great deal of time to get paid on all 50 of the ACA enrollments he helped complete, he finally received the last payment he was waiting for two weeks ago.

“I’ve been paid on everything now, but it took effort, and some luck,” he says. While Blue Shield of California was the most communicative carrier about the status of commissions, he says all three  of the major carriers he worked with — Kaiser and Anthem Blue Cross were the other two — settled up to his satisfaction. As a broker, you just have to learn the new system, he adds.

On the federally run exchange in Illinois, which had many issues due to its connection with Healthcare.gov and all the problems on the backend of that sites, Anne Petry, insurance broker and consultant at Jaggi Insurance and Investments in Forsyth, Ill., says she only has a few commissions left to be paid on.

“Surprisingly, I haven't had too much of a problem with getting paid on exchange plans,” she says.

Not all rosy

However, in Texas — also a federally run exchange state — Kelly Fristoe, president and CEO of Financial Partners in Wichita Falls, says he’s having a few big issues with one of the insurance carriers, Blue Cross Blue Shield of Texas, paying commissions and its affecting more brokers than just him.

“I was told by the insurance company that the commission department is overwhelmed with commission issues being submitted in duplication because they are slow in getting issues fixed, and in the meantime the agents are submitting the same data from previous errors each month — not just new commission errors that show up,” he says.

Meanwhile, in speaking with more than half a dozen brokers across the country, Fristoe was the only person with serious complaints and issues with the exchange carriers and he was quick to note that he’s pleased they’re willing to work with him on remedying the problems.

Ebenconcept’s Smith notes that the next open enrollment should go better overall, and the one component all brokers can directly control is their own recordkeeping and efforts to ensure they’re getting paid by following up closely with clients and staying in touch with them throughout the year.

“You have to recognize you have to work to get paid,” he says.

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