Brokers continue to be a pivotal resource for individuals enrolling in health care coverage on the marketplaces setup under the Affordable Care Act, with some brokers saying in 2015 they helped more than 100 individuals enroll in health care coverage on the marketplaces.

Sixty percent of brokers say they helped up to 50 marketplace consumers during the 2015 ACA open enrollment period, while 20% of brokers said they helped more than 100, according to the 2015 Kaiser Foundation Survey of Health Insurance Marketplace Assister Programs and Brokers. On average, brokers report helping about 140 consumers, both in and outside of the marketplace, with eligibility and enrollment during the second open enrollment period, according to the survey.

Brokers also reported a higher degree of client continuity from year one compared to assister programs, indicating they may be establishing more ongoing relationships with their clients than assister programs have been able to do so far, the survey found.

“Every day that health insurance becomes more complicated, the value of what we do for or customers becomes more valuable,” says Kelly Fristoe, president and CEO of employee benefit brokerage Financial Partners in Wichita Falls, Texas.

“We have more dialogue with our customers. They are our source of revenue. It comes down to customer service. One of our primary goals is to make sure we take care of people,” Fristoe says.

Broker intel

Further, he says, brokers may be privy to information from insurance carriers outside of open enrollment that navigators and assisters may not, which allows for a window of opportunity when brokers can begin to help clients prepare for changes to open enrollment before it even begins.

For example, last month BlueCross BlueShield of Texas revealed it will drop individual PPO plans in 2016, which, in Texas, means all individuals enrolled on the exchanges will have to move to an HMO plan or move off the exchange to find a PPO plan.

“We as agents get that information from insurance companies, so we’re able to reach back out to our clients and have a conversation with them now, so that when we get into open enrollment, we can find something suitable for them,” Fristoe says. “And we can help them learn how an HMO will work and what it will mean to them, since many of them have been consumers of a PPO for the past few years.”

Brokers generally engaged in similar consumer assistance activities as assister programs, but with emphasis on different services, the survey found. For example, the vast majority of both brokers and assister programs said they help consumers compare and select qualified health plans, apply for premium tax credits, and resolve post-enrollment problems.

But, compared to assister programs, brokers were less likely to engage in outreach and public education activities (33% vs 80%) and less likely to help consumers appeal marketplace eligibility decisions (39% vs 58%), the survey found.

Compared to assister programs brokers were more likely to help small businesses select coverage (34% vs 9%).

Similar to assister programs, most brokers said, on average it took about one-to-two hours to help each client that was applying to the marketplace for the first time, and about one hour to help clients who were returning to renew or change their marketplace coverage. Also similar to Assister Programs, most brokers said they would like to receive additional training on a range of topics, including tax related issues, marketplace appeals and renewal procedures, Medicare, and Medicaid. And, similar to assister programs, brokers report that when they did need to seek technical assistance from marketplace call centers, help was often inconsistent or ineffective.

The business of non-group sales

Experts say the establishment of the ACA exchanges has completely changed the business of selling non-group health coverage for benefit brokers.

Brokers say the time involved in selling a private policy has increased relative to pre-ACA days and revenue earned per policy has decreased (57%); but most also say they sell more non-group policies overall than they did pre-ACA (60%), according to the Kaiser Foundation survey.

Fristoe agrees, saying his agency has definitely sold more individual plans in the past few years than it did previously. While that brings increased revenue, he says, it also brings an increased workload. One for which, Fristoe says he has even contemplated hiring extra staff.

The majority (86%) of brokers who sold non-group coverage in the marketplace this year had done so during the first open enrollment period and prior to 2014.

Similar to assistance programs, 80% of returning brokers said they thought this year’s open enrollment went better than the first.


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