Insurance brokers in Nevada, fed up over not getting paid commissions by the state’s health exchange, have filed suit against the Silver State Health Insurance Exchange and its website contractor, Xerox.

Six brokers filed the lawsuit Aug. 26 in Nevada’s Clark County District Court and are seeking class-action status on behalf of more than 1,600 brokers in the state, according to benefit adviser Patrick Casale.

“We’re putting in long hours and not getting paid for it,” he tells EBA, adding that for at least one of his clients he’s filed paperwork with the exchange more than 10 times and still not received all of the commissions due him.

Another Nevada broker has enrolled more than 40 clients on the exchange and not received a single commission.

See related story: Some brokers still not paid on ACA exchanges

In some cases, Casale says, the broker’s name is being inadvertently erased from a client’s application, making it difficult or impossible to receive credit for the enrollment.

The lawsuit claims the exchange and Xerox failed to ensure broker producer numbers and other identifying details were provided to insurers. It also claims Xerox and the exchange “improperly retained premiums paid by consumers and collected interest on those premiums for months while causing unnecessary delays in the payments of commissions to brokers and agents.”

“Agents are working hard to get their clients insured, but the system is not acknowledging that and we’re not getting paid,” Casale adds.

Representatives from the Silver State Health Exchange had not returned calls for comment at press time.

The brokers’ representing attorney Matt Callister also filed suit against the state’s exchange in April on behalf of consumers who paid for coverage but say they have yet to receive a policy number or be able to use insurance to pay for medical care.

“People are making payments but can’t get seen by a doctor or use their insurance,” Casale says, adding that one of his clients had to wait so long to receive her coverage, a cancerous tumor that may have been treatable just months earlier when she originally wanted to see her doctor, ended up killing her.

Three of the other agents named in the suit are also from Clark County, Nevada. The remaining two are of Washoe County.

‘It’s not about the money’

Further exasperating the situation, Casale says, is that navigators in the state are having no difficulty getting paid, even when the individual’s enrollment never goes through.

“Their clients are coming to me for help getting enrolled,” Casale says. “The navigators are getting paid and can’t get them insured, while agents are getting the consumers enrolled and can’t get paid.”

That’s why, Casale says, the lawsuit is not really about the money, but about the future of the benefit adviser role in America.

“I’m not against the Affordable Care Act,” he says, “I’m against the idea you don’t need brokers. Buying insurance is not like buying a plane ticket.”

Individuals need somebody who understands the complexities and nuances of the law, he says. “Brokers and advisers are more important than ever before.”

Still, they can’t work for free, he says, adding that some agents he knows have been forced to take out payday loans to pay bills while waiting for commissions to roll in from the state exchange.

See related story: Expanded coverage under ACA means more work advisers, little extra pay 

 

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