Considering all of the expansions under the Affordable Care Act, some health care industry sources now estimate 20 million Americans have gained coverage as a result of the health care reform law, increasing the workload for benefit advisers, but not necessarily the compensation they receive.
Including young adults who have gained coverage under their parents policies, individuals, such as those with pre-existing conditions, who bought plans directly from insurers, people who purchased plans through the exchanges, and adults and children who enrolled in Medicaid or the Childrens Health Insurance Program, an estimated 20 million Americans have gained coverage as of May 1, 2014, according to a report published in the New England Journal of Medicine and supported by The Commonwealth Fund.
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More covered individuals and all of the expansions under the ACA have led to benefit advisers working harder than ever, says Ronnell Nolan, president and CEO of the Baton Rouge, La.-based Health Agents for America, but she and her membership agree its translated into more work for little or no compensation.
The increase of dependents on employer plans coupled with the more than 50% decrease in commissions for agents, brokers and advisers continues to equal more work for less pay," Nolan says.
Helping applicants with the federally-facilitated marketplace applications, troubleshooting problems with the subsidy applications, and tracking policies from the marketplace to the carrier are just some of the added responsibilities advisers are taking on under the ACA, according to HAFA members.
However, we continue to be proud of our industry, refuse to give up and do not scare from hard work, Nolan adds.
Important role
The complexities of the ACA and its expansions also highlight the importance of using a benefit adviser or broker, Nolan says.
With rate changes, each dependent/child's age will be included in future rating purposes, Nolan says of family health insurance coverage, so advisers will be critical in determining whether parents might be able to purchase coverage for that child on their own and receive a subsidy.
Benefit advisers are crucial in educating clients about their choices and navigating the enrollment process, according to one HAFA member, who adds that for some clients it make take up to two hours to narrow down whether their doctors and medicines will be covered on a plan.
In 2010, the ACA began requiring all insurers to allow young adults up to age 25 to enroll in a parents health plan. About 7.8 million men and women ages 19 to 25 enrolled in a parents plan last year; most would have been ineligible to do so without the law, according to the report published in the Journal.
The law also disallows insurers from denying coverage to someone because of a preexisting health condition, leading to the Congressional Budget Offices estimate that 5 million people will purchase coverage directly from an insurer this year.
The CBO also projects that new enrollment in Medicaid and the Childrens Health Insurance Program will reach 7 million in 2014, and 13 million eventually. Six million people enrolled in the two programs within the first six months after the launch of the ACAs coverage provisions, the report says.
