Under health reform, state health care exchanges are slated to operate in 2014 - not much time to figure out the role a broker will play in the system. As we await more definitive information on what exactly constitutes a "navigator," one can look toward California, which is further along in setting up its exchange, as a potential model, says Neil Crosby, director of sales at Westlake Village, Calif.-based Warner Pacific Insurance Services.
In the small employer market, while they are still working on putting it on paper, California regulators "want to offer as close to market-based compensation for agents" as possible, Crosby says. "[In] every discussion that [has been] the case."
With many brokers worried about their role in the exchanges, Crosby says, for him, it is more about concern than worry. "The California exchange realizes that the best way to bring employers and business into the exchanges is through the agent model, and therefore a prudent person would be concerned," he says. "Those people creating the exchanges will understand and create it in a model the consumer wants - which is using the agent."
But he points out that for a broker to be sure they are included in the exchange they should join their local National Association of Health Underwriters chapter, which is working to "make inroads with the exchange board in each of the states," he says. "And to me that is the vital part because exchange boards make the decision, not the legislative [branch]."
As VP of public affairs for the California Association of Health Underwriters, Crosby encourages others to follow the CAHU approach of having "multiple meetings around the state with multiple brokers, with exchange directors and consumer organizations."
Familiarize yourself now
Meanwhile, other public and private exchanges are up and running across the U.S., so brokers must be thoroughly familiar with the model, says Dan Garlitz, executive director of technology provider bswift Exchange Solutions.
Speaking to advisers at the June NAHU convention, Garlitz pointed to four exchanges - public exchanges in Massachusetts and Utah, and private ones by HealthPass New York and the Connecticut Business & Industry Association - as examples of do's and don'ts for the model.
One of the key features that makes exchanges work is having broad plan selection. But, Garlitz says, most critical is having multiple carriers participating so the consumer has a choice. Further, it is important to comply with all the laws and regulations regarding the exchanges, says Susan Nash, a partner in the law firm McDermott Will & Emery, in a phone interview.
"Legally speaking, you have to have the enrollment periods up and running, have to have a toll-free call center and an Internet website for those who want to enroll," she says. "Also, [you need] to provide comparative information on the different benefit options that are available."
These changes present an opportunity for brokers, Nash adds, to prepare their clients, who could face penalties for improper compliance under the exchange system. Ensure clients plans are both affordable and don't charge too high a premium, she says.
