More than 10 million sought ACA enrollment help outside of brokers

More than 10 million people sought help outside of brokerages and agencies during the Affordable Care Act’s first open-enrollment period, but benefit adviser help was still considered by many to be most valuable.

An estimated 10.6 million people nationally received personal help from navigators and assisters during the ACA’s first open enrollment period, according to a new Kaiser Family foundation survey of navigators and assister programs. The survey estimates that the 4,400 assister programs operating nationally had an estimated 28,000 full-time staff and volunteers, suggesting each assister would have helped more than 370 people on average during the six-month open enrollment period that ran from Oct. 1, 2013 through March 31, 2014.

While the results show navigators and assisters were used often, separate data released recently from the Urban Institute’s Health Policy Center found that most (80%) of the adults who obtained information on marketplaces found insurance agents and brokers to be more helpful than other sources of information.

See related: Brokers are best ACA exchange resource, survey says

That same survey found that half of adults who obtained information on marketplaces only used a website, which two-thirds of users considered helpful. Nearly 75% said they found any assistance involving a person, other than a call center, to be helpful.

According to the 2014 Kaiser Family Foundation Survey of Marketplace Assister Programs, at least four out of five assister programs reported that most or nearly all the 10.6 million consumers they served sought help because of their limited understanding of the ACA, because they needed help understanding their plan choices, and because they did not feel they could apply on their own.

Almost 90% of assister programs said that most consumers who sought their help were uninsured, and three quarters of programs say most struggled to understand health insurance terms such as “deductible” or “network service.”

See related: Why the uninsured flocked for coverage off the exchanges

Assister programs, according to the Kaiser survey, typically spent between one and two hours helping each consumer.  Often, consumer questions about health plans couldn’t be answered by information posted on marketplace websites, and wait times for call-center assistance also slowed the process.

Assister programs also reported challenges in answering consumer questions or resolving problems.  The challenges reported as most difficult to resolve by the largest share of programs include helping consumers with online technical difficulties, helping consumers understand plan choices, and helping consumers with a limited understanding of the ACA. 

Benefit advisers helping enroll consumers on the exchanges had similar challenges, which many advisers feel highlights the need for assistance from a highly trained and experienced benefit broker or agent.

Benefit advisers are crucial in educating clients about their choices and navigating the enrollment process, one member of Health Agents for America said last week, adding that for some clients it may take up to two hours to narrow down whether their doctors and medicines will be covered on a plan. 

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

For reprint and licensing requests for this article, click here.
Benefit plan design Healthcare reform
MORE FROM EMPLOYEE BENEFIT NEWS