When it comes to the public health exchanges, the broker experience may vary drastically from state to state. In Maryland, one of the 18 states (including Washington, D.C.) that is approved to create its own exchange, exchange staff are anticipating outreach to brokers sometime this month about the certification process that will prep them for open enrollment. For the 33 states that are under the umbrella of the federal exchange, brokers may hear something between now and August — the month that the Centers for Medicare and Medicaid Services has outlined that training for brokers will be complete.
“The value of the state-based exchange is being able to utilize what’s already working in our state,” says Rebecca Pearce, executive director of Maryland’s exchange, explaining that it helps that the Medicaid eligibility workers, brokers, Medicaid systems and more gave her state a leg up in preparing for opening.
The recent news that the U.S. Department of Health and Human Services has delayed the small business marketplace option, known as SHOP, on the federal public exchange shines a light on the question of timing and implementation for brokers. While small businesses can still obtain coverage through the federal exchange, their employees won’t get the option of selecting a plan. This may mean changes for brokers’ anticipated role with small businesses.
“[Brokers] are a key decision maker for the businesses that are too small to have their own HR offices. They’re looked at as an extension of their staff,” says Vince Ashton of HealthPass New York, a private small business exchange that’s been operating since 1999. He adds that the limited options on SHOP may delay some of the additional counseling expected from brokers when employees are able to make their own decisions on the exchange.
In February, Employee Benefit Adviser reported on a listing in the Federal Register that confirmed that broker solicitation and training at the federal level would take place. A CMS spokesperson said that further information is coming soon. The Illinois Department of Insurance, one of the states that has partnered with HHS on an exchange, says that brokers, or producers as Illinois refers to them, “should receive information from the carriers they represent and continually monitor bulletins on a federal and state level. The Department will issue bulletins and fact sheets, as needed.”
According to Ashton, who’s watched brokers operate on his private exchange for years, the sooner the information, the better. “If I’m a broker, it’s tell me what it is, what’s happening, how’s it working,” he says. “It’s the lack of information for the brokers right now that makes it very difficult.” He adds that brokers who will deal specifically with small businesses do have some leeway. “There’s still time. If we’re looking at small businesses not on the January open enrollment schedule, they have up to a year to make a change, so things could pick up more in 2014.”
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