State-run exchanges are taking vastly different approaches to broker training, a move that National Association of Health Underwriters’ CEO Janet Trautwein is wary about. For example, Trautwein “disagrees” with Vermont's plan to train navigators and brokers in basically the same way. Instead, she touts as "correct" the District of Columbia’s plan to train brokers separately — a job that NAHU is contracted to do.

“You can’t say that someone who has no background in insurance needs the same kind of training as someone who may have been doing it for 20 years,” Trautwein says.

Vermont Health Access, the state’s name for its exchange, is certifying brokers and navigators through essentially the same training process because, “if you think about them as doors into the website, both brokers and navigators are providing a similar service in terms of in-person assistance,” says Mark Larson, commissioner, Department of Vermont Health Access. 

He says the biggest distinction between the training is that “brokers don’t receive the outreach and education module” that navigators do. He understands the two entities may be providing a much different service outside of the portal in the “real world.”

Larson says the online portion of the training is not yet ready, but is “on track” to get navigators and brokers ready before September. Vermont held the first in-person training for navigators and brokers two weeks ago and had about 170 people in attendance.

Trautwein says one reason for the separation of in-person assisters (D.C.’s Health Benefit Exchange Authority is not using the term navigator) and brokers on the D.C. exchange is partly due to demographics of the capital city. In-person assisters’ "primary focus is really on public programs,” she says. “The biggest focus of their training is focused on Medicare, Medicaid. But it does touch some on the private programs.” 

Trautwein says that the broker training they’re developing is “quite the opposite.” It will focus mostly on the private insurance offerings on the public exchange, including subsidies, but will be peppered with some information about Medicaid and Medicare in case some of the people brokers work with qualify for those services. NAHU is planning to use the organization’s extensive resources in broker education to support this training project, which it announced July 17. Trautwein says their education format has been proven and tested over the years.

Maryland's state-run exchange is also separating broker and navigator training. “Whereas brokers and agents are already licensed by the state of Maryland, navigators, we believe, need a more robust training,” says Tequila Terry, director of partner and plan management at the Maryland Health Benefit Exchange. “They will learn more on the basics of industry — health insurance 101 so-to-speak,” she says of navigators.

Terry says the group’s plan for broker training is a three-phase process because “we want brokers to be very clear about how they can work with us.” The first phase rolls out next week and is an application for the broker to fill out to express interest. The second is the actual training to understand the system, which kicks off in August, and the third is a notification by Maryland exchange officials that the broker has been certified. She confirms that navigator training is separate, and because it is more robust, is still in the process of being finalized.

The decision about how to train brokers and navigators is only in the hands of the 17 states, including D.C., that have elected to run their own exchange. The other 33 states, seven of which are state partnerships, will default to the federal government’s plan for implementing training. A CMS official says the training will be developed now that the navigator and broker rule, announced July 12, is final and will be done before the navigator grants are awarded. A CMS marketplace timeline provided to EBA in April stated that CMS had a goal of completing broker training by August. With only a month to go, CMS officials did not respond to a request for an update on timing.

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