MLR: An existential threat to benefit brokers

The Medical Loss Ratio provision of the ACA has put benefit brokers in a dangerous place.

Due to the MLR provision, Aetna, Anthem, Humana, United Healthcare, Healthspan, and BlueCross BlueShield of North Carolina are now paying brokers the sum of $0.00 for our hard work. Brokers in NC have only 3 carriers to present to individual clients: Aetna, United Healthcare and BlueCross BlueShield of NC. None will now pay brokers a dime for everything that we do.

The situation may not be so dire where you are, but it most certainly will be. The MLR provision is the very worst part of the ACA, and it places constant pressure on the insurance companies’ bottom lines. The rules of the game are these: You can’t make much money, but you can lose a whole lot if things don’t go your way.

Some of you would suggest that we should charge the consumer directly for our services. This would result in an undeniable and irreversible “adverse impact” on the poor and minorities among us. I can’t accept that.

Fortunately, there is a bipartisan solution to this problem. Senator Chris Coons (D) and Senator Johnny Isakson (R) have proposed Senate bill 1661: The Access to Independent Health Insurance Advisors Act of 2015. https://www.congress.gov/bill/114th-congress/senate-bill/1661/all-info But the chances of this bill getting traction depend on you.

This is not something to leave up to the folks at your GA or the carriers or NAHU or HAFA. These may be our allies (I’m asking them and others to help me get the word out), but make no mistake: if you don’t fight for this bill no one else will.

Taking action

What can you do about it? http://www.senate.gov/general/contact_information/senators_cfm.cfm This is the address of every U.S. Senator. I would suggest that we each write them as many letters as we can about S. 1661. Be respectful in your letters. Recognize that these Senators have the power to fix this problem should they choose to do so. Stress the bipartisan nature of the bill, and keep your points to S. 1661 and S. 1661 only, because issues surrounding the ACA are so thoroughly politicized that some will immediately tune you out if you go off on a tangent.

Make it truly impossible for them to ignore you. Members of NAHU have sent 8300 letters; we need to send tens of thousands more.

The facts are these:

1) Without passage of this bill, the role of the broker as we know it will die.

2) Many of us could survive by charging consumers directly for our services, but this has a very significant and undeniable “adverse impact” on poor and minority communities.

3) The chances of this bill ever making it out of committee without aggressive broker action are very slim.

4) There are over 100 bipartisan cosponsors of a companion bill in the House.

If you love what you do, now is the time to take action! Have you written all 100 US Senators about this bill yet?

a) You haven’t? It’s about time to get started!

b) You have? OK, Great! Send another round of letters!

Our future as a profession depends on this.