Managers say
they will conduct three big auto re-enrollment waves
Dec 02, 2016 | By Allison Bell
The November
auto re-enrollment wave affected enrollees who were shifted to plans from a
different issuer, officials say. (Photo: Screenshot)
Managers of
HealthCare.gov have confirmed that they are leaving agent and broker
compensation concerns out of efforts to help exchange users facing potential
coverage gaps.
HealthCare.gov
has developed an "auto re-enrollment" process for users affected by
issuer decisions to drop specific health plans. If a consumer's plan goes away,
and the consumer fails to choose a replacement plan, the exchange system will
try to move the consumer, or move the consumer into a similar plan from the
same issuer. HealthCare.gov calls that process "crosswalking."
If an issuer
has left the HealthCare.gov system in the consumer's areas, the exchange will
try to crosswalk the consumer into a similar plan from a different issuer.
One of the
secret to fighting health care costs might, actually, be you.
Some agents and
brokers who have struggled to help consumers sign up for HealthCare.gov
coverage have been wondering whether the exchange will do anything to increase
the odds that the replacement plans will pay commissions to the agents or
brokers of record.
HealthCare.gov
managers said Nov. 16, during a private conference call with HealthCare.gov
agents and brokers, that they will not.
HealthCare.gov
"does not take into consideration whether an issuer pays a commission when
auto-renewing consumers," exchange managers said, according to a written
version of the answer posted on an exchange technical assistance website.
The
HealthCare.gov managers talked about one rule that could help exchange plan
agents: If HealthCare.gov moves an agent's clients into new plans, and the
issuers of the new plans do pay commissions, the issuers of the new plans can
pay the commissions to the agent even if the agent's exchange registration has
expired.
Managers said,
in a separate meeting slidedeck, that they have planned three major auto
re-enrollment waves.
The
re-enrollment waves
The first,
which started Oct. 12, affected enrollees who were being moved into new plans
from the same issuer.
The second,
which started Nov. 21, affected enrollees who were being moved into new plans
from a different issuer.
The third,
which will take place this month, will affect enrollees with a variety of more
complicated problems, such as problems with clearing up questions about tax
credit subsidy applications.
When
HealthCare.gov moves enrollees into new plans, HealthCare.gov will
"generally" send the agents' producer numbers to the issuers of the
new plans, managers said.
"Enrollment
information will not be visible in consumers' accounts until Dec. 16,"
managers said.
Open enrollment
for 2017 started Nov. 1 and is set to end Jan. 31.
Drafters of the
Affordable Care Act created the public health insurance exchange system, or
web-based health insurance supermarket, in an effort to cut the average ratio
of claims per enrollee enough to make selling coverage without medical
underwriting financially sustainable.
ACA drafters
were hoping the exchange system, and exchange system premium subsidies, would
tempt enough young, healthy people to buy coverage to offset the cost of
requiring insurers to cover people with cancer, severe heart disease,
hemophilia and liver failure at standard rates.
The U.S.
Department of Health and Human Services set up HealthCare.gov to provide
exchange services in states that are unwilling or unable to provide exchange
services themselves.
This year, many
big, for-profit issuers that lost money on exchange plans in 2015 have decided
to pull out of the HealthCare.gov system in many counties in 2017.
Agents and
brokers have complained that even some of the issuers that will keep their
products on the HealthCare.gov shelves will not pay commissions in 2017, and
that some issuers have failed to pay the commissions owed for 2016 sales or
earlier sales.
California v.
HealthCare.gov
Managers of the
state-based ACA exchanges in some states have supported agents' efforts to
enforce compensation agreements, and even to impose minimum agent and broker
exchange plan sales compensation standards.
In California,
for example, Covered California has lobbied for national exchange agent
compensation standards and set minimum standards for its own
issuers.
HealthCare.gov managers
have allowed issuers to pay commissions but have repeatedly said that they
will not set payment standards, or help agents and brokers
enforce existing compensation agreements.
HealthCare.gov
does require issuers to offer the same compensation levels inside and
outside the exchange system, and agents and brokers can ask HealthCare.gov for
help with compensation-level differences, HealthCare.gov managers said
during the conference call meeting.
http://www.lifehealthpro.com/2016/12/02/fix-for-stranded-healthcaregov-users-may-cost-agen?eNL=584056a9140ba0a5463084f1&utm_source=LHPro_Daily&utm_medium=EMC-Email_editorial&utm_campaign=12052016&page_all=1
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