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Life Health > Health Insurance > Health Insurance

PPACA: The NAIC Loves Agents

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The National Association of Insurance Commissioners (NAIC) has adopted a resolution expressing its commitment to preserving the role of health insurance agents.

If states and federal do a poor job of creating the new “Navigator” program that is supposed to help consumers use the new health insurance exchange system, “this program could provide an avenue for untrained individuals to evade producer licensing requirements and expose consumers to harm,” members of the NAIC, Kansas City, Mo., resolved Tuesday at the NAIC summer meeting in Seattle.

To understand the changes made by the Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act (PPACA), “employers and consumers will need professional guidance even more in the future,” NAIC members resolved. “It is important for federal policymakers to acknowledge the critical role of producers and to establish standards for the exchanges so that insurance professionals will continue to be adequately compensated for the services they provide, and so that the duties of exchange navigators appropriately reflect the important role of insurance producers who are skilled, knowledgeable, educated and licensed and regulated.”

The Affordable Care Act, will require states to set up a new system of nonprofit “Navigators” to help individuals and small groups buy subsidized health coverage from a new “health insurance exchange” distribution system.

The exchange system is supposed to start up in 2014.

Some of the consumer groups and health policy followers who are seeking to influence the NAIC and federal regulators say policymakers should minimize or eliminate the amount of money going to intermediaries, and that any intermediaries that participate in the navigator systems must not earn commissions from insurers.

Timothy Stoltzfus Jost, a law professor who represents consumer interests in proceedings organized by the NAIC, Kansas City, Mo., testified in July at an NAIC hearing in Washington that insurance agents and brokers can be health insurance navigators, but that

producers involved in the navigator system “may not receive any direct or indirect consideration from an insurer for the enrollment of an individual or employer.”

Sponsors of the resolution expressing NAIC support for keeping agents and brokers involved included regulators from large states such as California, New York, Illinois and Florida.

The other sponsoring states were Alaska, Connecticut, Delaware, Kansas, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, Tennessee, Utah and Washington.

Florida Insurance Commissioner Kevin McCarty put out a statement welcoming adoption of the resolution.

“Although it is not considered a ‘medical expense,’ trained health care agents must remain an integral part of the health insurance process by helping businesses and families tailor health care insurance plans to meet their individual needs,” McCarty says.


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