Some states could apply insurance producer or consultant licensing rules to the new state health insurance exchange entities, according to a National Association of Insurance Commissioners (NAIC) panel.
The Exchanges Subgroup at the NAIC, Kansas City, Mo., has posted an exposure draft of the American Health Benefit Exchange Model Act on its section of the NAIC website.
The subgroup has developed the model to implement Section 1321 of the Patient Protection and Affordable Care Act (PPACA), a component of the Affordable Care Act.
Section 1321 requires the U.S. secretary of Health and Human Services to work with the NAIC and member regulators, health insurers, consumer groups and others to set up a system of American Health Benefit Exchanges that will be used to distribute subsidized individual coverage, and a system of Small Business Health Options Program exchanges to distribute subsidized small group coverage.
The exchanges are supposed to go into operation in 2014, and they are supposed to set up Navigator programs. The Affordable Care Act calls for the Navigator program to help individuals and small group benefits buyers compare and enroll in the health plans sold through the exchange system.
A state can set up a whole-state exchange; divide itself into regions and create separate exchanges for each region; or join with other states to participate in multi-state exchange entities.
The National Association of Health Underwriters (NAHU), Arlington, Va., has argued that the state agencies setting up exchanges should promote the participation of licensed agents and brokers in advising exchange participants.
“All successful state-level private purchasing pools and exchanges have elected to utilize the services of agents and brokers for this reason,” NAHU says in a comment submitted to the Exchanges Subgroup. “Those did not do so initially, like the Health Insurance Plan of California, which was the longest-running state public purchasing pool to date (operational from 1993-2006), quickly found that the active participation of licensed agents and brokers was the key to the pool’s enrollment success.”
America’s Health Insurance Plans (AHIP), Washington, says the new exchanges
should supplement, not replace, existing markets, and that regulatory functions should not be duplicated.