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May 16, 2012 at 08:51 AM
The Center for Consumer Information and Insurance Oversight (CCIIO) says “federal facilitated exchanges” (FFEs) will work about as closely with agents and brokers as the states will let them.
CCIIO officials talk about the relationship between the FFEs and agents in a new batch of exchange guidance.
CCIIO, an arm of the U.S. Department of Health and Human Services (HHS), also has released a set of guidance aimed at states that are setting up their own exchanges.
Provisions in the Patient Protection and Affordable Care Act of 2010 (PPACA) encourage states to set up “health insurance exchanges,” or Web-based insurance supermarkets, that individuals and small businesses can use to buy health coverage.
PPACA opponents are fighting the act in Congress as well as in the courts. If the act takes effect as written and works as drafters expect, a state could choose between setting up an exchange, participating in a multi-state exchange consortium, or letting the federal government provide exchange services, or FFE services, for its residents.
Agents and brokers have been wondering just how much state and federal agencies will let them participate in the exchange system, and how likely they will be able to generate significant commission or fee revenue by working with the exchanges.
“HHS expects that licensed agents and brokers will continue to assist consumers in accessing health insurance, and will work with agents and brokers to promote enrollment through the exchange,” officials say in the FFE guidance. “To the extent permitted by a state, an FFE will permit agents and brokers to enroll individuals in a [qualified health plan (QHP)] ‘through an exchange’ if the agent or broker ensures that an individual completes the eligibility verification and enrollment application using the exchange Internet site or the agent or broker’s site that meets certain conditions; the exchange transmits the enrollment information to the QHP issuer; and the agent or broker meets other applicable requirements (an agreement, training, and registration).”
HHS will provide licensed agents and brokers with a portal to the FFE Web site if those producers meet HHS standards, officials say.
Producers can use the portal to help individuals apply for eligibility for enrollment in a QHP and for insurance affordability programs, and if applicable, select and enroll in a QHP through an FFE, officials say.
