Researchers: Producer Role in Exchanges Still Evolving

In California, agents “complained vocally at one  point that the exchange would freeze them out of selling through the exchange,” the researchers say. “Efforts have been taken  to reassure them that their participation is welcome,  especially for the employers’ Small Business Health  Options Program (SHOP) exchange, recognizing that  most employers rely on agents to help them choose  insurance.”

But “the compensation and role of  agents remain to be determined,” the researchers say.

The California exchange is a governmental  entity, “with strict conflict of interest rules that bar  employment or board membership for anyone affiliated with insurers, agents, or providers,” the researchers say.

Insurers have been taking a “wait-and-see”  stance toward the exchange, and agents have been even more cautious, the researchers say.

In Colorado, the researchers say, the exchange board is supposed to get a majority of its members from outside the health insurance industry, but the list of the initial appointees includes 3 members who work for large insurers.

Colorado exchange advisory working groups have been meeting regularly since July 2011.

“State planners vowed from the beginning to build the  exchange ‘from the inside out,’ with substantial stakeholder involvement,” the researchers say. “It is hoped this will result in an  exchange structure and operations that most insurers,  employers, and brokers will embrace, or, at least, not  actively oppose.”

But, so far, ”insurance brokers are not represented on the board,” the researchers say.

Issues that have yet to be  addressed by the working groups or board include matters such as “the extent to which benefit structures might be  standardized, how the exchange will be funded and how administrative costs will be assessed, and determining how brokers will be compensated,” the researchers say.