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November 01, 2012 at 06:44 PM
The Patient Protection and Affordable Care Act of 2010 (PPACA) could create new opportunities for employers to get health insurers to compete for their business — and new opportunities for health insurance exchanges to mess up enrollment.
Summer Hamilton, an executive at BeneTrac, said benefits brokers should keep enrollment-related errors and omissions (E&O) challenges in mind when thinking about whether and how they might do business with either the new PPACA exchanges or the private exchanges that are popping up.
One challenge is that people are using the word “exchange” to refer to many different kinds of entities, Hamilton said.
The drafters of PPACA are hoping the Small Business Health Options Program (SHOP) exchanges will create a vehicle that small business owners can use to compare carefully vetted, largely standardized health plans from many different carriers.
Creators of exchanges that are forming outside the PPACA framework are applying the term to almost any kind of Web-based system that can give employers or individuals a chance to choose from a wide selection of health plans.
Either way, brokers have to think just as hard about how the enrollment process will work when they are placing business through an exchange as when they are dealing with one of the “back end” companies that handles enrollment data or send enrollment data directly to insurers, Hamilton said Thursday in an interview.
The idea of eliminating paper is great, but one challenge is that some of the companies that design online enrollment systems may not understand benefit plan quirks, Hamilton said.
