Advisor role in exchanges causes clash

At the same time, NCOIL, which held its spring meeting over the weekend, adopted a resolution urging local policymakers to establish a state-based regulatory framework for navigators and in-person assisters that would ensure a strong role for agents.

The resolution urges states to utilize their authority to ensure that navigators are subject to the jurisdiction and oversight of state officials, and was lauded by officials of the Independent Insurance Agents and Brokers of America (IIABA).

“The IIABA welcomes NCOIL’s recommendations concerning navigators and strongly agrees that states are best suited to oversee this new category of entity and protect consumers,” said Wes Bissett, IIABA outside senior counsel, government affairs. “Ensuring that there is proper scrutiny over navigator qualifications and behavior is good public policy.”

In their comments at the NPC Newsmakers event, Keiser and Kofman agreed.

“We have grave concern in North Dakota about creating thousands of navigators out there that were offering an additional service, such as AARP, Chambers of Commerce, labor unions, who did not understand insurance but were out there giving insurance advice with no ability to control once it got out of the box,” Keiser said. “They have no regulatory authority,” Keiser said.

“So we felt strongly that we should maintain the integrity of the 21,000 insurance agents and brokers in our state,” Keiser said. “It wasn’t fence-building. We believe that providing advice on health insurance is extremely important.”

Keiser said North Dakota provided a commission structure within the federal exchange it will use so that agents can be compensated, but acknowledged that that doesn’t mean that citizens can’t still independently use the exchange.”

Kofman said one aspect of her job is helping people determine whether they are eligible for Medicaid and to figure out whether they are eligible for premium tax credits. “We are focused on the brokers to help people figure out what is the best health plan option that is best for that family or that small business,” she said.

She called it a “two-pronged approach.”

Kofman said that, “We realize health insurance is very complicated, it not like buying a car, you can’t kick it or test-drive it for a short period, and know ahead of time if it is going to work for you. So we are relying on the expertise of professionals.”

She said their help “is going to be critical to help consumers who may have never been insured before, or who may not have ever used a health insurance agent when they were insured to make the best possible health insurance decisions.”

Kofman said that, “Moreover, we view our brokers as experts available to help people after they enroll. There are always issues, for example, sometimes you get your medical cards late, they don’t always arrive on time, or a claim is denied, so we view our brokers as expert people who help consumers even after enrollment.”

At the same meeting, Sen. Neil Breslin, D-N.Y., said that in New York, “We are trying to make sure that navigators are objective, don’t have an interest, are not likely to be questioned on the advice they give.”

So far, he said, “that seems to be working well.”

In general, he said New York is seeking to make that navigators are giving people advice as to what is the best health-care plan, and that the is given by people who can be objective when they give that advice, there are no conflicts of interest and they act to ensure that the right decision is made.”