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PPACA exchanges start to line up distributors

By Allison Bell

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Some of the new health insurance exchanges are moving ahead with efforts to set up distribution teams.

Nevada’s exchange, the Silver State Health Insurance Exchange, says it has received about 20 applications from individuals and organizations that want to serve as navigators, enrollment assisters or certified application counselors and expects to present the final selection results May 9, at a board meeting.

The Colorado Health Benefit Exchange has received about 20 applications from organizations that hope to qualify for exchange assister grants. 

 The Maryland Health Benefit Exchange has awarded about $24 million in grants to government agencies and nonprofit groups that will oversee exchange assistance and enrollment in six regions. Officials there are expecting the “connector entities” to create about 300 jobs and employ 50 subcontractors that will support the efforts of exchange navigators and in-person assisters.

Meanwhile, in Arkansas, the Arkansas News is reporting that Cynthia Crone, the official overseeing the creation of a federally facilitated exchange in that state, is preparing to spend about $17 million on vendors that will hire exchange “guides,” or navigators employed by governmental and nongovernmental entities that will work for the state insurance department.

Crone said she expects the vendors to hire 600 to 800 guides and is hoping that 1,000 agents and brokers will want to advise consumers on exchange plans in exchange for commission payments from the insurers. Crone said the guides could earn about $12 per hour.

The federal exchange managers are hoping to have a producer registration Web portal running in July and to start getting agents and brokers certified to sell federal exchange coverage in August. The federal exchange managers also have posted an application that would-be federal exchange navigators can use to seek a share of $54 million in navigator grant funding. The applications are due June 7.

The state and federal exchange builders are implementing provisions in the federal Patient Protection and Affordable Care Act of 2010 (PPACA) that call for the U.S. Department of Health and Human Services (HHS) to work with the states to set up exchanges, or Web-based health insurance supermarkets, in all 50 states and the District of Columbia by Oct. 1.

PPACA requires exchanges to offer navigators, or ombudsmen, who are independent from health insurers to help consumers understand how to use the exchanges. Since PPACA was signed into law, regulators have created other categories of helpers, such as in-person assisters, guides and application counselors.

Although some exchange builders already have completed accepting at least one round of applications for some kind of consumer helper program, other exchange builders are just getting started.

New Mexico, for example, has said that it wants to set up its own exchange, rather than relying on the federal government to provide exchange services for its residents, but that state’s exchange board just held its first meeting Monday.

Some states have been vague about just how much money consumer helpers will get.

Nevada exchange officials say they will be awarding about $2.3 million in grants to navigators and enrollers for state fiscal year 2014.

The state has a total of 588,000 uninsured people, and it is estimating that 118,000 could sign up for coverage during the initial open-enrollment period, in 2014.

If 60,000 uninsured people used navigators or enrollers to enroll, rather than the exchange website, or agents and brokers paid by the insurers, the navigators and enrollers could get an average of about $35 per uninsured individual enrolled through a live human.  

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