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Life Health > Health Insurance > Health Insurance

On the Third Hand: Exchange jobs, part 1

By Allison Bell

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Some readers are about as happy with the idea of having anything to do with the Patient Protection and Affordable Care Act (PPACA) health insurance exchanges as they are about the idea of partying with spiders.

Others have reluctantly or enthusiastically embraced the idea of trying to help small employers, individual consumers (or both) sign up for coverage through the PPACA exchanges, either to expand their commercial business or to try to do their part to ease the plight of the uninsured.

Readers are sending me emails with questions along the lines of, “What are navigators?,” “How do I get trained to be a navigator?” and “Where on earth are the want ads for the navigators if organizations supposedly need so many of them?”

Here are my thoughts.

I’m morally opposed to PPACA. This whole article disgusts me. What should I do?

Maybe you could find some way to work with colleagues to get a carrier to provide products aimed specifically at people who find PPACA to be morally objectionable and want to minimize involvement with anything PPACA-related as much as the law will allow.

If I’m a licensed insurance agent or broker, do a I necessarily have to be a navigator to help people get exchange coverage?

In most states, no.

In most states, including the states with the “federally facilitated exchanges” to be run by the U.S. Department of Health and Human Services (HHS), agents and brokers can sell exchange coverage and non-exchange coverage, and get commissions or other compensation from the insurers through whatever arrangements the insurers and producers want to negotiate.

So, if you’re already an agent or broker, you might find it easier to serve consumers in your capacity as a producer than to try to get a job as a navigator or some other kind of exchange helper.

If I’m a licensed agent or broker, how, in that case, do I work with a PPACA exchange and the carriers selling through the exchange?

All exchanges will require licensed producers to go through some kind of online training and licensing process with the exchange, and, in most cases, to get appointments from the insurers selling coverage through the exchange.

Some exchanges may be doing better than others at posting the information producers need to figure out how to do business with the exchanges.

Maryland, for example, has already held two producer application process meetings.

Other exchanges may have published virtually nothing.

The best way to find out about exchange application activities might be to bookmark every state exchange website and producer trade group website that you can find, and be religious about attending producer group meetings and reading their newsletters and message boards.

Should I consider trying to be a “broker for exchange users?”

If you simply want to be a health insurance broker who provides the fullest possible service, you have no moral or ethical objections to participating, and your state makes it easy for you to participate, why not?

If you need to make money working with the exchanges, consider the following questions:

  • Do you know a lot of uninsured people who could qualify for exchange coverage? If, say, you know a lot of broke artists who have simply never found the time to apply for coverage, that’s probably a plus. If you have many uninsured friends, but they’re all undocumented aliens, that wouldn’t help you because undocumented aliens cannot apply for exchange coverage.
  • Do you have, or could you create, referral relationships with, for example, tax preparers in low-income neighborhoods, or other types of people who might have many uninsured people in their waiting rooms and, in many cases, have access to those people’s tax returns or other financial records?
  • Do you already volunteer with nonprofit groups that could steer large numbers of uninsured people to your office, or to your card table?
  • Are you already someone who’s involved enough in legislative and regulatory affairs in your area that you have a decent idea about how the exchanges are supposed to work in your community?

To be continued tomorrow.

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