Feds let agents use Web broker systems

In states with CMS-run exchanges, Web brokers can open up their sites to outside agents and brokers, CMS says.

“The Web-broker must cooperate with HHS in taking compliance actions against a noncompliant agent or broker, including facilitating a shut-down of any connection to HHS systems while privacy and security incidents and breaches are investigated,” CMS said.

In a discussion about states that want to set up SHOP-only exchange programs, CMS acknowledged that some commenters argued that individual-SHOP programs are better.

CMS will compromise by limiting use of the SHOP-only exchange option only to states that are unable to set up an individual-SHOP program, officials said.

CMS already has given Utah and New Mexico permission to set up SHOP-only exchanges. Both of those states had CMS permission to set up both an individual exchange and a SHOP exchange.

Mississippi, a state that failed to get permission to set up an individual-SHOP exchange, now is trying to set up a SHOP-only program.

Elsewhere in the final regulations, CMS:

• Said it will come up with a list of payment methods an exchange plan issuer must accept later, but that any requirements will apply to the first customer payment for coverage as well as later payments;
• Refused to require SHOP exchanges to accept applications on paper or over the telephone. Small businesses can still apply for coverage through in-person meetings with agents, brokers or navigators;
• Refused to accept recommendations that it let “navigators,” or independent exchange program ombudsmen, act as “SHOP application filers.”
• Noted that the effective date of the regulations is Oct. 1, but argued that any market participants should be ready to adopt the regulations, because the information has already been available in other public documents.

See also:

• Feds still working on multistate plans
• IRS drafts large-group minimum value rules
• Feds move to close congressional benefits gap