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Life Health > Health Insurance > Health Insurance

Who do PPACA exchange agents help?

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Consultants in Colorado say insurance agents and brokers may have helped improve the public exchange enrollment experience for members of the general public as well as for their own customers.

The consultants from the Spark Policy Institute talk about the role of licensed producers in a pair of reports included in a document packet for an upcoming Connect for Health Colorado board meeting. The state-based exchange tried to reach out to producers.

About 25 percent of the qualified health plan (QHP) buyers who filled out customer satisfaction surveys received help from producers, and producers were the second most common source of QHP assistance for the survey participants. About 70 percent said they got help from the exchange call center. Just 17 percent listed the exchange website as a source of help.

Low-income QHP buyers can get cost-sharing reduction subsidies. The subsidies help cut the users’ out-of-pocket health care bills. In a marketplace analysis, the Spark consultants show that brokers’ clients were slightly less likely to qualify for the cost-sharing reduction subsidies than other QHP buyers.

Thirty-eight percent of the brokers’ clients earned more than 250 percent of the federal poverty level and were unable to get the subsidies, compared with 36 percent of all enrollees, and 61 percent of the brokers’ clients had health coverage before they bought exchange QHPs. But 15 percent of the brokers’ clients were poor enough to qualify for the maximum subsidy level.

Colorado does not let nonprofit health coverage guides recommend specific QHPs. In some cases, the Spark consultants said, the health care guides overcame that restriction by having consumers talk to agents and brokers.

“In-depth interviews revealed that, in some instances, having a broker provide advice to a client was a benefit, even if the customer returned to the health coverage guide to finalize enrollment,” the consultants say.


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