The government has set up the Patient Protection and Affordable Care Act (PPACA) public health insurance exchange (HIX) system.
Private companies are setting up private health insurance exchange systems.
In many cases, the public HIX and private HIX worlds are converging. The PPACA exchanges usually use private exchange system vendors to build and run their exchange systems.
Now the private exchange companies are expanding efforts to connect with the public exchange system.
The managers of the eHealthInsurance.com, GoHealthInsurance.com and GetInsured.com retail health insurance sales sites are just three of the retail vendors that have been certified as “Web broker entities,” and the managers of the Quotit quotation and enrollment systems for brokers have also gotten certified.
Towers Watson, a big private exchange organizer, was talking about seeking Web broker entity status more than a year ago, and it actually signed a Web broker entity agreement in August 2013. It and the retail Web brokers have started the Association of Web-based Health Insurance Brokers (AWHIB).
An exchange system developer, hCentive, announced that it had achieved Web broker entity status in October.
Robin Babu, the director of exchanges at another company, PlanSource, said in an interview that his company — which provides the systems powering Utah’s highly regarded, pioneering Avenue H Small Business Health Options Program (SHOP) exchange — is evaluating the Web broker entity certification process.
See also: His company scares public exchange managers.
PlanSource wants the private exchanges it runs for large and midsize employers to be able to automate the process of helping workers who are not eligible for an employer-sponsored major medical plan to apply for public exchange plan coverage.
Babu said the managers of his company have been involved with health insurance and electronic benefits sales systems for about 25 years. Its OneMarket Exchange program and PlanSource Advantage administration platform program have relationships with companies such as Aetna, Anthem, Assurant, Guardian, Lincoln and the Standard.
The managers of the public exchange went through well-publicized struggles to get up and running.
“We have been through that before,” Babu said.
What could convergence of the public exchange and private exchange worlds mean for benefits agents and brokers? For some ideas, read on.