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Should PPACA exchanges warm up to brokers?

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Urban Institute analysts have summarized reasons why public exchanges might want to use — or avoid using — agents and brokers to increase exchange plan sales.

The analysts — Sabrina Corlette, Linda Blumberg and Erik Wengle — write about the advantages and disadvantages of using licensed producers in a commentary backed by the Robert Wood Johnson Foundation.

The drafters of the Patient Protection and Affordable Care Act of 2010 (PPACA) put funding for “navigators,” or nonprofit exchange ombudsmen, in the section of PPACA that created the PPACA public exchange system. The U.S. Department of Health and Human Services (HHS) later came up with more money for other types of nonprofit exchange helper programs.

Now, the PPACA outreach money is running out. Using licensed producers to help with sales requires no use of public funds, the analysts say.

But “brokers do not have a legal responsibility to inform clients of the full array of plans available,” the analysts say.

Producers may not necessarily represent all of the insurers licensed to sell qualified health plans (QHPs) through a public exchange, and variations in how insurers pay producers for different types of sales could lead to gaps in the QHP information that brokers give to consumers, or to moves to steer sicker consumers toward some QHPs and away from others, the analysts say.

Another challenge is that producers may lack experience with working with the kinds of low-income consumers that the PPACA exchanges were created to serve, the analysts add.

The analysts note that the producers have complaints of their own about the exchange programs. They list steps public exchange managers could take to improve their relationships with producers:

  • Improve Web-based producer directories.

  • Improve training that focuses on enrollment procedures and specific complicated scenarios, such as efforts to help immigrants and non-traditional families.

  • Make it easier for producers who’ve helped an applicant to stay attached to an applicant’s case and eventually get paid.

  • Survey producers to see what they want.

  • Hire producers to act as exchange-producer liaisons.

See also: PPACA exchange group plan gotchas