Insurers and agents are getting ready for the second annual Patient Protection and Affordable Care Act (PPACA) nap period.
Insurers, exchange managers and regulators created the system to keep the new PPACA restrictions on medical underwriting from letting consumers wait until they get sick to pay for coverage.
Many public health insurance exchanges, and many health insurers, are still holding the digital door open for consumers who missed 2016 individual major medical coverage open enrollment period deadline. In some states, consumers have to show that they had an application in the exchange enrollment system by midnight Sunday to get more enrollment completion time. In other states, consumers can get extensions by making a pinkie promise that they had technical problems, or by simply deciding to apply for coverage.
GoHealth, a Web broker entity, is one of the brokers trying to get out the word about enrollment extension periods. ”If you tried to enroll but are still uninsured, it’s not too late to get coverage,” Brandon Cruz, GoHealth’s president, said in a statement.
Once the extension enrollment periods end, people who want to buy major medical coverage for 2015 will have to show that they qualify for a special enrollment period (SEP).
The U.S. Department of Health and Human Services (HHS) could still create a broad SEP for consumers who are just starting to learn about the PPACA individual mandate penalty system, but even a tax SEP would probably end before people turn their air conditioners on.
What are health agents and brokers doing to fight the silence of the phones?
To learn about three major strategies, read on.
1. Work hard at helping consumers qualify for SEPs.
Even before PPACA came along, typical major medical buyers were people who needed coverage because they had lost access to other coverage due to a move, the loss of a job, or aging out of access to parents’ job.
Last year, some major medical sellers said SEP sales amounted to just 10 percent to 25 percent of open enrollment period sales.
Jeff Smedsrud, the chief executive officer of HealthCare.com, a Web broker, has argued that the percentage would be closer to 40 percent if consumers understood the SEP system a little better and would simply apply for SEPs.
One drawback is that producers who try to help consumers qualify for SEPs may have to spend more time getting to understand the consumers’ lives, and the SEP process, than they would like.
Another drawback is that selling SEP coverage (like selling other PPACA-era major medical coverage) may pay less compensation than producers would like, if producers can eventually collect what they are owed.
The advantage is that producers will get a chance to demonstrate their superior customer service and advanced PPACA knowledge for consumers who (if they have moved recently) may need referrals for everything from new dental insurance to new hair stylists.