The Centers for Medicare & Medicaid Services (CMS) is continuing to proceed on the assumption that the Patient Protection and Affordable Care Act (PPACA) and the PPACA public exchanges will return for the 2016 open enrollment period.
CMS officials recently presented a webinar aimed at companies that want to serve as Web brokers for the exchanges that use the HealthCare.gov system for enrollment — and it included a discussion of how a Web broker can share its exchange system pipelineline with other agents and brokers.
CMS, a division of the U.S. Department of Health and Human Services (HHS), set up HealthCare.gov for the states in HHS administers the exchange program.
Companies must meet many regulatory requirements to act as Web brokers for the HHS-run exchanges. A Web broker must warn shoppers that its site is separate from HealthCare.gov, provide as much information as possible about all available “qualified health plans” (QHPs), and warn consumers when it’s providing fewer details than HealthCare.gov would.
If Web brokers want to give consumers premium tax credit estimates, they must use a HealthCare.gov tax credit tool to verify the estimates.
Web brokers’ sites must be accessible for people who have only a limited ability to use English, and for people who have disabilities.
But acting as a Web broker, may give a broker a chance to capture some of the premium revenue flowing into the PPACA exchange system, and Web brokers may be able to charge users’ service fees.
For more about what CMS officials said at the Web broker webinar, read on.
1. Charging QHP buyers a separate service fee is complicated, but it’s possible.
The HHS officials who set up the PPACA program have always expressed an interest in working with traditional health insurance agents and brokers, combined with complicated views on whether and how producers who sell QHPs ought to get paid.
At the webinar, officials said Web brokers should not offer financial incentives, such as rebates or giveaways, to QHP buyers.