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5 PPACA exchange broker insights from Kaiser’s new survey

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Tens of thousands of health insurance brokers stuck with the public health insurance exchange system during the second open enrollment period.

Some said they and their individual and family health insurance clients continued to have problems with the Patient Protection and Affordable Care Act (PPACA) exchange system during the second annual open enrollment period, but many said the exchange programs handled consumer questions somewhat or much better the second time around, according to analysts at the Henry J. Kaiser Family Foundation.

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Analysts at the foundation included survey responses from 662 exchange brokers, along with 713 assisters who work for nonprofit navigator programs, certified application counselor programs, and other nonprofit assister programs, in a report on a recent survey of public exchange assisters.

The analysts note that they had to use different strategies for locating exchange brokers in some states than in others, and that the brokers approached were only about half as likely to participate in the survey.

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But the survey report gives some numbers to support what producers have been telling one another informally about what PPACA World is now like.

For a look at some of those numbers, read on.

Client meeting

1. The brokers had an average of about 140 non-group exchange and off-exchange health clients.

The Centers for Medicare & Medicaid Services (CMS), an arm of the U.S.Department of Health and Human Services (HHS), says it had 77,600 registered exchange agents and brokers for the second open enrollment period, or 46 percent more than it had at the end of the first open enrollment period.

Managers of state-based exchanges have registered thousands of producers of their own. Covered California alone had about 13,000 agents. 

Some states have posted information about the number of exchange plan enrollees brokers helped, but HHS has not.

The Kaiser team tackled this question in several different ways. They found that the exchange brokers gave different answers when asked about individual health volume in different ways, but the volume may have been similar during the first open enrollment period, which lasted from Oct. 1. 2013, through the spring of 2014, and the second, which ran from Nov. 15, 2014, through Feb. 15, 2015.

But the analysts found that a typical exchange broker served fewer than 50 non-group individuals in the exchange market during the second open enrollment period, and that they served fewer than 50 non-group enrollees in the off-exchange market.

Exchange sales accounted for about two-thirds of the exchange brokers’ non-group health sales.

For typical brokers and typical non-broker assisters, handling a non-group exchange application took an average of about one to two hours, according to the survey data.

Back in 2013, CMS estimated applying for an exchange plan would take an average of about 10 minutes for consumers who could handle the job completely online, and about 50 minutes for a consumer working with a navigator or other in-person assister.

See also: How long does it take to buy an exchange plan?


2. Repeat business made up a big share of the brokers’ 2015 non-group health business.

About 47 percent of the brokers said all, nearly all or most of the individual health clients they helped during the open enrollment period this year were returning clients, compared with 33 percent of the other assisters.

Measuring tape

3. Brokers had a hard time matching capacity with non-group business volume.

Only 22 percent said they got capacity just right, compared with 35 percent of the other assisters.

Fifty percent said they had too much, compared with 46 percent of the other assisters.

But 28 percent of the brokers said they had to turn or a great deal of business away, compared with just 19 percent of the other assisters.


4. Brokers’ health clients had Internet service, and good identification papers.

Only 10 percent of the brokers’ clients lacked Internet service at home this year, and just 10 percent had trouble verifying their identity or citizenship status.

The other assisters reported 35 percent of their clients lacked home Internet service, and 25 percent had some kind of identity or citizenship verification problem.

Confused eyes

5. Brokers’ plugged-in health clients were just as confused as the other assisters’ clients.

Brokers themselves said the exchange program itself seemed to be somewhat more effective this year at handling tasks such as answering consumer questions about plan choices.

But the brokers said about 84 percent of their non-group health clients had limited understanding of PPACA requirements and benefits, compared with just 77 percent of the other assisters’ clients.

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