Managers of the HealthCare.gov system really want to know when consumers come in with printouts from the websites of affiliated “Web broker entities.”
Officials at the Center for Consumer Information and Insurance Oversight, the arm of the Centers for Medicare & Medicaid Services that runs HealthCare.gov, have included new Web broker entity printout requirements in a HealthCare.gov enrollment manual update.
HealthCare.gov provides Affordable Care Act enrollment and administration services in states that are unwilling or unable to handle exchange enrollment themselves.
The enrollment manual covers topics such as how HealthCare.gov gets consumers into medical plans and dental plans, how consumers can drop their coverage, and what the consumers, exchange customer service representatives and others do when consumers have problems.
Other enrollment manual sections talk about the rules for “Web broker entities” — companies licensed to connect their own Web-based enrollment systems directly with HealthCare.gov systems. Many of those Web broker entities make their pipes into HealthCare.gov available to insurance agents, retail brokers and private exchange systems.
When the insurance oversight office was setting exchange program parameters for 2017, it implied in discussions of disciplinary rules for Web broker entities, agents and retail brokers that it may have had problems with some exchange plan sellers.
A comparison of the new update with a version of the manual released in October 2015 shows that the insurance oversight office wants to improve the ability of HealthCare.gov customer service reps and others to figure out whether a consumer got exchange or exchange plan information from the website of a particular Web broker entity.
The new requirements
If a Web broker entity is letting agents or brokers use its website, the entity must ensure that its name and National Producer Number “appear prominently” on every page of the website, even if the agent or broker can customize its portion of the entity’s website.
The Web broker entity’s name and producer number also must appear prominently on the cover or first page of all written materials containing exchange plan information that can be directly printed from the entity’s website, according to the manual update.
That includes all files containing exchange plan information “that can be directly downloaded from or viewed directly on the website,” according to the manual. “Documents linked to from the site that a separate entity maintains are not included in this definition.”
The insurance oversight office has also added a new section on Form 1095-A, the former an ACA exchange is supposed to use to tell exchange users how much exchange coverage they had it, when they had it, how much the premiums cost, and how much ACA premium tax credit subsidy money they got.
The new 1095-A section includes suggestions about how insurers should answer questions about the notices, how HealthCare.gov and others should go about correcting 1095-A errors, and how HealthCare.gov and others should handle situations in which long-running appeals of HealthCare.gov decisions might lead to retroactive changes to the 1095-A notices sent out in earlier years.
Have you followed us on Facebook?