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HealthCare.gov creates maze for agents' clients

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Managers of HealthCare.gov continue to put barriers in front of consumers who want help from agents or brokers with buying, and using, public exchange plan coverage.

The U.S. Department of Health and Human Services set up HealthCare.gov to provide Affordable Care Act exchange enrollment and account administration services in states that are unwilling or unable to provide those services themselves.

Managers of HealthCare.gov, who prefer to call it the Marketplace, describe the complicated process consumers have to go through to use producer help in a new agent webinar slidedeck.

Consumers may be using agents and brokers because they have no time or energy to call the HealthCare.gov call center for help. But, just to authorize producers to handle HealthCare.gov tasks on their behalf, consumers have to call the HealthCare.gov call center at the beginning of the open enrollment period.

Once a consumer gets through the call center queue and reaches a live human representative, the consumer has to give the rep the producer’s full name and national producer number. A consumer then has to brave the call center queue every 365 days to reauthorize the producer’s authorization.

“For quickest service,” HealthCare.gov managers say, “we suggest calling during off-peak hours, and avoiding enrollment deadline days whenever possible.”

Related: 5 things Healthcare.gov is telling agents and brokers now

Open enrollment for 2017 starts Tuesday and is set to run until Jan. 31. In many counties, HealthCare.gov is on track to offer only a limited menu of plans.

In some markets, issuers appear to be offering plans mainly as a courtesy to state insurance regulators and to the Centers for Medicare & Medicaid Services, the HHS agency that runs HealthCare.gov. The reluctant issuers are offering little or no compensation to the producers who bring them individual exchange business.

In the new slidedeck, HealthCare.gov managers give the producers who are still serving exchange users detailed instructions about when it is and is not “appropriate for agents and brokers to seek Marketplace call center assistance.”

It is not appropriate for “consumer (or you with the consumer’s assistance)” to seek call center help if the consumer “has not attempted to complete all required data fields in the online application,” managers say.

Managers emphasize that call center reps will not give producers any information about clients’ applications if the clients are not part of three-way calls or have not previously authorized the agents to work on their behalf.

In a separate, semiprivate document, posted Friday, HealthCare.gov managers repeat their earlier position that they have nothing to do with exchange plan issuers’ decisions to pay, or not pay, producers to sell exchange plans.

The only HealthCare.gov requirement is that issuers pay the same commissions for the sale of the same product both inside and outside the exchange system, exchange managers say. 

Related:

5 things Healthcare.gov is telling agents and brokers now

4 tales from the PPACA agent misery files

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