Managers of HealthCare.gov have confirmed that they are leaving agent and broker compensation concerns out of efforts to help exchange users facing potential coverage gaps.
HealthCare.gov has developed an “auto re-enrollment” process for users affected by issuer decisions to drop specific health plans. If a consumer’s plan goes away, and the consumer fails to choose a replacement plan, the exchange system will try to move the consumer, or move the consumer into a similar plan from the same issuer. HealthCare.gov calls that process “crosswalking.”
If an issuer has left the HealthCare.gov system in the consumer’s areas, the exchange will try to crosswalk the consumer into a similar plan from a different issuer.
Some agents and brokers who have struggled to help consumers sign up for HealthCare.gov coverage have been wondering whether the exchange will do anything to increase the odds that the replacement plans will pay commissions to the agents or brokers of record.
HealthCare.gov managers said Nov. 16, during a private conference call with HealthCare.gov agents and brokers, that they will not.
HealthCare.gov “does not take into consideration whether an issuer pays a commission when auto-renewing consumers,” exchange managers said, according to a written version of the answer posted on an exchange technical assistance website.
The HealthCare.gov managers talked about one rule that could help exchange plan agents: If HealthCare.gov moves an agent’s clients into new plans, and the issuers of the new plans do pay commissions, the issuers of the new plans can pay the commissions to the agent even if the agent’s exchange registration has expired.
Managers said, in a separate meeting slidedeck, that they have planned three major auto re-enrollment waves.
The re-enrollment waves
The first, which started Oct. 12, affected enrollees who were being moved into new plans from the same issuer.
The second, which started Nov. 21, affected enrollees who were being moved into new plans from a different issuer.
The third, which will take place this month, will affect enrollees with a variety of more complicated problems, such as problems with clearing up questions about tax credit subsidy applications.
When HealthCare.gov moves enrollees into new plans, HealthCare.gov will “generally” send the agents’ producer numbers to the issuers of the new plans, managers said.
“Enrollment information will not be visible in consumers’ accounts until Dec. 16,” managers said.