Executives at Softheon Inc. are hoping HealthCare.gov’s new, flexible approach to web brokers will make the individual major medical market work smoothly this fall.
The company is doing everything it can to get a direct enrollment proxy connection with HealthCare.gov running up Nov. 1, the scheduled start date for the Affordable Care Act individual major medical open enrollment period for 2018.
Mike Baker, director of broker solutions at Softheon, a Stony Brook, New York-based insurance enrollment and relationship management systems company, talked about the company’s direct enrollment proxy effort Monday, in a telephone interview.
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The Centers for Medicare and Medicaid Services (CMS), the agency in charge of HealthCare.gov, intends to move the end date of the open enrollment period to Dec. 15, from Jan. 31 in the past few years. Given how short the open enrollment period will be, “brokers are going to have to make sure they’re super efficient,” Baker said. “The window is going to be so tight.”
Access to a smoothly running, web-based enrollment system could make that level of efficiency possible, Baker said.
“Web broker entities” (WBEs), or web-based organizations that meet CMS business and data security standards, have been able to pass customers on to the HealthCare.gov enrollment system through an indirect process. In May, officials in President Donald Trump’s CMS said they would take off the web broker entities’ digital mittens and let WBEs that agree to go through auditing programs connect directly to HealthCare.gov.
CMS began holding Direct Enrollment Proxy technical support sessions for the WBEs on Aug. 3. The agency has also been releasing proxy program technical specifications.
Softheon, the parent of Welltheos, a private exchange platform that also serves as a HealthCare.gov web broker entity, has sent executives directly to Washington, to talk to members of the staff of the Center for Consumer Information and Insurance Oversight, the CMS division that actually runs HealthCare.gov.
The CCIIO representatives seem to be eager to work with private-sector organizations, Baker said
“They’ve got an appreciation of the role of the broker community,” Baker said.
Softheon needs direct enrollment program specifications “as soon as possible” to get systems ready for Nov. 1, but, if CCIIO sticks to its current specification release schedule, meeting the Nov. 1 deadline should be doable, Baker said.
Baker also expressed cautious optimism about the 2018 issuer population.