A superhero with a HealthCare.gov logo on his chest, based on a Shutterstock image with a CMS logo (Image: CMS)

The Trump administration may have mixed feelings about the HealthCare.gov health insurance supermarket system — but it has named HealthCare.gov’s first super broker.

The agency in charge of HealthCare.gov announced Tuesday that it will let the web broker, HealthSherpa, use a new Enhanced Direct Enrollment pathway.

Translation

If the new pathway works properly, HealthSherpa will get what amounts to a super power: It will be able to whisk customers into Affordable Care Act exchange plans, with ACA advance premium tax credit subsidies, on its own website, without handing the customers off to the HealthCare.gov website.

(Related: HealthSherpa CEO Sees Individual Health Recovery)

HealthSherpa computers will be able to share customer eligibility information with government computers behind the scenes, through an application programming interface, or API, without bothering the customers.

The Old Process

In the past, HealthCare.gov web brokers that wanted to sell ACA exchange plan coverage with federal subsidies have had to hand customers off to HealthCare.gov.

A customer who went over to the HealthCare.gov site then had to return to the web broker’s site to complete the process of signing up for coverage on the web broker’s website.

The hand-off process itself scared off some customers and hurt conversion rates.

In some cases, hand-off-related glitches cut customers off.

The hand-off maze was one of the obstacles that have limited agents’ and brokers’ ability to sell exchange plan coverage online.

Agents and brokers have been asking for streamlined tools they could use to sell exchange plan coverage since former President Barack Obama signed the legislation creating the ACA framework, in 2010.

Officials at the Centers for Medicare and Medicaid Services announced in May 2017, after Donald Trump became president, that CMS would let firms that met CMS security standards enroll consumers directly in exchange plans, with ACA premium tax credit subsidies.

(Related: Web Brokers Win a Major HealthCare.gov War)

When using the website of one of the new Enhanced Direct Enrollment brokers, a consumer can use the broker’s site to download ACA exchange notices, get coverage status updates, and upload documents for data matching and special enrollment period verification, as well as to sign up for coverage, officials say.

HealthSherpa

HealthSherpa is a San Francisco-based company officially known as Geozoning Inc.

The company operates both as a retail web broker and as an enrollment support partner for other agents and brokers. That means the new, streamlined HealthCare.gov access approval could help producers who use HealthSherpa support services as well as HealthSherpa itself.

 

What HealthCare.gov Tells Consumers

The HealthCare.gov page for consumers who want to use web brokers now distinguishes Enhanced Direct Enrollment pathway brokers from other “certified enrollment partners” by identifying the Enhanced Direct Enrollment pathway brokers as “full service partners.”

Here’s what HealthCare.gov says about “full service partners” and other web brokers:


How to use certified partner websites to enroll

How you’ll use a certified partner website to enroll depends on the services they offer:

  • Some partners start you on their websites and connect you to Healthcare.gov part of the time, where you’ll complete your Marketplace application. But you’ll shop for plans and enroll on their website.
  • Others are full service partners. This means they offer more features that allow you to apply and enroll, and manage your coverage throughout the year, all on their website.

Resources

A fact sheet about the Enhanced Direct Enrollment system is available here.

The HealthCare.gov web page for consumers who want to use certified enrollment partner websites is available here.

The current list of all CMS-approved web broker entities is available here.

— Read BigWave to Continue to Power HealthCare.gov Broker Finder Toolon ThinkAdvisor.

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