HealthCare.gov managers have announced the names of six new super web brokers, and Cigna Corp. is one of the companies that has achieved that status.
Cigna and the other five companies on the new list can serve as “enhanced direct enrollment ” (EDE) partners for HealthCare.gov.
Earning the EDE designation means that the companies have met the security requirements and other requirements imposed on companies that want to connect their online health insurance sales systems directly to the federal Affordable Care Act exchange plan application verification system.
Cigna and the five other new EDE partners can help consumers sign up for Affordable Care Act exchange plan coverage, with ACA premium tax credit subsidies, directly through their own websites, without handing the consumers off to HealthCare.gov.
The EDE partner companies can do that by embedding an “application programming interface,” or connection to the federal ACA exchange application verification system, on their websites.
HealthCare.gov managers named the first EDE partner, HealthSherpa, in December. HealthCare.gov now has a total of seven EDE partners, and it appears to be processing more EDE partner applications.
GetInsured, a web broker, says on its website that it’s applying to be an EDE partner.
In the past, HealthCare.gov web brokers had to pass health insurance shoppers who qualified for ACA premium tax credit subsidies over to HealthCare.gov. Web brokers rarely managed to keep their producer numbers attached to those shoppers’ applications.
Web brokers could earn commissions from selling ACA exchange plans to full-pay customers, but they had a hard time getting paid to sell plans to consumers who qualified for subsidies.
The new EDE system could give web brokers a new incentive to reach out to low-income and moderate-income health insurance shoppers, by increasing the odds that web brokers will get paid to get those health insurance shoppers covered.
What Is HealthCare.gov?
The drafters of the Affordable Care Act wanted to create web-based supermarkets for health insurance, to help people shop for private health insurance plans on an apples-to-apples basis, and to use government subsidies to pay for the coverage.
The U.S. Department of Health and Human Services (HHS) set up HealthCare.gov to provide ACA exchange programs in states that were unwilling or unable to provide all exchange services.
For 2019, HealthCare.gov is providing exchange account setup and plan enrollment services in 39 states.
The Six New EDE Partners
In addition to Cigna, the other new partners are Aspirus Arise Health Plan of Wisconsin, Blue Cross Blue Shield of North Carolina, Dean Health Plan, MercyCare Health Plans, Molina Healthcare, Security Health Plan of Wisconsin, and Stride Health.
A copy of the new EDE partners list is available here.
— Read The 2020 Draft Health Market Rules Are Here Now, on ThinkAdvisor.