Breaking News - Role of Agents, Brokers, and Web - Brokers in Health Insurance Marketplaces

[Sam]

HHS has just released some guidance on the role of agents and brokers in the federally run exchanges

http://cciio.cms.gov/resources/regulations/Files/agent-broker-5-1-2013.pdf

 

[timsip]

HHS has just released some guidance on the role of agents and brokers in the federally run exchanges

http://cciio.cms.gov/resources/regulations/Files/agent-broker-5-1-2013.pdf

Web-brokers must display all QHPs available through a Marketplace, irrespective of compensation or appointment arrangements.

Does anyone have handy what ACA defines 'Web-Brokers' as? I understand Ehealth would be considered a web-broker, but if I have a quoting engine on my website, does that make me a web-broker simply because you can get a quote on your own through my website?

 

[MORGRUTH]

I'm confused. Broker/agents and navigators are two different things, but if a broker 'navigates', then they can't get paid, but a navigator can still give all of the options to the client anyway? What incentive do they have to even go to a broker/agent in the first place, then? If they must purchase through a broker in the marketplace then I can see this, but then what is the need for a navigator except to funnel people to their preferred brokers/agencies? Large companies/corporations will apply for the navigation grants and then have other arms of their businesses with insurance interests get the guaranteed business from those clients. Ugh!

Also, if a agent/broker has to show the client all of their options, what happens to the broker whose client chooses a policy not underwritten by a company they are contracted with? Would an agent/broker have to get contracted with all of the companies participating in the marketplace?

"Federally-facilitated Marketplaces, including State Partnership Marketplaces,will not establish a commission schedule or pay commissions directly to agents or brokers. As is the case in the market today, we expect that the amount and terms of any commission would be negotiated by the issuer and the agent or broker.... As described in Section I of this document, Federally-facilitated Marketplaces and State Partnership Marketplaces will transmit agent and broker identifying information to issuers to facilitate payment.4...
4Agents and brokers who are acting as Navigators may not receive compensation from issuers."
​

The line between navigator and agent/broker seems to be quite fine at this point, mostly determining who pays you and I'm sure there will be more changes coming about this in the future.

 

[deathbyaca14]

HHS has just released some guidance on the role of agents and brokers in the federally run exchanges

Just read this doc, my brain hurts.

 

[Yagents]

My question is: Can an individual independent agent be a web broker?
In the first part it says yes, business can be done off the agent's website. But towards the end, it talks about all of security requirements to become a web broker

 

[timsip]

My question is: Can an individual independent agent be a web broker?
In the first part it says yes, business can be done off the agent's website. But towards the end, it talks about all of security requirements to become a web broker

That is where I am coming with my question. Does HHS consider you and I web brokers because our websites offer the general public an ability to get a quote without talking directly to us, or does the majority of the business have to be based on the web like Ehealth? This could mean major changes to strategy for some. If we are lumped in with the Ehealths, then we have to have all carriers that participate in the exchange on our sites regardless of our contracts as. Quotes generated also can not be listed with any bias such as having our contracted carriers listed first.

 

[Dave020]

To my way of thinking, web brokers and agents using the web will fall under two different areas.

The web based entity/broker is one who provides access and quoting via a proprietary web model like ehealth. Concern is that any entity using it's own quoting and enrollment software system may lack in security or may use algorithms to generate to certain carriers over others.

The agent (like us) will be using a 3rd party vendor quoting and enrollment system either from a quoting service like Quotit or Norvax which, in turn, becomes the web based entity, or carrier direct quoting and enrollment which turns the carrier into the web entity. In either case the agent relies on the features and protections of the 3rd party software to meet requirements.

 

[Ann H]

To my way of thinking, web brokers and agents using the web will fall under two different areas.

The web based entity/broker is one who provides access and quoting via a proprietary web model like ehealth. Concern is that any entity using it's own quoting and enrollment software system may lack in security or may use algorithms to generate to certain carriers over others.

The agent (like us) will be using a 3rd party vendor quoting and enrollment system either from a quoting service like Quotit or Norvax which, in turn, becomes the web based entity, or carrier direct quoting and enrollment which turns the carrier into the web entity. In either case the agent relies on the features and protections of the 3rd party software to meet requirements.

Great summary, Dave020. My understanding is the same as your description above.

 

[timsip]

To my way of thinking, web brokers and agents using the web will fall under two different areas.

The web based entity/broker is one who provides access and quoting via a proprietary web model like ehealth. Concern is that any entity using it's own quoting and enrollment software system may lack in security or may use algorithms to generate to certain carriers over others.

The agent (like us) will be using a 3rd party vendor quoting and enrollment system either from a quoting service like Quotit or Norvax which, in turn, becomes the web based entity, or carrier direct quoting and enrollment which turns the carrier into the web entity. In either case the agent relies on the features and protections of the 3rd party software to meet requirements.

I hope you are right and your thoughts make the most sense....but we are talking about HHS....

 

[deadhead]

Hurt my head by page 6. Must take nap